Endoscopic resection of primary rectal teratoma

A 76-year-old female was noted to have a rectal mass on evaluation for postmenopausal bleeding. There was no history of abdominal pain, constipation, or rectal bleeding. Flexible sigmoidoscopy revealed a 3-cm pedunculated rectal mass at 10 cm. Hair fibers were visible through the smooth glistening surface. At colonoscopy, the polyp was removed by snare polypectomy. Histology showed epidermal, mesodermal, and endodermal components diagnostic of benign cystic teratoma. Subsequent total abdominal hysterectomy and bilateral salpingo-oophorectomy revealed endometrial carcinoma and postmenopausal ovaries. Primary rectal teratoma is a very rare rectal mass that may present endoscopically. Since 1865, only 33 cases have been reported in the literature. Endoscopic photographs, histology, and a review of the literature are presented.