article · International Journal of Surgery Case Reports
Mature teratomas are non-cancerous germ cell tumours that usually develop in the gonads. Their occurrence outside the gonads, particularly around the navel, is extremely unusual and can be difficult to diagnose. This report describes a nine-year-old girl with a four-year history of a growing umbilical mass and occasional discomfort, presenting with a firm mass protruding through a perforated navel despite having no congenital abdominal wall defects. A contrasted computed tomography scan identified a well-encapsulated, heterogeneous mass with calcifications and no deep abdominal extension. Surgeons completely removed the tumour, and microscopic examination confirmed it was a mature teratoma. The patient experienced a smooth recovery without recurrence. The findings highlight the importance of considering rare tumours when assessing persistent umbilical masses, using medical imaging to distinguish them from other conditions, and performing complete surgical excision.
Unusual presentations of benign tumours can easily be mistaken for more common issues such as infections or simple hernias. Documenting rare cases where an umbilical mass causes perforation helps clinicians maintain a high level of suspicion. Prompt recognition and appropriate imaging ensure timely surgical removal, preventing further tissue damage, infection, and unnecessary complications for paediatric patients.
The abstract does not indicate an application pathway, as it is a single clinical case report describing standard diagnostic imaging and surgical management.
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BACKGROUND: Mature teratomas are benign germ cell tumors that predominantly occur in gonadal regions. Extra-gonadal teratomas, especially in the umbilical region, are rare and often present significant diagnostic challenges. A delayed presentation with umbilical perforation in absence of congenital abdominal wall defects is uncommon. CASE PRESENTATION: A 9-year-old female presented with a four-year history of progressively enlarging umbilical mass with occasional discomfort. Examination revealed a firm, pedunculated mass protruding through a perforated umbilicus. A contrasted CT scan, revealed a well-encapsulated heterogeneous mass containing calcifications, with no evidence of deep intra-abdominal involvement. Complete surgical excision of the tumor was performed. Histopathological analysis confirmed a mature teratoma. Recovery was uneventful, and follow-up showed no recurrence. DISCUSSION: Umbilical teratomas are rare entities, particularly in children without congenital abnormalities. This case illustrates delayed presentation of umbilical perforation and diagnostic challenges in unusual located teratoma, emphasizing the need for high suspicious index when evaluating persistent umbilical masses. Radiology plays a critical role in differentiating these tumors from other conditions like granulomas, infections, or congenital anomalies. Complete surgical excision is the treatment of choice. CONCLUSION: This report highlights the rarity and diagnostic complexity of mature teratomas in atypical locations. Early recognition of this rare differential diagnosis in cases of persistent umbilical symptoms is essential to prevent complications such as infection and perforation. Awareness and early intervention are critical to achieving favorable outcomes in such cases. This case contributes to the limited literature on extragonadal teratomas with umbilical perforation and the need for timely diagnosis and management.
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DOI: 10.1016/j.ijscr.2025.111285
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