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Limitations in the Diagnosis of Childhood Teratoid Lesions on Fine Needle Aspiration Cytology

OBJECTIVE
To present and discuss our experience with cytologic study of fine needle aspiration for the diagnosis of histologically confirmed childhood teratomas/teratoid lesions and to highlight the limitations in diagnosis.


STUDY DESIGN
Cases with histologic diagnosis of teratoma from the archives of the histopathology section of the Department of Pathology were identified. Only cases preceded by fine needle aspiration cytology were included in the study.


RESULTS
The 11 cases of teratoma/teratoid lesions were from 4 males and 7 females. Their ages ranged from 3 months to 12 years (mean, approximately 3 years). The clinicoradiologic diagnosis varied between neuroblastoma, Wilms tumor and teratomas. The radiologic features were available in only 6 cases at the time of aspiration. Squamous cells were the main findings in cases diagnosed as teratomas. Other elements, like neuroectodermal cells and mesodermal derivatives like muscle, adipose tissue and columnar cells, were also seen. Immature mesenchymal fragments were recognized in 2 cases.


CONCLUSION
Clinical details and radiologic investigations are crucial to the cytologic diagnosis of teratomas, differentiating them from the other common childhood tumors.