Main Article Content
Teratoma, Radiography, Low back pain
Objective: To describe the finding of an incidental teratoma in a patient receiving care in a chiropractic college outpatient clinic.
Clinical Features: A 25-year-old female had a complaint of chronic mild-to-moderate low back pain that was unresponsive to multiple courses of conservative care. Radiography revealed a calcific abdominal density suggesting a teratoma.
Intervention and Outcome: Referral was made to a gynecologist, who confirmed the presence of teratoma via ultrasound. The patient underwent an oophorectomy. The teratoma diagnosis was also confirmed surgically. At 1-year post-surgery, the patient had only infrequent mild low back pain.
Conclusion: Chiropractors may consider radiography for patients when they fail to respond to care. Some findings, such as calcific densities in females, may be incidental yet important. Patient preference is an integral part of the doctor/patient relationship. When calcific densities are seen in the abdominal cavity of a female, consider teratoma and refer to a gynecologist due to slight risk of malignant degeneration. In this case, after recovery from surgery, the patient reported improvement of her chronic, non-responsive low back pain though its causality remains unknown.
1. Kaeser MA, McDonald JK, Kettner NW. A calcific pelvic mass in a woman with chronic spinal pain: a case of mature cystic teratoma. J Chiropr Med 2011;10(4):327-332
2. Deloison B, Socolov D, Hornoy P, Couly G, Ville Y, Salomon LJ. Atypical case of prenatal cystic epignathus teratoma. Ultrasound Obstet Gynecol 2014;44(4):495-496
3. Giancotti A, La Torre R, Bevilacqua E, D'Ambrosio V, Pasquali G, Panici PB. Mediastinal masses: a case of fetal teratoma and literature review. Clin Exp Obstet Gynecol 2012;39(3):384-387
4. Dutta M, Roy S, Ghatak S. Naso-oropharyngeal choristoma (hairy polyps): an overview and current update on presentation, management, origin and related controversies. Eur Arch Otorhinolaryngol 2015;272(5):1047-1059
5. Lakhoo K. Neonatal teratomas. Early Hum Dev 2010;86(10):643-647
6. Mature cystic teratoma of the ovary [Internet]. DynaMed 2018 [cited 3/15/2019]. Available from: https://www.dynamed.com/topics/dmp~AN~T115294
7. Damjanov I, Linder I, An J. Anderson's pathology (10th Ed. 2 Vol Set): Jajr; 1996
8. Gazula S, Mathur SR, Iyer VK, Gupta AK, Pawar DK, Agarwala S. Thoraco-abdominal mature teratoma in a left diaphragmatic hernia. Indian J Pediatr 2010;77(5):563-564
9. Yoon HM, Byeon SJ, Hwang JY et al. Sacrococcygeal teratomas in newborns: a comprehensive review for the radiologists. Acta Radiol 2018;59(2):236-246
10. Lin YH, Huang RL, Lai HC. Presacral teratoma in a Curarrino syndrome woman with an unreported insertion in MNX1 gene. Taiwan J Obstet Gynecol 2011;50(4):512-514
11. Sun K, You Q, Zhao M, Yao H, Xiang H, Wang L. Concurrent primary carcinoid tumor arising within mature teratoma and clear cell renal cell carcinoma in the horseshoe kidney: report of a rare case and review of the literature. Int J Clin Exp Pathol 2013;6(11):2578-2584
12. Oh HS, Kim TW, Park KH. Spinal teratoma concomitant with intracranial lipid droplet dissemination. Korean J Spine 2015;12(1):15-18
13. Shubha AM, Mohanty S, Das K, Garg I. Spinal teratoma with salivary glandular differentiation. Neurol India 2009;57(6):821-822
14. Kingo PS, Hoyer S, Marinovskij E, Rawashdeh YF. Paediatric urachal benign teratoma: a case report and review of the literature. APMIS 2014;122(9):761-765
15. Gadducci A, Guerrieri ME, Cosio S. Squamous cell carcinoma arising from mature cystic teratoma of the ovary: A challenging question for gynecologic oncologists. Crit Rev Oncol Hematol 2019;133:92-98
16. Multani J, Kives S. Dermoid cysts in adolescents. Curr Opin Obstet Gynecol 2015;27(5):315-319
17. Sahin H, Abdullazade S, Sanci M. Mature cystic teratoma of the ovary: a cutting edge overview on imaging features. Insights Imaging 2017;8(2):227-241
18. Young WF, Jr. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med 2007;356(6):601-610
19. Globe GA, Morris CE, Whalen WM, Farabaugh RJ, Hawk C. Chiropractic management of low back disorders: report From a consensus process. JManipulative Physiol Ther 2008;31(9):651-658
20. Rogers EM, Allen L, Kives S. The recurrence rate of ovarian dermoid cysts in pediatric and adolescent girls. J Pediatric Adolescent Gynecol 2014;27(4):222-226
21. Tokmak A, Guzel A, Erkilinc S et al. Factors affecting recurrence after surgery for ovarian mature cystic teratoma. J Obstetrics Gynaecol 2016;36(3):289-292