[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-457928-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-457928-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","hepatoduodenal-ligament-teratoma-presenting-with-fever-in-a-young-adult","Hepatoduodenal ligament teratoma presenting with fever in a young adult","","Hepatoduodenal ligament teratomas are extremely rare, with fewer than 20 reported cases. A 22-year-old woman presented with fever and acute abdominal pain due to a mature cystic teratoma located in the hepatoduodenal ligament. This presentation with acute cholangitis represented the first reported case in the literature for this rare tumor. The mass was successfully excised while preserving portal triad structures, adding clinical insight into acute febrile illness and characteristic imaging findings in young adults.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/hepatoduodenal-ligament-teratoma-presenting-with-fever-in-a-young-adult/457928/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/hepatoduodenal-ligament-teratoma-presenting-with-fever-in-a-young-adult/457928.png","ImageObject",300,407,{"name":42,"@type":43},"Jiven","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are hepatoduodenal ligament teratomas difficult to remove surgically?","Question",{"text":63,"@type":64},"The hepatoduodenal ligament contains the portal triad—portal vein, hepatic artery, and common bile duct. Their proximity makes resection technically challenging due to risk of iatrogenic injury.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What imaging features supported the diagnosis in this case?",{"text":68,"@type":64},"CT demonstrated a 4–5 cm cystic lesion in the hepatoduodenal ligament with fat density and fluid components, without calcifications or biliary dilatation, suggesting a mature cystic teratoma.",{"name":70,"@type":61,"acceptedAnswer":71},"How was the patient managed and what was the outcome?",{"text":72,"@type":64},"Antibiotics were started for suspected acute cholangitis, with fever resolving within 24 hours. Surgery then achieved complete excision with careful preservation of portal triad structures, and the postoperative course was uncomplicated.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},457928,1791169856,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":55,"preview_page_count":4},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","Journal of Surgical Case Reports, 2026, 1, rjaf1056  \n[https://doi.org/10.1093/jscr/rjaf1056](https://doi.org/10.1093/jscr/rjaf1056)  \nCase Report  \nCase Report  \nHepatoduodenal ligament teratoma presenting with fever in a young adult  \nMete Ucdal1 , 2 , *, Evren Ekingen1  \n1 Etimesgut Sehit Sait Erturk State Hospital, Ankara, Turkiye  \n2 Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye  \n*Corresponding author. Department of Internal Medicine, Etimesgut Sehit [Sait Erturk State Hospital. E-mail:](Sait Erturk State Hospital. E-mail: meteucdal@hacettepe.edu.tr)[ meteucdal@hacettepe.edu.tr](Sait Erturk State Hospital. E-mail: meteucdal@hacettepe.edu.tr)  \nAbstract  \nHepatoduodenal ligament teratomas are very rare, and there are fewer than 20 cases reported in the literature. A 22-year-old woman with fever and acute abdominal pain due a mature cystic teratoma in the hepatoduodenal ligament. This occurrence when presented with acute cholangitis was the first case of this rare tumor. Previous cases seen in adults were asymptomatic and were diagnosed incidentally on investigations. The mass was successfully removed operation on this patient without affecting the portal triad structures. This case adds to our knowledge of how these rare tumors may present clinically. It also highlights the relevance of this diagnosis in young adults with acute febrile illness and appropriate imaging characteristics.  \nKeywords: hepatoduodenal ligament; teratoma; fever; cholangitis; young adult; extragonadal germ cell tumor  \nIntroduction  \nTeratomas arise from pluripotent germ cells and contain tissue from all three embryonic layers: ectoderm, mesoderm, and endoderm. While most develop in gonads, extragonadal sites include the mediastinum, retroperitoneum, and sacrococcygeal region [1] . Hepatoduodenal ligament teratomas are extremely rare, with fewer than 20 cases in literature [2 , 3] . Most occur in childhood, often diagnosed antenatally or presenting with abdominal distension [2] . Adult cases are exceedingly rare, typically incidental findings during imaging [4 , 5] . The hepatoduodenal ligament extends from the porta hepatis to the duodenum, containing the portal triad: portal vein, hepatic artery, and common bile duct [6] . Teratomas at this site result from blocked germ cell migration during embryologic development. Proximity to portal triad structures creates technical challenges during resection due to potential iatrogenic injury [7] . We report a hepatoduodenal ligament teratoma in a 22-year-old woman presenting with fever and acute abdominal pain, not previously described.  \nCase report  \nA healthy 22-year-old woman presented with right upper quadrant pain and fever for 3–4 days. She reported home temperature of 38 .5◦ C and denied jaundice, nausea, vomiting, or weight loss. Examination revealed temperature 38 .2◦ C, pulse 96/minute, blood pressure 120/75 mmHg, marked right upper quadrant tenderness with positive Murphy’s sign and peritoneal irritation. No mass or jaundice was detected.  \nLaboratory studies showed leukocytosis (12500/μl) with neutrophilia. Liver enzymes showed mild alkaline phosphatase (185 U/L) and gamma-glutamyl transferase (95 U/L) elevation. Total bilirubin, aminotransferases, renal function, and alphafetoprotein were normal. Acute cholangitis or cholecystitis was suspected. She received intravenous ceftriaxone, metronidazole, and fluids.  \nAbdominal computed tomography (CT) demonstrated a 4–5 cm cystic lesion in the hepatoduodenal ligament (Fig. 1a) containing fat density and fluid without calcifications. No biliary dilatation, cholecystitis, or vascular compression was seen. The gallbladder was normal. The liver was slightly enlarged with normal contours. Minimal intrahepatic bile duct prominence was noted.  \nFat attenuation within a hepatoduodenal cystic lesion suggested mature cystic teratoma, possibly infected given acute febrile presentation. After stabilization, semi-urg","cbCaiuFf4gYFnokg","https://ap.wps.com/l/cbCaiuFf4gYFnokg","pdf",306087,"English","# Introduction\n## Teratoma origins and rarity of hepatoduodenal ligament cases\n## Anatomy of the hepatoduodenal ligament and surgical challenges\n# Case report\n## Presentation and initial assessment\n## Laboratory findings and clinical suspicion\n## Imaging findings on CT\n## Management and surgical findings\n## Pathology and postoperative course","[{\"question\":\"Why are hepatoduodenal ligament teratomas difficult to remove surgically?\",\"answer\":\"The hepatoduodenal ligament contains the portal triad—portal vein, hepatic artery, and common bile duct. Their proximity makes resection technically challenging due to risk of iatrogenic injury.\"},{\"question\":\"What imaging features supported the diagnosis in this case?\",\"answer\":\"CT demonstrated a 4–5 cm cystic lesion in the hepatoduodenal ligament with fat density and fluid components, without calcifications or biliary dilatation, suggesting a mature cystic teratoma.\"},{\"question\":\"How was the patient managed and what was the outcome?\",\"answer\":\"Antibiotics were started for suspected acute cholangitis, with fever resolving within 24 hours. Surgery then achieved complete excision with careful preservation of portal triad structures, and the postoperative course was uncomplicated.\"}]","Hepatoduodenal ligament teratoma presenting with fever in a young adult | PDF",1790750901]