Photoclinic Diagnosis: Mesenteric Teratoma

Aneonate who was born at 24 weeks of gestational age died in few minutes after birth. In physical examination a distended abdomen, ambiguous genitalia and imperforated anus was seen. Autopsy revealed female gender, agenesis of left kidney and a large cystic mass containing 1.5 liter fluid with attachment to a small portion of the small intestine. Pathology demonstrated a fibromuscular tissue that was covered by stratified squamous epithelium and one layer of cubeidal cells. Also unremarkable intestinal tissue was present. The neonate’s mother was a 24 year old woman referred to the clinic because of severe abdominal distention, respiratory distress and palpitation. In ultrasound she revealed a single fetus with a large intra-abdominal mixed cystic mass measuring 108x65mm displacing normal organs and extending to the presacral area. Fat-fluid levels (fluid-fluid appearance) and severe polyhydramnios was also observed. She underwent hystrotomy. She and her husband were first cousins. There was no family history of congenital anomalies or medication use during pregnancy.