J Oral Maxillofac Surg 69:e294-e296, 2011 Massive Craniofacial Teratoma: A Case Report Reza Tabrizi, DMD,* Abbas Khodayari, DMD,† and Amir Vahedi, MD‡ Teratoma is a germ cell tumor, which is derived from pluripotent cells. It is composed of different types of tissue originating from 1 or more of the 3 germ cell layers and is most often found in the ovary or testis. Rare teratomas in the head and neck region primarily arise from the Rathke pouch remnants in the sphe- noid bone region, the lateral neck, and the tongue. The histologic appearance of these tumors is most often benign 1 and varies noticeably in terms of the differentiation and maturation of the involved tissues. Some lesions contain fingers, teeth, jawbone, or di- minutive skeletons, whereas others do not show more than an admixture of various types of tissue, with no attempt at maturation or structural develop- ment. 2 Paraoral cases are mostly cystic and relatively undifferentiated. Oral lesions, however, have been known to contain tissues from many parts of the body, including brain, bone, cartilage, skin, lung, and gastrointestinal tract. 3 Treating a teratoma consists of conservative surgical removal, which often requires delicacy because of its close proximity to important anatomic structures in the head and neck region. Case Report A 17-year-old male patient was referred to our depart- ment in November 2006. He was mentally handicapped and kept at a public assistance center; thus he did not have any parents and was not treated since attending our hospital. Clinically, a huge tumoral mass was observed attaching to the frontal site and 2 other separate masses were seen in the cranial region. The patient had difficulty with nasal respira- tion and a limited visual field (Fig 1). Palpation showed a *Associate Professor, Craniomaxillofacial Department, Shiraz Uni- versity of Medical Science, Shiraz, Iran. †Associate Professor, Maxillofacial Surgery Department, Shahid- beheshti University of Medical Science, Tehran, Iran. ‡Assistance Professor, Pathology Department, Tabriz University of Medical Science, Tabriz, Iran. Address correspondence and reprint requests to Dr Tabrizi: Craniomaxillofacial Ward, Chamran Hospital, Chamran Ave, Shiraz, Fars, Iran; e-mail: tabmed@gmail.com © 2011 American Association of Oral and Maxillofacial Surgeons 0278-2391/11/6907-0047$36.00/0 doi:10.1016/j.joms.2011.02.123 FIGURE 1. A, B, Preoperative views of patient showing huge tumoral lesion, which covers face and visual field. Tabrizi, Khodayari, and Vahedi. Massive Craniofacial Teratoma. J Oral Maxillofac Surg 2011. e294