American Journal of Medical Case Reports, 2015, Vol. 3, No. 3, 75-78 Available online at http://pubs.sciepub.com/ajmcr/3/3/6 © Science and Education Publishing DOI:10.12691/ajmcr-3-3-6 Cervical Teratoma: A Rare Neck Swelling in an Adult Sze Li Siow * , Hans Alexander Mahendran Department of Surgery, Sarawak General Hospital, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia *Corresponding author: szeli18@yahoo.com Received January 20, 2015; Revised January 30, 2015; Accepted February 03, 2015 Abstract Cervical neck teratoma in adult is rare. It has a distinctly different clinicopathological behavior compared to those of the neonate and infant. We report an 18-year-old man who presented with a benign cervical neck teratoma, and present a review of cervical neck teratoma in the literature. Surgery is the primary modality of treatment as malignant transformation occurs during adulthood. The diagnosis of malignancy is based on histopathologic examination. Adjuvant chemotherapy is indicated when malignancy is confirmed. Keywords: teratoma, adult, cervical neck, surgery Cite This Article: Sze Li Siow, and Hans Alexander Mahendran, “Cervical Teratoma: A Rare Neck Swelling in an Adult.” American Journal of Medical Case Reports, vol. 3, no. 3 (2015): 75-78. doi: 10.12691/ajmcr-3-3-6. 1. Introduction Cervical teratomas are uncommon pathological entities that are usually diagnosed at birth and rarely reported in older children and adults. We report a mature cervical teratoma in an adult and offer a brief review of the literature. 2. Case An 18-year-old teenage male presented with a 4 months history of a progressive anterior midline neck swelling. There was no associated dysphagia, shortness of breath or hoarseness of voice. He had no prior surgery or irradiation to his neck and he was clinically and biochemically euthyroid. Clinical examination showed a firm, oval-shaped mass that had a smooth surface in the midline of the anterior neck. The lesion measured 4x5 cm and moved with swallowing and protrusion of tongue. There were no palpable cervical lymph nodes and the rest of his physical examination was otherwise unremarkable. Ultrasonography of the neck findings revealed a midline tubular structure that ended in a well-defined cystic structure separate from the thyroid gland suggestive of a thyroglossal cyst. The thyroid gland had a few subcentimeter nodules in the left thyroid gland that were homogenous in appearance. He was counseled for a Sistrunk procedure with a left hemithyroidectomy. A neck collar skin crease incision with elevation of subplatysmal flaps followed by retraction of the strap muscles laterally revealed a tubular structure extending from the hyoid bone extending inferiorly in the pretracheal plane. This tubular structure measuring 5cm in length, ended in a lobular mass that was located anterior to the left thyroid gland (Figure 1), distinctly separate from the gland and extended to the retrosternal area. Post- operatively, he was well with no haematoma or wound infection. He was discharged without complication uneventfully on the first post-operative day. Histopathological examination of the specimen showed features that are in keeping with mature teratoma (Figure 2, Figure 3). At one-year follow-up he had no evidence of local recurrence. Figure 1. Dissected out cervical teratoma with its superiorly located tract extending to the center of the hyoid bone