J Korean Med Sci.  2009 Oct;24(5):989-991. 10.3346/jkms.2009.24.5.989.

A Primary Extragonadal Teratoma of the Proximal Humerus

• Koh JS
• Park JH
• Kang CH

• KMID: 1782031
• DOI: http://doi.org/10.3346/jkms.2009.24.5.989

Abstract

A extragonadal malignant teratoma of the extremity is a rare pheonemenon. We describe a extremely rare case of malignant teratoma of the left proximal humerus in a 14-yr-old female. Radiologic evaluations, including magnetic resonance imaging, suggested a malignant bone tumor, but a pathological examination revealed an immature bony teratoma. Bone scintigraphy and positron emission tomography computed tomography scan showed increased uptake of proximal humerus but no other abnormal lesion.

Keyword

Extragonad; Bone Neoplasms; Teratoma

MeSH Terms

Adolescent
Bone Neoplasms/*diagnosis/pathology/radiography
Female
Humans
*Humerus/radiography
Magnetic Resonance Imaging
Positron-Emission Tomography
Teratoma/*diagnosis/pathology/radiography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 (A) A radiograph revealing ill defined moth eaten to permeative destructive lesion associated with cortical perforation in the epiphysis and metaphysic of the humerus. (B) Consecutive transaxial T2-weighted gradient-echo MR images showing the intraosseous and extraosseous extent of the tumor, which displayed inhomogeneous high signal intensity. The tumor has penetrated the cortex and lifted the periosteal membrane. This coronal T1-weighted spine echo MR image obtained after intravenous gadolinium administration reveals inhomogeneous tumor enhancement. Note the diaphyseal tumor extension. (C) Reconstruction after wide excision was undertaken using a tumor prosthesis.

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  Fig. 2 Gross photograph showing a homogenous grayish white flesh-like tumor that replaced the humeral epiphysis and metaphysis. The gross specimen sliced in the sagittal plane and the extent of viable tumor and the area of necrosis correspond well with the MR images.

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  Fig. 3 Microscopic views showing a mature squamous cell nest (A), differentiated neuroglial tissue (B), and immature glandular structure showing prominent nucleoli and a rare mitotic figure (C). GFAP immunohistochemical staining revealed diffuse reactivity in neuroglial tissue (D).

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