Laparoscopic resection of a huge mature cystic teratoma of the right adrenal gland through retroperitoneal approach: a case report and literature review

Background: At present, the primary mature cystic teratoma in the adrenal gland is extremely rare in adults, according to the literature. In addition, a completely retroperitoneoscopic resection of mature cystic teratomas has been reported only in two cases. Case presentation: We report a case of a large mature cystic teratoma with a regular margin in the right adrenal gland. Three months before surgery, abdominal enhanced computer tomography revealed a 5.7 x 4.9 x 4.3 cm lipoid tumour of mixed density with calcification in the tumorous centre, clinically diagnosed as adrenal myelolipoma or adenoma. Retroperitoneoscopic adrenalectomy was successfully performed; however, the tumour had increased in size to approximately 6.0 x 7.0 x 11 cm. The pathological report suggested the final diagnosis of mature cystic teratoma. The patient had an uneventful course after the surgery and was free of recurrence or metastasis within 8 months of follow-up. Conclusions: Retroperitoneoscopic adrenalectomy for large adrenal masses is safe and feasible. To the best of our knowledge, this is the first report where of a large mature cystic teratoma of the right adrenal gland has been completely resected using retroperitoneoscopic approach.