Se presenta el caso de un paciente con diagnóstico de novo de hipopituitarismo, cuya manifestación inicial fue con hiponatremia grave, secundaria a una insuficiencia suprarrenal central. Adicionalmente se documentó hipotiroidismo e hipogonadismo centrales. El paciente tuvo una lesión cerebral traumática cuatro décadas atrás y se encontraron en la resonancia nuclear de hipófisis hallazgos de hipoplasia hipofisaria y aracnoidocele selar, apoyando el diagnóstico de hipopituitarismo anterior. El caso resalta la presentación de hipopituitarismo diagnosticado décadas después de una lesión cerebral traumática. Se propone un enfoque para el diagnóstico, tratamiento y seguimiento de estos pacientes en nuestro medio.

Abstract
We present the case of a patient with previously undiagnosed hypopituitarism, it presents whose initial manifestation was a severe hyponatremia secondary to a central adrenal insufficiency, and besides this deficit he had central hypothyroidism and hypogonadism. In his past medical history he had a moderate traumatic brain injury almost 40 years before. The case highlights the presentation of hypopituitarism decades after a traumatic brain injury. An approach to the diagnosis, treatment and follow-up of these patients in our environment is proposed.

1. Coronado VG, Xu L, Basavaraju SV, et al. Surveillance for traumatic brain injury-related deaths--United States, 1997-2007. MMWR SurveillSumm. 2011; 60:1-32.
2. Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hy- pothalamus pituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA. 2007; 298: 1429-1438.
3. Agha A, Rogers B, Sherlock M, et al. Anterior pituitary dysfunction in survivors of traumatic brain injury. J ClinEndocrinolMetab. 2004; 89(10):4929–4936.
4. Aimaretti G, Ambrosio MR, Di Somma C, et al. Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J ClinEndocrinolMetab. 2005; 90(11):6085–6092.
5. Schneider HJ, Schneider M, Saller B, et al. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006; 154(2):259–265.
6. Tanriverdi F, Senyurek H, Unluhizarci K, Selcuklu A, Casanueva FF, Kelestimur F. High risk of hypopituitarism after traumatic brain injury: a prospective investigation of anterior pituitary function in the acute phase and 12 months after trauma. J ClinEndocrinolMetab. 2006;91(6): 2105–2111.
7. Tanriverdi F, Ulutabanca H, Unluhizarci K, Selcuklu A, Casanueva FF, Kele- stimur F. Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study. ClinEndocrinol (Oxf ). 2008; 68(4):573–579.
8. Tanriverdi F, De Bellis A, Ulutabanca H, et al. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity? J Neurotrauma. 2013; 30(16):1426–1433.
9. Lauzier F, Turgeon AF, Boutin A, et al. Clinical outcomes, predictors, and prevalence of anterior pituitary disorders following traumatic brain injury: a systematic review. CritCareMed. 2014;42:712-721.
10. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974; 2(7872):81–84.
11. Cryan E. Pituitary damage due to skull base fracture. DtschMedWochenschr. 1918; 44:1261.
12. Streetz-van der Werf C, Karges W, Blaum M, ..Kreitschmann-Andermahr. Addisonian Crisis after Missed Diagnosis of Posttraumatic Hypopituitarism. J Clin Med. 2015 May; 4(5): 965–969.
13. Tanriverdi F, Schneider HJ, Aimaretti G, Masel BE, Casanueva FF, Kelestimur F. Pituitary dysfunction after traumatic brain injury: a clinical and patho- physiological approach. Endocr Rev. 2015 Jun;36(3):305-42.
14. Tanriverdi F,Kelestimur F. Pituitary dysfunction following traumatic brain injury: clinical perspectives Neuropsychiatr Dis Treat. 2015; 11: 1835– 1843.
15. Tritos N, Yuen K, Kelly D. A neuroendocrine approach to patients with traumatic brain injury. EndocrPract. 2015;21: 823-831.

Se presenta el caso de un paciente con diagnóstico de novo de hipopituitarismo, cuya manifestación inicial fue con hiponatremia grave, secundaria a una insuficiencia suprarrenal central. Adicionalmente se documentó hipotiroidismo e hipogonadismo centrales. El paciente tuvo una lesión cerebral traumática cuatro décadas atrás y se encontraron en la resonancia nuclear de hipófisis hallazgos de hipoplasia hipofisaria y aracnoidocele selar, apoyando el diagnóstico de hipopituitarismo anterior. El caso resalta la presentación de hipopituitarismo diagnosticado décadas después de una lesión cerebral traumática. Se propone un enfoque para el diagnóstico, tratamiento y seguimiento de estos pacientes en nuestro medio.

Abstract
We present the case of a patient with previously undiagnosed hypopituitarism, it presents whose initial manifestation was a severe hyponatremia secondary to a central adrenal insufficiency, and besides this deficit he had central hypothyroidism and hypogonadism. In his past medical history he had a moderate traumatic brain injury almost 40 years before. The case highlights the presentation of hypopituitarism decades after a traumatic brain injury. An approach to the diagnosis, treatment and follow-up of these patients in our environment is proposed.

1. Coronado VG, Xu L, Basavaraju SV, et al. Surveillance for traumatic brain injury-related deaths--United States, 1997-2007. MMWR SurveillSumm. 2011; 60:1-32.
2. Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hy- pothalamus pituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA. 2007; 298: 1429-1438.
3. Agha A, Rogers B, Sherlock M, et al. Anterior pituitary dysfunction in survivors of traumatic brain injury. J ClinEndocrinolMetab. 2004; 89(10):4929–4936.
4. Aimaretti G, Ambrosio MR, Di Somma C, et al. Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J ClinEndocrinolMetab. 2005; 90(11):6085–6092.
5. Schneider HJ, Schneider M, Saller B, et al. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006; 154(2):259–265.
6. Tanriverdi F, Senyurek H, Unluhizarci K, Selcuklu A, Casanueva FF, Kelestimur F. High risk of hypopituitarism after traumatic brain injury: a prospective investigation of anterior pituitary function in the acute phase and 12 months after trauma. J ClinEndocrinolMetab. 2006;91(6): 2105–2111.
7. Tanriverdi F, Ulutabanca H, Unluhizarci K, Selcuklu A, Casanueva FF, Kele- stimur F. Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study. ClinEndocrinol (Oxf ). 2008; 68(4):573–579.
8. Tanriverdi F, De Bellis A, Ulutabanca H, et al. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity? J Neurotrauma. 2013; 30(16):1426–1433.
9. Lauzier F, Turgeon AF, Boutin A, et al. Clinical outcomes, predictors, and prevalence of anterior pituitary disorders following traumatic brain injury: a systematic review. CritCareMed. 2014;42:712-721.
10. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974; 2(7872):81–84.
11. Cryan E. Pituitary damage due to skull base fracture. DtschMedWochenschr. 1918; 44:1261.
12. Streetz-van der Werf C, Karges W, Blaum M, ..Kreitschmann-Andermahr. Addisonian Crisis after Missed Diagnosis of Posttraumatic Hypopituitarism. J Clin Med. 2015 May; 4(5): 965–969.
13. Tanriverdi F, Schneider HJ, Aimaretti G, Masel BE, Casanueva FF, Kelestimur F. Pituitary dysfunction after traumatic brain injury: a clinical and patho- physiological approach. Endocr Rev. 2015 Jun;36(3):305-42.
14. Tanriverdi F,Kelestimur F. Pituitary dysfunction following traumatic brain injury: clinical perspectives Neuropsychiatr Dis Treat. 2015; 11: 1835– 1843.
15. Tritos N, Yuen K, Kelly D. A neuroendocrine approach to patients with traumatic brain injury. EndocrPract. 2015;21: 823-831.

Se presenta el caso de un paciente con diagnóstico de novo de hipopituitarismo, cuya manifestación inicial fue con hiponatremia grave, secundaria a una insuficiencia suprarrenal central. Adicionalmente se documentó hipotiroidismo e hipogonadismo centrales. El paciente tuvo una lesión cerebral traumática cuatro décadas atrás y se encontraron en la resonancia nuclear de hipófisis hallazgos de hipoplasia hipofisaria y aracnoidocele selar, apoyando el diagnóstico de hipopituitarismo anterior. El caso resalta la presentación de hipopituitarismo diagnosticado décadas después de una lesión cerebral traumática. Se propone un enfoque para el diagnóstico, tratamiento y seguimiento de estos pacientes en nuestro medio.

Abstract
We present the case of a patient with previously undiagnosed hypopituitarism, it presents whose initial manifestation was a severe hyponatremia secondary to a central adrenal insufficiency, and besides this deficit he had central hypothyroidism and hypogonadism. In his past medical history he had a moderate traumatic brain injury almost 40 years before. The case highlights the presentation of hypopituitarism decades after a traumatic brain injury. An approach to the diagnosis, treatment and follow-up of these patients in our environment is proposed.

1. Coronado VG, Xu L, Basavaraju SV, et al. Surveillance for traumatic brain injury-related deaths--United States, 1997-2007. MMWR SurveillSumm. 2011; 60:1-32.
2. Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hy- pothalamus pituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA. 2007; 298: 1429-1438.
3. Agha A, Rogers B, Sherlock M, et al. Anterior pituitary dysfunction in survivors of traumatic brain injury. J ClinEndocrinolMetab. 2004; 89(10):4929–4936.
4. Aimaretti G, Ambrosio MR, Di Somma C, et al. Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J ClinEndocrinolMetab. 2005; 90(11):6085–6092.
5. Schneider HJ, Schneider M, Saller B, et al. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006; 154(2):259–265.
6. Tanriverdi F, Senyurek H, Unluhizarci K, Selcuklu A, Casanueva FF, Kelestimur F. High risk of hypopituitarism after traumatic brain injury: a prospective investigation of anterior pituitary function in the acute phase and 12 months after trauma. J ClinEndocrinolMetab. 2006;91(6): 2105–2111.
7. Tanriverdi F, Ulutabanca H, Unluhizarci K, Selcuklu A, Casanueva FF, Kele- stimur F. Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study. ClinEndocrinol (Oxf ). 2008; 68(4):573–579.
8. Tanriverdi F, De Bellis A, Ulutabanca H, et al. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity? J Neurotrauma. 2013; 30(16):1426–1433.
9. Lauzier F, Turgeon AF, Boutin A, et al. Clinical outcomes, predictors, and prevalence of anterior pituitary disorders following traumatic brain injury: a systematic review. CritCareMed. 2014;42:712-721.
10. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974; 2(7872):81–84.
11. Cryan E. Pituitary damage due to skull base fracture. DtschMedWochenschr. 1918; 44:1261.
12. Streetz-van der Werf C, Karges W, Blaum M, ..Kreitschmann-Andermahr. Addisonian Crisis after Missed Diagnosis of Posttraumatic Hypopituitarism. J Clin Med. 2015 May; 4(5): 965–969.
13. Tanriverdi F, Schneider HJ, Aimaretti G, Masel BE, Casanueva FF, Kelestimur F. Pituitary dysfunction after traumatic brain injury: a clinical and patho- physiological approach. Endocr Rev. 2015 Jun;36(3):305-42.
14. Tanriverdi F,Kelestimur F. Pituitary dysfunction following traumatic brain injury: clinical perspectives Neuropsychiatr Dis Treat. 2015; 11: 1835– 1843.
15. Tritos N, Yuen K, Kelly D. A neuroendocrine approach to patients with traumatic brain injury. EndocrPract. 2015;21: 823-831.

Se presenta el caso de un paciente con diagnóstico de novo de hipopituitarismo, cuya manifestación inicial fue con hiponatremia grave, secundaria a una insuficiencia suprarrenal central. Adicionalmente se documentó hipotiroidismo e hipogonadismo centrales. El paciente tuvo una lesión cerebral traumática cuatro décadas atrás y se encontraron en la resonancia nuclear de hipófisis hallazgos de hipoplasia hipofisaria y aracnoidocele selar, apoyando el diagnóstico de hipopituitarismo anterior. El caso resalta la presentación de hipopituitarismo diagnosticado décadas después de una lesión cerebral traumática. Se propone un enfoque para el diagnóstico, tratamiento y seguimiento de estos pacientes en nuestro medio.

Abstract
We present the case of a patient with previously undiagnosed hypopituitarism, it presents whose initial manifestation was a severe hyponatremia secondary to a central adrenal insufficiency, and besides this deficit he had central hypothyroidism and hypogonadism. In his past medical history he had a moderate traumatic brain injury almost 40 years before. The case highlights the presentation of hypopituitarism decades after a traumatic brain injury. An approach to the diagnosis, treatment and follow-up of these patients in our environment is proposed.

1. Coronado VG, Xu L, Basavaraju SV, et al. Surveillance for traumatic brain injury-related deaths--United States, 1997-2007. MMWR SurveillSumm. 2011; 60:1-32.
2. Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hy- pothalamus pituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA. 2007; 298: 1429-1438.
3. Agha A, Rogers B, Sherlock M, et al. Anterior pituitary dysfunction in survivors of traumatic brain injury. J ClinEndocrinolMetab. 2004; 89(10):4929–4936.
4. Aimaretti G, Ambrosio MR, Di Somma C, et al. Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J ClinEndocrinolMetab. 2005; 90(11):6085–6092.
5. Schneider HJ, Schneider M, Saller B, et al. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006; 154(2):259–265.
6. Tanriverdi F, Senyurek H, Unluhizarci K, Selcuklu A, Casanueva FF, Kelestimur F. High risk of hypopituitarism after traumatic brain injury: a prospective investigation of anterior pituitary function in the acute phase and 12 months after trauma. J ClinEndocrinolMetab. 2006;91(6): 2105–2111.
7. Tanriverdi F, Ulutabanca H, Unluhizarci K, Selcuklu A, Casanueva FF, Kele- stimur F. Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study. ClinEndocrinol (Oxf ). 2008; 68(4):573–579.
8. Tanriverdi F, De Bellis A, Ulutabanca H, et al. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity? J Neurotrauma. 2013; 30(16):1426–1433.
9. Lauzier F, Turgeon AF, Boutin A, et al. Clinical outcomes, predictors, and prevalence of anterior pituitary disorders following traumatic brain injury: a systematic review. CritCareMed. 2014;42:712-721.
10. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974; 2(7872):81–84.
11. Cryan E. Pituitary damage due to skull base fracture. DtschMedWochenschr. 1918; 44:1261.
12. Streetz-van der Werf C, Karges W, Blaum M, ..Kreitschmann-Andermahr. Addisonian Crisis after Missed Diagnosis of Posttraumatic Hypopituitarism. J Clin Med. 2015 May; 4(5): 965–969.
13. Tanriverdi F, Schneider HJ, Aimaretti G, Masel BE, Casanueva FF, Kelestimur F. Pituitary dysfunction after traumatic brain injury: a clinical and patho- physiological approach. Endocr Rev. 2015 Jun;36(3):305-42.
14. Tanriverdi F,Kelestimur F. Pituitary dysfunction following traumatic brain injury: clinical perspectives Neuropsychiatr Dis Treat. 2015; 11: 1835– 1843.
15. Tritos N, Yuen K, Kelly D. A neuroendocrine approach to patients with traumatic brain injury. EndocrPract. 2015;21: 823-831.

Prueba 

prueba

Los programas de posgrado en endocrinología en Colombia son relativamente recientes. El primero que se creó fue en la Universidad Nacional de Colombia en el año de 1982, seguido de otros en Bogotá en las universidades Javeriana, Militar, Rosario, FUCS, y los establecidos en Medellin en la Universidad de Antioquia, siendo el último el de la Pontificia Universidad Bolivariana. Además, se creó el de endocrinología pediátrica de la Universidad de Antioquia. Estos posgrados forman en general dos endocrinólogos por año. Antes de esa época, los que ejercíamos como endocrinólogos nos habíamos formado en escuelas fuera del país.

Endocrinología
medicina general

Los teratomas tiroideos son tumores raros, de características en la mayoría de los casos benignas y de presentación predominantemente en la infancia, su importancia radica en la confusión que causa sobre cuál es el tejido de origen del tumor, por lo que es de vital importancia sospecharlos para evitar demoras en el diagnóstico y manejos inadecuados. Presentamos el caso de un niño de 3 años con teratoma tiroideo benigno, la biopsia por aspirado con aguja fina fue sospechosa de teratoma. Se realizó biopsia por congelación y hemitiroidectomía izquierda, con diagnóstico de teratoma benigno constituido principalmente por elementos condroides. El paciente se encuentra vivo y sin recaídas seis años después del manejo quirúrgico.

Abstract
Thyroid teratomas are very rare tumors, most are benign and usually occur during childhood. The importance of these tumors relies in the common confusion generated by uncertainties about the origin of the lesion. An early diagnosis it is very important to avoid a late management. A case of thyroid benign teratoma in a 3-year-old boy is presented. The fine needle aspiration biopsy was suspicious for this disease. A frozen biopsy followed by left hemithyroidectomy was done and the diagnosis of benign teratoma was confirmed based on the findings of chondroid elements. The patient is alive without recurrence of the disease 6 years after the initial management.

1. Oak CY, Kim HK, Yoon TM, Lim SC, Park HB, Park HC, et al. Benign teratoma of the thyroid gland. Endocrinol Metab (Seoul). 2013;28(2):144-8.
2. Pérez-Mies B, Regojo Zapata RM, García-Fernández E, Serrano MN. Malignant teratoma of the thyroid in a pregnant woman. Ann Diagn Pathol.
2010;14(4):264-7.
3. Mohammad MA. Thyroid cervico-thoracic teratoma in a 14-month old child. Afr J Paediatr Surg. 2010;7(2):117-9.
4. Thompson LD, Rosai J, Heffess CS. Primary thyroid teratomas: a clinicopathologic study of 30 cases. Cancer. 2000;88(5):1149-58.
5. Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, et al. Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report. J Korean Med Sci. 2007;22(3):568-71.
6. Deb M, Mohanty S, Ananthamurthy A, Garg I, Das K. Atypical extragonadal germ cell tumors. J Indian Assoc Pediatr Surg. 2012;17(1):9-15.
7. LaRiviere CA, Waldhausen JH. Congenital cervical cysts, sinuses, and fistulae in pediatric surgery. Surg Clin North Am. 2012;92(3):583-97, viii.
8. Fan SQ, Liang QC, Jiang Y. Thyroid teratoma in an 11-month-old infant. Int J Surg. 2008;6(6):462-4.
9. Riedlinger WF, Lack EE, Robson CD, Rahbar R, Nosé V. Primary thyroid teratomas in children: a report of 11 cases with a proposal of criteria for their diagnosis. Am J Surg Pathol. 2005;29(5):700-6.
10. Ranaldi R, Morichetti D, Goteri G, Martino A. Immature teratoma of the mediastinum arising in ectopic thyroid tissue: a case report. Anal Quant Cytol Histol. 2009;31(4):233-8.
11. DeLellis R, Lloyd R, Heitz P, C E. World Health Organization Classification of Tumours. Pathology and Genetics of Tumors of Endocrine Organs. Lyon: IARCS Press; 2004.
12. Hazama K, Miyoshi S, Ohta M, Matsuda H. Matured mediastinal teratoma extending into the cervical neck of an adult. Interact Cardiovasc Thorac Surg. 2003;2(3):265-7.
13. Kimler SC, Muth WF. Primary malignant teratoma of the thyroid: case report and literature review of cervical teratomas in adults. Cancer. 1978;42(1):311-7.
14. Zhang YZ, Li WH, Zhu MJ, Li YH, Gao Y. An unusual mature thyroid teratoma on CT and 99Tcm scintigraphy imaging in a child. Pediatr Radiol.
2010;40(11):1831-3.
15. Al-Sobhi S, Bazarbashi S, Al-Jiffry B, Akhtar M, Ingemansson S. Immature teratoma of the thyroid gland: A case report and review of the literature. Ann Saudi Med. 1998;18(3):254-6.
16. Nishihara E, Miyauchi A, Hirokawa M, Kudo T, Ohye H, Ito M, et al. Benign thyroid teratomas manifest painful cystic and solid composite nodules: three case reports and a review of the literature. Endocrine. 2006;30(2):231-6.
17. Martins T, Carrilho F, Gomes L, Mesquita C, Martins MJ, Carvalheiro M. Malignant teratoma of the thyroid: case report. Thyroid. 2006;16(12):1311-3.
18. Tsang RW, Brierley JD, Asa SL, Sturgeon JF. Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery. Thyroid. 2003;13(4):401-4.
19. Majhi U. Primary malignant teratoma of the thyroid in a child with nodal metastases. Indian J Pathol Microbiol. 2009;52(2):234-6.
20. Craver RD, Lipscomb JT, Suskind D, Velez MC. Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components. Ann Diagn Pathol. 2001;5(5):285-92.

Los teratomas tiroideos son tumores raros, de características en la mayoría de los casos benignas y de presentación predominantemente en la infancia, su importancia radica en la confusión que causa sobre cuál es el tejido de origen del tumor, por lo que es de vital importancia sospecharlos para evitar demoras en el diagnóstico y manejos inadecuados. Presentamos el caso de un niño de 3 años con teratoma tiroideo benigno, la biopsia por aspirado con aguja fina fue sospechosa de teratoma. Se realizó biopsia por congelación y hemitiroidectomía izquierda, con diagnóstico de teratoma benigno constituido principalmente por elementos condroides. El paciente se encuentra vivo y sin recaídas seis años después del manejo quirúrgico.

Abstract
Thyroid teratomas are very rare tumors, most are benign and usually occur during childhood. The importance of these tumors relies in the common confusion generated by uncertainties about the origin of the lesion. An early diagnosis it is very important to avoid a late management. A case of thyroid benign teratoma in a 3-year-old boy is presented. The fine needle aspiration biopsy was suspicious for this disease. A frozen biopsy followed by left hemithyroidectomy was done and the diagnosis of benign teratoma was confirmed based on the findings of chondroid elements. The patient is alive without recurrence of the disease 6 years after the initial management.

1. Oak CY, Kim HK, Yoon TM, Lim SC, Park HB, Park HC, et al. Benign teratoma of the thyroid gland. Endocrinol Metab (Seoul). 2013;28(2):144-8.
2. Pérez-Mies B, Regojo Zapata RM, García-Fernández E, Serrano MN. Malignant teratoma of the thyroid in a pregnant woman. Ann Diagn Pathol.
2010;14(4):264-7.
3. Mohammad MA. Thyroid cervico-thoracic teratoma in a 14-month old child. Afr J Paediatr Surg. 2010;7(2):117-9.
4. Thompson LD, Rosai J, Heffess CS. Primary thyroid teratomas: a clinicopathologic study of 30 cases. Cancer. 2000;88(5):1149-58.
5. Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, et al. Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report. J Korean Med Sci. 2007;22(3):568-71.
6. Deb M, Mohanty S, Ananthamurthy A, Garg I, Das K. Atypical extragonadal germ cell tumors. J Indian Assoc Pediatr Surg. 2012;17(1):9-15.
7. LaRiviere CA, Waldhausen JH. Congenital cervical cysts, sinuses, and fistulae in pediatric surgery. Surg Clin North Am. 2012;92(3):583-97, viii.
8. Fan SQ, Liang QC, Jiang Y. Thyroid teratoma in an 11-month-old infant. Int J Surg. 2008;6(6):462-4.
9. Riedlinger WF, Lack EE, Robson CD, Rahbar R, Nosé V. Primary thyroid teratomas in children: a report of 11 cases with a proposal of criteria for their diagnosis. Am J Surg Pathol. 2005;29(5):700-6.
10. Ranaldi R, Morichetti D, Goteri G, Martino A. Immature teratoma of the mediastinum arising in ectopic thyroid tissue: a case report. Anal Quant Cytol Histol. 2009;31(4):233-8.
11. DeLellis R, Lloyd R, Heitz P, C E. World Health Organization Classification of Tumours. Pathology and Genetics of Tumors of Endocrine Organs. Lyon: IARCS Press; 2004.
12. Hazama K, Miyoshi S, Ohta M, Matsuda H. Matured mediastinal teratoma extending into the cervical neck of an adult. Interact Cardiovasc Thorac Surg. 2003;2(3):265-7.
13. Kimler SC, Muth WF. Primary malignant teratoma of the thyroid: case report and literature review of cervical teratomas in adults. Cancer. 1978;42(1):311-7.
14. Zhang YZ, Li WH, Zhu MJ, Li YH, Gao Y. An unusual mature thyroid teratoma on CT and 99Tcm scintigraphy imaging in a child. Pediatr Radiol.
2010;40(11):1831-3.
15. Al-Sobhi S, Bazarbashi S, Al-Jiffry B, Akhtar M, Ingemansson S. Immature teratoma of the thyroid gland: A case report and review of the literature. Ann Saudi Med. 1998;18(3):254-6.
16. Nishihara E, Miyauchi A, Hirokawa M, Kudo T, Ohye H, Ito M, et al. Benign thyroid teratomas manifest painful cystic and solid composite nodules: three case reports and a review of the literature. Endocrine. 2006;30(2):231-6.
17. Martins T, Carrilho F, Gomes L, Mesquita C, Martins MJ, Carvalheiro M. Malignant teratoma of the thyroid: case report. Thyroid. 2006;16(12):1311-3.
18. Tsang RW, Brierley JD, Asa SL, Sturgeon JF. Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery. Thyroid. 2003;13(4):401-4.
19. Majhi U. Primary malignant teratoma of the thyroid in a child with nodal metastases. Indian J Pathol Microbiol. 2009;52(2):234-6.
20. Craver RD, Lipscomb JT, Suskind D, Velez MC. Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components. Ann Diagn Pathol. 2001;5(5):285-92.

Los teratomas tiroideos son tumores raros, de características en la mayoría de los casos benignas y de presentación predominantemente en la infancia, su importancia radica en la confusión que causa sobre cuál es el tejido de origen del tumor, por lo que es de vital importancia sospecharlos para evitar demoras en el diagnóstico y manejos inadecuados. Presentamos el caso de un niño de 3 años con teratoma tiroideo benigno, la biopsia por aspirado con aguja fina fue sospechosa de teratoma. Se realizó biopsia por congelación y hemitiroidectomía izquierda, con diagnóstico de teratoma benigno constituido principalmente por elementos condroides. El paciente se encuentra vivo y sin recaídas seis años después del manejo quirúrgico.

Abstract
Thyroid teratomas are very rare tumors, most are benign and usually occur during childhood. The importance of these tumors relies in the common confusion generated by uncertainties about the origin of the lesion. An early diagnosis it is very important to avoid a late management. A case of thyroid benign teratoma in a 3-year-old boy is presented. The fine needle aspiration biopsy was suspicious for this disease. A frozen biopsy followed by left hemithyroidectomy was done and the diagnosis of benign teratoma was confirmed based on the findings of chondroid elements. The patient is alive without recurrence of the disease 6 years after the initial management.

1. Oak CY, Kim HK, Yoon TM, Lim SC, Park HB, Park HC, et al. Benign teratoma of the thyroid gland. Endocrinol Metab (Seoul). 2013;28(2):144-8.
2. Pérez-Mies B, Regojo Zapata RM, García-Fernández E, Serrano MN. Malignant teratoma of the thyroid in a pregnant woman. Ann Diagn Pathol.
2010;14(4):264-7.
3. Mohammad MA. Thyroid cervico-thoracic teratoma in a 14-month old child. Afr J Paediatr Surg. 2010;7(2):117-9.
4. Thompson LD, Rosai J, Heffess CS. Primary thyroid teratomas: a clinicopathologic study of 30 cases. Cancer. 2000;88(5):1149-58.
5. Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, et al. Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report. J Korean Med Sci. 2007;22(3):568-71.
6. Deb M, Mohanty S, Ananthamurthy A, Garg I, Das K. Atypical extragonadal germ cell tumors. J Indian Assoc Pediatr Surg. 2012;17(1):9-15.
7. LaRiviere CA, Waldhausen JH. Congenital cervical cysts, sinuses, and fistulae in pediatric surgery. Surg Clin North Am. 2012;92(3):583-97, viii.
8. Fan SQ, Liang QC, Jiang Y. Thyroid teratoma in an 11-month-old infant. Int J Surg. 2008;6(6):462-4.
9. Riedlinger WF, Lack EE, Robson CD, Rahbar R, Nosé V. Primary thyroid teratomas in children: a report of 11 cases with a proposal of criteria for their diagnosis. Am J Surg Pathol. 2005;29(5):700-6.
10. Ranaldi R, Morichetti D, Goteri G, Martino A. Immature teratoma of the mediastinum arising in ectopic thyroid tissue: a case report. Anal Quant Cytol Histol. 2009;31(4):233-8.
11. DeLellis R, Lloyd R, Heitz P, C E. World Health Organization Classification of Tumours. Pathology and Genetics of Tumors of Endocrine Organs. Lyon: IARCS Press; 2004.
12. Hazama K, Miyoshi S, Ohta M, Matsuda H. Matured mediastinal teratoma extending into the cervical neck of an adult. Interact Cardiovasc Thorac Surg. 2003;2(3):265-7.
13. Kimler SC, Muth WF. Primary malignant teratoma of the thyroid: case report and literature review of cervical teratomas in adults. Cancer. 1978;42(1):311-7.
14. Zhang YZ, Li WH, Zhu MJ, Li YH, Gao Y. An unusual mature thyroid teratoma on CT and 99Tcm scintigraphy imaging in a child. Pediatr Radiol.
2010;40(11):1831-3.
15. Al-Sobhi S, Bazarbashi S, Al-Jiffry B, Akhtar M, Ingemansson S. Immature teratoma of the thyroid gland: A case report and review of the literature. Ann Saudi Med. 1998;18(3):254-6.
16. Nishihara E, Miyauchi A, Hirokawa M, Kudo T, Ohye H, Ito M, et al. Benign thyroid teratomas manifest painful cystic and solid composite nodules: three case reports and a review of the literature. Endocrine. 2006;30(2):231-6.
17. Martins T, Carrilho F, Gomes L, Mesquita C, Martins MJ, Carvalheiro M. Malignant teratoma of the thyroid: case report. Thyroid. 2006;16(12):1311-3.
18. Tsang RW, Brierley JD, Asa SL, Sturgeon JF. Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery. Thyroid. 2003;13(4):401-4.
19. Majhi U. Primary malignant teratoma of the thyroid in a child with nodal metastases. Indian J Pathol Microbiol. 2009;52(2):234-6.
20. Craver RD, Lipscomb JT, Suskind D, Velez MC. Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components. Ann Diagn Pathol. 2001;5(5):285-92.

Los teratomas tiroideos son tumores raros, de características en la mayoría de los casos benignas y de presentación predominantemente en la infancia, su importancia radica en la confusión que causa sobre cuál es el tejido de origen del tumor, por lo que es de vital importancia sospecharlos para evitar demoras en el diagnóstico y manejos inadecuados. Presentamos el caso de un niño de 3 años con teratoma tiroideo benigno, la biopsia por aspirado con aguja fina fue sospechosa de teratoma. Se realizó biopsia por congelación y hemitiroidectomía izquierda, con diagnóstico de teratoma benigno constituido principalmente por elementos condroides. El paciente se encuentra vivo y sin recaídas seis años después del manejo quirúrgico.

Abstract
Thyroid teratomas are very rare tumors, most are benign and usually occur during childhood. The importance of these tumors relies in the common confusion generated by uncertainties about the origin of the lesion. An early diagnosis it is very important to avoid a late management. A case of thyroid benign teratoma in a 3-year-old boy is presented. The fine needle aspiration biopsy was suspicious for this disease. A frozen biopsy followed by left hemithyroidectomy was done and the diagnosis of benign teratoma was confirmed based on the findings of chondroid elements. The patient is alive without recurrence of the disease 6 years after the initial management.

1. Oak CY, Kim HK, Yoon TM, Lim SC, Park HB, Park HC, et al. Benign teratoma of the thyroid gland. Endocrinol Metab (Seoul). 2013;28(2):144-8.
2. Pérez-Mies B, Regojo Zapata RM, García-Fernández E, Serrano MN. Malignant teratoma of the thyroid in a pregnant woman. Ann Diagn Pathol.
2010;14(4):264-7.
3. Mohammad MA. Thyroid cervico-thoracic teratoma in a 14-month old child. Afr J Paediatr Surg. 2010;7(2):117-9.
4. Thompson LD, Rosai J, Heffess CS. Primary thyroid teratomas: a clinicopathologic study of 30 cases. Cancer. 2000;88(5):1149-58.
5. Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, et al. Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report. J Korean Med Sci. 2007;22(3):568-71.
6. Deb M, Mohanty S, Ananthamurthy A, Garg I, Das K. Atypical extragonadal germ cell tumors. J Indian Assoc Pediatr Surg. 2012;17(1):9-15.
7. LaRiviere CA, Waldhausen JH. Congenital cervical cysts, sinuses, and fistulae in pediatric surgery. Surg Clin North Am. 2012;92(3):583-97, viii.
8. Fan SQ, Liang QC, Jiang Y. Thyroid teratoma in an 11-month-old infant. Int J Surg. 2008;6(6):462-4.
9. Riedlinger WF, Lack EE, Robson CD, Rahbar R, Nosé V. Primary thyroid teratomas in children: a report of 11 cases with a proposal of criteria for their diagnosis. Am J Surg Pathol. 2005;29(5):700-6.
10. Ranaldi R, Morichetti D, Goteri G, Martino A. Immature teratoma of the mediastinum arising in ectopic thyroid tissue: a case report. Anal Quant Cytol Histol. 2009;31(4):233-8.
11. DeLellis R, Lloyd R, Heitz P, C E. World Health Organization Classification of Tumours. Pathology and Genetics of Tumors of Endocrine Organs. Lyon: IARCS Press; 2004.
12. Hazama K, Miyoshi S, Ohta M, Matsuda H. Matured mediastinal teratoma extending into the cervical neck of an adult. Interact Cardiovasc Thorac Surg. 2003;2(3):265-7.
13. Kimler SC, Muth WF. Primary malignant teratoma of the thyroid: case report and literature review of cervical teratomas in adults. Cancer. 1978;42(1):311-7.
14. Zhang YZ, Li WH, Zhu MJ, Li YH, Gao Y. An unusual mature thyroid teratoma on CT and 99Tcm scintigraphy imaging in a child. Pediatr Radiol.
2010;40(11):1831-3.
15. Al-Sobhi S, Bazarbashi S, Al-Jiffry B, Akhtar M, Ingemansson S. Immature teratoma of the thyroid gland: A case report and review of the literature. Ann Saudi Med. 1998;18(3):254-6.
16. Nishihara E, Miyauchi A, Hirokawa M, Kudo T, Ohye H, Ito M, et al. Benign thyroid teratomas manifest painful cystic and solid composite nodules: three case reports and a review of the literature. Endocrine. 2006;30(2):231-6.
17. Martins T, Carrilho F, Gomes L, Mesquita C, Martins MJ, Carvalheiro M. Malignant teratoma of the thyroid: case report. Thyroid. 2006;16(12):1311-3.
18. Tsang RW, Brierley JD, Asa SL, Sturgeon JF. Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery. Thyroid. 2003;13(4):401-4.
19. Majhi U. Primary malignant teratoma of the thyroid in a child with nodal metastases. Indian J Pathol Microbiol. 2009;52(2):234-6.
20. Craver RD, Lipscomb JT, Suskind D, Velez MC. Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components. Ann Diagn Pathol. 2001;5(5):285-92.