Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.2192
Peer-review started: June 11, 2021
First decision: July 27, 2021
Revised: July 29, 2021
Accepted: October 27, 2021
Article in press: October 27, 2021
Published online: December 27, 2021
Primary liver teratoma is an extremely rare tumor usually affecting children under the age of 3 years. Specific signs of teratoma on ultrasound, computed tomography (CT) or magnetic resonance imaging are lacking, which makes morphology the only diagnostic tool. Misdiagnosis of a mature teratoma may lead to excessive liver resection, whereas misdiagnosis of an immature teratoma may result in spread, causing a life-threatening condition. Consequently, a careful tumor examination is important, and the rarest types of tumors must be accounted for.
We describe a 52 years old female who presented with a solid mass in the left liver lobe. Contrast-enhanced CT and magnetic resonance imaging (MRI) revealed a round, heterogeneous lesion containing a number of fluid areas and areas of calcification in the middle, and the provisional diagnosis was cholangiocarcinoma. The patient underwent resection of liver segment I. Immunohistochemistry analysis of the resected lesion indicated thyroid follicular epithelium; however, the thyroid gland was intact. 10 years prior to presentation the patient underwent a surgery due to mature teratoma of the right ovary, nevertheless the tumor was benign and could not spread to the liver, in addition teratoma of the liver was also benign. This led to the final diagnosis of primary mature liver teratoma.
Primary hepatic teratoma, including heterotopia of the thyroid gland in the liver, is an extremely rare condition in adults that needs to be considered in the differential diagnosis of solid-cystic neoplasms in the liver and cholangiocarcinoma. This case adds to the limited literature on the patient presentation, clinical workup and management of liver teratomas.
Core Tip: Primary liver teratoma is an extremely rare tumor. This condition in adults needs to be considered in the differential diagnosis of solid-cystic neoplasms in the liver and cholangiocarcinoma. A careful tumor examination is important, and the rarest types of tumors must be accounted for to allow the diagnosis of heterotopia of the thyroid gland in the liver.