Uncommon presentation of a mature teratoma in a toddler

Paediatric head and neck teratomas are rare and present diagnostic challenges. We report a case of a toddler with a recurrent growth in her upper jaw, initially removed at birth and diagnosed as fibrolipoma. A recent examination revealed a pinkish growth with fine hairs, identified as a mature teratoma on biopsy. Histopathology showed tissue from ectodermal and mesodermal germ layers. We discuss diagnostic challenges, histological features and teratoma formation theories, distinguishing them from dermoids. The unclear aetiology may involve pluripotent cell abnormalities or germ cell anomalies. This case highlights the critical role of comprehensive histopathological evaluation in diagnosing congenital and recurrent oral lesions accurately and ensuring appropriate management. Furthermore, the initial misdiagnosis led to a delay in recognition, underscoring the challenges of identifying such lesions beyond the neonatal period.