Best cases from the AFIP - Liver teratoma

The patient was a previously healthy 53-year-old woman who presented to a general surgeon in December 2001 after the discovery of an incidental right per quadrant mass at ultrasound (US). She had initially presented to her physician several years earlier after multiple episodes of heavy vaginal bleeding and was given the presumptive diagnosis of uterine fibroids. At this time of presentation, the patient was experiencing significant constipation, and it was thought that this could possibly be related to the fibroids causing her extrinsic obstructive bowel symptoms. She underwent barium enema examination for further assessment of her history of constipation and abdominal US for evaluation of the fibroids. At US, an incidental complex mass was noted in the right upper quadrant. She had no symptoms on presentation to the general surgery outpatient clinic. Her constipation had resolved. She had no pain, decreased appetite, weight loss, night sweats, or fever. She was a nonsmoker with an unremarkable medical and surgical history, other than three uncomplicated pregnancies and subsequent tubal ligation. She had no history of trauma and was not currently taking any medications. At physical examination, the abdomen was soft and nontender with no masses or organomegaly detected. Therefore, the patient underwent preoperative computed tomography (CT) and magnetic resonance (MR) imaging of the abdomen.