Rare cause of abdominal incidentaloma: Hepatoduodenal ligament teratoma

Table 1 Reported cases of hepatoduodenal ligament teratoma (adapted and expanded with permission from Ukiyama et al[8])

Patient	1	2	3	4	5	6	7	8	9	10
Year reported	1986	1989	1993	2004	2004	2005	2008	2008	2012	2013
Ref.	Frexes et al[2]	Akimov et al[3]	Kim et al[4]	Demircan et al[5]	Wang et al[6]	Sasaki et al[7]	Ukiyama et al[8]	Souftas et al[9]	Bagga et al[10]	Our case
Age	Neonate	6 yr	5 yr	4 mo	29 yr	38 yr	20 mo	26 yr	11 yr	27 yr
Sex	NA	NA	Male	Female	Female	Male	Male	Female	Female	Female
Origin	Extrahepatic bile duct	HL	CBD	Anomalous CBD	HL	HL	HL	HL	HL and fistulization with the CBD	HL
Signs and symptoms	Jaundice	Portal hypertension	Jaundice	Jaundice, abdominal distension	Portal hypertension	Abdominal mass	Abdominal mass	Abdominal pain	Jaundice, abdominal mass	Asymptomatic
Size	Small mass	NA	NA	Cystic mass 15 cm	Solid mass 7 cm × 6 cm × 6 cm	Cystic mass 8 cm	Solid mass 9 cm × 6 cm × 6 cm	Cystic mass 11 cm	Cystic mass 9 cm × 9 cm	5 cm × 4 cm
Pathology	Teratoma	NA	Endodermal sinus tumor associated with teratoma	Benign cystic teratoma	Benign teratoma	Benign cystic teratoma	Benign teratoma	Dermoid cyst	Benign cystic teratoma	Benign teratoma
Treatment	Local excision, recurrence, re-excision with chemotherapy	NA	Whipple’s operation with chemotherapy	Extirpation with CBD	Extirpation	Extirpation with CBD, Roux-en-Y, Choledocho-jejunostomy	Extirpation	Excision of the tumor	Extirpation leaving the outer cyst wall in situ (Lilly technique), hepatico-duodenostomy	Extirpation
Prognosis	Asymptomatic after 5 yr	Death	Death	Asymptomatic after 4 yr	Asymptomatic after 2 yr	NA	Asymptomatic after 5 yr	Asymptomatic after 33 mo	Asymptomatic after 2 yr	Asymptomatic after 6 mo

CBD: Common bile duct; HL: Hepatoduodenal ligament; NA: Not available.