Cukurova et al. Journal of Medical Case Reports 2012, 6:147 http://www.jmedicalcasereports.com/content/6/1/147 C A S E R E P O R T JOURNAL OF MEDICAL CASE REPORTS Open Access A benign teratoma presenting as an obstruction of the nasal cavity: a case report Ibrahim Cukurova1, Murat Gumussoy1*, Aytekin Yaz1, Umit Bayol2 and Orhan Gazi Yigitbasi1 Abstract Introduction: Teratoma refers to a neoplasm that recapitulates all three germ layers. Teratomas may be histologically mature and oncologically benign. Teratomas may also be histologically immature while being oncologically benign, or they may harbor malignant components and have the potential to exhibit an aggressive biological behavior. Teratomas of the head and neck are extremely rare and usually present in the neonatal period. As a general rule, pediatric teratomas of the head and neck tend to be oncologically benign, whereas adult teratomas tend to be histologically and oncologically malignant. Most of these teratomas are found in the cervical region and nasopharynx. Calcification within the mass is often evident. Case presentation: A 27-year-old Caucasian man complaining of a nasal obstruction was admitted to our clinic in January 2006. A transnasal endoscopic examination revealed a mass arising from the nasal septum which was completely removed using an endoscopic approach. Histologically, it was determined to be a benign teratoma. Conclusion: Herein, we present a rare case, along with a review of the related literature, in order to emphasize that a benign teratoma of the nasal septum should not be ignored. Introduction Benign teratomas are solid and cystic tumors composed of a variety of both immature and mature tissues derived from all three germ layers. The epithelial component of a benign teratoma usually consists of mature squamous epithelium and immature intestinal or respiratory epi- thelium. Primitive neuroepithelium with rosettes, pseu- dorosettes or neurofibrillary matrix predominates in some tumors. Pigmented retinal epithelium can also be seen. The mesodermal component consists of fibroblasts and embryonic, immature spindle cells embedded in a myxoid matrix. Islands of cartilage, smooth muscle cells, and skeletal muscle cells exhibiting varying degrees of maturity may also be present. Teratomas of the head and neck are extremely rare and usually seen during the neonatal period. While pediatric teratomas of the head and neck tend to be be- nign tumors, adult teratomas tend to be histologically and oncologically malignant. Calcification within the mass is often evident. Sinonasal masses present with * Correspondence: mgumussoy@hotmail.com 1Department of Otolaryngology and Head and Neck Surgery, the Ministry of Health Izmir Tepecik Training and Research Hospital, Izmir 35120, Turkey Full list of author information is available at the end of the article nasal obstruction symptoms. The presenting symptoms are those associated with a sinonasal mass. Radiologic- ally and grossly, these tumors are heterogeneous and composed of solid and cystic components [1]. The following should be considered in the differential diagnosis of sinonasal teratomas: immature teratomas, teratomas with malignant transformation, sinonasal yolk sac tumors, sinonasal teratocarcinosarcomas, dermoid cysts, hamartomas, and hairy polyps. While teratomas can be surgically resected, malignant teratomas also re- quire adjuvant radiotherapy [2]. Case presentation A 27-year-old Caucasian man who had been suffering from a nasal obstruction for eight years was admitted to the Department of Otolaryngology and Head and Neck Surgery, the Ministry of Health Izmir Tepecik Training and Research Hospital in January 2008. His past medical and family history did not include any abnormal or not- able features. A mass with smooth surface, arising from the left posterior side of the nasal septum and filling the whole nasopharyngeal cavity, was seen on his endoscopic nasal examination. Other systemic examinations were normal. Complete blood count (CBC), activated partial © 2012 Cukurova et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.