E4854. Cross-Sectional Imaging Spectrum of Teratomas From Head to Toe: Common, Rare, and Exotic
Authors
Vijayanadh Ojili;
UT Health San Antonio
Sriram Jaganathan;
UT Health San Antonio
Devendra Kumar;
Al Wakra Hospital
Pankaj Nepal;
Inova Fairfax Hospital
Prem Batchala;
UVA Health
Arpit Nagar;
Ohio State University Wexner Medical Center
Sree Harsha Tirumani;
University Hospitals Cleveland Medical Center
Background
Teratomas are ubiquitous tumors that can occur in almost any part or organ of the body, but they are usually found in locations that are sacrococcygeal, gonadal (ovarian and testicular), intracranial, cervicofacial, mediastinal, or retroperitoneal. They can occur in both children and adults and are mostly asymptomatic at the time of diagnosis. Patients may present to the emergency room with complications that can result in significant morbidity and mortality. Imaging plays a vital role in the management of these patients not only in diagnosis but also aids in detection of complications. The purpose of this exhibit is to provide a detailed review of teratomas from head to toe and to discuss the role imaging, particularly MDCT and MRI, in the evaluation of these patients.
Educational Goals / Teaching Points
1. Describe the imaging appearances of teratomas from head to toe. 2. Discuss the diagnostic and management strategy in asymptomatic patients with teratomas. 3. Discuss the role of imaging in the management of patients presenting with complications due to teratomas.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Teratomas are usually asymptomatic, but may present clinically as an emergency due to complications and require early and accurate diagnosis for prompt treatment. These include torsion, rupture, secondary infection, and airway and spinal cord compression. MDCT is both highly sensitive and specific in the detection of these complications. The adjuvant role of MRI is also discussed. Anti-NMDA encephalitis, which is a rare emergent manifestation of ovarian teratoma, is highlighted.
Conclusion
Imaging plays a key role in the evaluation of patients with teratomas. Knowledge of their common locations and potential complications and their imaging features can help the radiologist to promptly triage the patients, thereby facilitating appropriate management.
