Successful management of a pancreatic mature cystic teratoma with Whipple procedure: A case report

Abstract

Background

Mature cystic teratomas of the pancreas, also known as dermoid cysts, are exceptionally rare tumors characterized by well-differentiated parenchymal tissues. Typically containing diverse tissues from all three germ layers, these teratomas are most commonly found in the ovaries and testes, with infrequent occurrences in the pancreas.

Case presentation

A 30-year-old male with type 2 diabetes mellitus presented with elevated liver enzymes and serum CEA levels. A CT scan detected an 8.8 × 7.2 cm retroperitoneal mass with calcifications. Due to the tumor's involvement with critical structures, a Whipple procedure was performed. Post-surgery, the tumor was confirmed to be a mature cystic teratoma, and the patient experienced a smooth recovery.

Discussion

Pancreatic teratomas are rare, typically affecting younger patients and predominantly occurring in the body or head of the pancreas. These tumors, often categorized into mature and immature types. Diagnosis relies on imaging techniques such as ultrasound, CT, and MRI, which reveal key features like fat, calcifications, and fat-fluid levels. Differential diagnoses include various pancreatic cystic lesions. Surgical resection is the primary treatment, and this case highlights the diagnostic challenges and the critical role of imaging in guiding surgical decisions.

Conclusion

This report describes a rare case of a pancreatic mature cystic teratoma, one of only 52 documented cases. Despite the absence of significant symptoms, imaging revealed a large mass, and Whipple procedure was performed due to its complex relationship with vital structures. This case illustrates the diagnostic and therapeutic challenges associated with such rare tumors.