Adrenal Teratoma: a Case Series and Review of the Literature

Adrenal teratomas are rare neoplasms and there is limited data on their surgical outcomes and long-term prognosis. We aimed to review our institutional experience and compare this to the existing literature on adrenal teratomas in adults and children. An institutional pathology database was searched for cases of adrenal teratoma (June 1956–July 2016). Clinical and imaging data were abstracted from the medical records and pathology slides were obtained for review. In addition, a PubMed search for “adrenal teratoma” from June 1952 to July 2016 was performed to identify reports of primary adrenal teratoma in patients of all ages. Of 7706 patients who underwent adrenalectomy during the study period at our institution, three patients were identified with adrenal teratoma. Patients were 24, 26, and 29 years of age, respectively. Two patients presented with abdominal pain and two of the three underwent a laparoscopic adrenalectomy. A pathologic examination revealed mature cystic teratomas that frequently displayed well-differentiated respiratory, digestive, and squamous epithelia. Eighteen case reports in the literature were identified in patients 17–61 years of age. Patients presented most frequently with abdominal or flank pain (63.6%). Median tumor diameter was 9.0 cm and tumors were frequently left-sided (81.8%), cystic (63.6%), and calcified (72.7%) on either radiologic or pathologic examination. Primary adrenal teratomas are rare neoplasms that typically present as large, left-sided nodules with cystic and calcified components seen radiographically. Although the data are limited, they are generally amenable to laparoscopic resection and have a very favorable prognosis.