Calcified Extragonadal Pelvic Mature Teratoma in a 67-Year-Old Man Discovered Incidentally During Workup for Lumbosciatalgia: A Case Report

Abstract

Extragonadal teratomas are rare germ cell tumors, representing 2–5% of cases, with pelvic localization in adult males being exceptional. A 67-year-old male presented with lumbosciatalgia. Imaging revealed a calcified supravesical pelvic mass measuring 65 × 55 × 50 mm, adjacent to the sigmoid colon and iliac vessels. Tumor markers were within normal limits except for isolated elevation of CA19-9. Laparoscopic exploration identified a whitish calcified mass adherent to the left iliac fossa and sigmoid colon. Complete en bloc resection was performed, and histopathology confirmed a mature teratoma. Pelvic extragonadal teratomas in adult men are rarely reported. CT imaging is the diagnostic reference, with calcifications present in 50–60% of mature teratomas. Although typically benign, complications such as infection, rupture, compression, or malignant transformation (1–3%) justify complete surgical excision. Laparoscopy provides advantages in terms of recovery and morbidity. Extragonadal pelvic mature teratoma in elderly men is an exceptional entity. Diagnosis relies on imaging, and complete laparoscopic excision remains the standard of care to establish histology and prevent complications.