Abstract
BackgroundComposing of less than 1% of all ovarian cancers, immature teratoma is a malignancy that mainly affects the young, and they present with advanced disease. The treatment of immature teratoma is conservative primary surgery usually involving unilateral salpingo-oophorectomy followed by combination chemotherapy.Case presentationHere we present a case of a 68 year old woman with bilateral ovarian teratoma complicated with carcinosarcoma. The patient was diagnosed as FIGO stage IIIC. She underwent neoadjuvant chemotherapy and interval cytoreduction followed by optimal cytoreduction. The post operative management strategies and gynaecological follow up studies revealed no evidence of regional or distant metastasis.ConclusionThus the choice of initial treatment should be decided in a selective fashion depending on various prognostic factors in order to increase the survival of the patients.
Highlights
Conclusion: the choice of initial treatment should be decided in a selective fashion depending on various prognostic factors in order to increase the survival of the patients
The foundations of treatment for immature teratoma have been steadfast throughout decades: conservative primary surgery usually involving unilateral salpingo-oophorectomy followed by combination chemotherapy
Age alone has been shown to be an independent predictor of survival in those with ovarian cancer [8]
Summary
The term teratoma was derived from the Greek root teratos which means Monster [1]. Teratomas are the most common germ cell tumours (GCTs) composing of two or more germ layers (ectoderm, mesoderm or endoderm), derived from a pluripotent malignant precursor cell. Case presentation A 68 year old lady was referred to oncology outpatients in January 2010, with a month history of severe abdominal pain Her past clinical history included no tubal ligation or hormone replacement therapy. Histopathological examination confirmed bilateral teratoma complicated with carcinosarcoma (Figure 1B) with heterogeneous rhabdoid elements (Figure 1C) Microscopically the left ovarian tumour displayed variable size cyst lined by multilayered malignant squamous cells (Figure 1D) with rhabdoid spindle cells, cytoplasmic clearing, mature atypical cartilage (Figure 1E), malignant tubules, small round cells with rosettes, bone marrow and neural bundle. The patient recovered well from surgery and was referred for oncological follow up and post- surgical chemotherapy (same regime as NAC) Given her age and performance status a surveillance approach was taken with regular clinical examinations, serial tumour markers and routine CT scans. The follow up studies showed no evidence of recurrence, regional or distant metastasis
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