Abstract
Histologically distinct tumors that coexist in an organ without any histological admixture at their interface are denominated collision tumors. We report 3 cases of colliding mature cystic teratoma with mucinous cystadenoma and a case of mature cystic teratoma colliding with benign Brenner tumor in the ovary. We also provide a literature review based on 35 previously published ovarian collision cases. Ovarian tumors from all classes, benign, borderline and malignant lesions may collide. Both our case series and the literature review indicate that ovarian tumor collisions tend to be clinically and ultrasonographically/radiologically unrecognized. The awareness among surgeons, radiologists and pathologists of this rare phenomenon and histological recognition are crucial in order to offer adequate treatment to patients. There is a need to identify novel and more specific imaging clues pointing towards collision tumors in the ovary.
Highlights
Collision tumors are histologically distinct neoplasms that coexist in the same organ without any histological intermixing [1]
We report 3 cases of colliding mature cystic teratoma with mucinous cystadenoma and a case of mature cystic teratoma colliding with benign Brenner tumor in the ovary
We report and discuss the tumors colliding in the ovary that we witnessed in 4 patients and, provide a review based on 35 other cases identified by PubMed search for original articles electronically listed until October 2018 and by checking their respective references
Summary
Collision tumors are histologically distinct neoplasms that coexist in the same organ without any histological intermixing [1]. Abdominal and transvaginal ultrasonography revealed a cystic multilocular formation (2 locules), apparently originating from the right ovary and measuring 141 x 126 x 130 mm, with regular external and internal borders, “ground glass” content and Color Doppler score 1, i.e. no vascularization with Color Doppler (Figure 1A-C). A 42-year-old nulliparous, on the course of her gynecological follow-up due to uterine fibromas, performed a transvaginal ultrasound, which identified a cystic multilocular formation (4 locules), apparently originating from the parenchyma of the right ovary and measuring 54 x 54 x 52 mm, with regular external and internal borders, mixed content and Color Doppler score 1 (Figure 3). Histopathological examination established the diagnosis of colliding ovarian mature cystic teratoma (5 cm) and benign Brenner tumor (5 mm) This is the first reported case of a collision tumor of the ovary associated to a Brenner tumor, which was only postoperatively recognized.
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