Pediatric extragonadal mature teratoma of liver: a case report

Introduction: Teratomas are germ cell tumors composed of tissues derived from multiple embryonic layers and are most commonly found in the gonadal regions. Primary hepatic teratomas are extremely rare, particularly in infancy, and may pose significant diagnostic challenges due to their unusual location and resemblance to other pediatric liver masses. Case Presentation: A 4-month-old female presented with progressive abdominal distension since birth. Clinical examination revealed a large mass in the upper abdomen. Ultrasonography and contrast-enhanced computed tomography demonstrated a heterogeneous lesion with cystic, fatty, and calcified components, suggestive of a germ cell tumor. Intraoperatively, the mass was found attached to the quadrate lobe of the liver via a pedicle and excised without rupture. Histopathological examination revealed mature tissues from multiple germ layers, including glial tissue, cartilage, bone, and mucinous epithelium, consistent with a mature cystic teratoma. No immature or malignant elements were identified. The postoperative course was uneventful. Discussion: Hepatic teratomas are rare and typically present as complex cystic-solid abdominal masses, often mimicking other pediatric hepatic tumors. Radiological features, such as fat, calcification, and multicystic components, may suggest the diagnosis; however, definitive confirmation relies on histopathology. Complete surgical excision remains the cornerstone of management, and the surgical approach varies depending on tumor location and anatomical relationships. Conclusion: Primary hepatic mature teratoma should be considered in infants with complex liver masses. Complete excision is curative and associated with an excellent prognosis.