Mature Teratoma Presenting as a Large Nonfunctional Adrenal Lesion: A Case Report and Literature Review

Primary adrenal teratomas are an exceptionally rare subset of extragonadal germ cell tumors. In this report, we describe a mature adrenal teratoma in a 22-year-old female and provide an updated comprehensive review of adult cases published to date. Imaging studies of our patient revealed a large left adrenal lesion measuring 60 Å~ 90 Å~ 120 mm (depth Å~ width Å~ height), with fatty and calcified components. Hormonal evaluation confirmed that the adrenal lesion was nonfunctional. Laparoscopic adrenalectomy was performed, and histopathological examination confirmed an adrenal teratoma. Her postoperative course was uneventful, with no evidence of recurrence at 6-month follow-up. Including our patient, 53 adult cases of primary adrenal teratoma have been reported in the literature. The mean age of patients was 38.6 Å} 16.0 years; 77.4% were female. Most lesions were nonfunctional. Surgical resection was performed in all cases; 62.5% were laparoscopic. Histology confirmed mature teratomas in all, with 1 case showing malignant transformation. Although rare, adrenal teratomas should be considered in the differential diagnosis of adrenal masses. Complete surgical resection offers an excellent prognosis, but patients need long-term follow-up to detect recurrence or rare malignant transformation. Cite this article as: Fedai NK, Hepşen E, Koyunlu AN, et al. Mature teratoma presenting as a large nonfunctional adrenal lesion: A case report and literature review. Endocrinol Res Pract. 2026;30(1):72-76.