Abstract：Objective This study aimed to investigate the clinical, imaging, and pathological features of duodenal teratoma, as well as to improve clinicians' understanding of the special site of the tumor. Methods The clinical and pathological data of a patient with duodenal solid mature teratoma treated in Yantai Mountain Hospital of Yantai City, from March 2021 were analyzed retrospectively. Using "十二指肠/duodenal" and "畸胎瘤/teratoma" as keywords, the literature on duodenal teratoma before December 2020 was searched in CNKI, Wanfang database, Weipu database, and PubMed. Three English literature reports and two Chinese literature reports were found. Combined with a case reported in this paper, the clinical, imaging, and pathological features were summarized. Results This patient was a 40-year-old male. The clinical manifestation was upper abdominal pain and discomfort for half a year. The imaging manifestations were irregular mixed density shadow in the descending segment of the duodenum and irregular calcification like high density shadow and fat density shadow. The clinical diagnosis was descending duodenal space-occupying lesion, and duodenal mass resection was performed. The postoperative pathological diagnosis was solid mature teratoma of the duodenum, which recovered well. Combined with the five patients reported in the literature, there were 6 patients of duodenal teratoma (including 4 males and 2 females) aged from 7 days to 40 years. The clinical manifestations were intestinal obstruction or symptoms of intestinal obstruction, including 2 patients with anemia and 2 patients with abdominal mass. The diseased sites were located in the descending and horizontal part of the duodenum. Imaging examination: Five patients underwent CT and/or B-ultrasound examination, and all showed tumor or space-occupying lesions, including 1 patient of cystic tumor, 1 patient of cystic solid mass, and 3 patients of solid tumor; 2 patients were accompanied with characteristic adipose tissue and calcification. Only X-ray examination was performed in 1 patient without CT and B-ultrasound; the characteristic X-ray manifestation of "abdominal air level" was displayed. All 6 patients underwent surgery, and the maximum meridian of the tumor was 3–12 cm. During the operation, 4 patients presented a pipeline connection between the tumor and the duodenal intestinal wall. Five patients of duodenal mature teratoma and one case of malignant teratoma were diagnosed by postoperative pathology. Among the 5 patients of mature teratoma, 1 patient without report, the rest had a good prognosis and no recurrence during follow-up. One patient of malignant teratoma recurred and metastasized half a year after the operation and 3 months after chemotherapy. Conclusion Duodenal teratomas are rare, mostly in the descending and horizontal parts of the duodenum. The most of duodenal teratomas are mature teratomas, and complete surgical resection has a good prognosis. A few are malignant teratomas, which are easy to relapse and metastasize after operation. The most of the clinical manifestations are intestinal obstruction. The imaging features of fat and calcification in the lesion are the most valuable diagnostic features. Pathological diagnosis is the gold standard, and the histopathological changes are consistent with teratoma in other sites.
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