Gastric teratoma presenting as gastrointestinal bleeding in a neonate: a case report and review of literature

Abstract

Gastric teratoma accounts for ˂1% of pediatric teratomas and typically presents as an abdominal mass, distension, or vomiting, making gastrointestinal bleeding an unusual presentation. A 6-week-old male infant presented with black tarry stools since birth, non-bilious vomiting, and severe anemia requiring four packed red blood cell transfusions before referral. Examination revealed a large supraumbilical mass, and contrast-enhanced computed tomography showed a heterogeneous solid-cystic lesion with calcification abutting the greater curvature of the stomach, suggesting a gastric teratoma preoperatively. During laparotomy, an exophytic intragastric mass was excised with primary gastric repair. Histopathology confirmed a mature teratoma. Melena resolved by postoperative day five, and the infant was well at 1-month follow-up. This case adds to the limited literature on gastric teratoma presenting with gastrointestinal bleeding rather than a mass, and reinforces complete surgical excision as curative.