Abstract
Objective:To examine cases of mature cystic teratoma (MCT) that were diagnosed and treated in our clinic regarding their association with fertility, and to detect the rate of malignant degeneration and the types of malignancies.Material and Methods:Patients who underwent surgery due to adnexal mass between April 2012 and August 2017 and were diagnosed as having MCT were retrospectively examined. The mean age of the 80 patients who met the inclusion criteria was 30.60±10.5 years. Nine had infertility according to hospital records. Sixty-seven percent of these (n=6) had accompanying endometriosis and MCT was bilateral in 55.5% (n=5). Malignant degeneration was present in 6.25% (n=5), all were monodermal tumors. Malignant degeneration was more common among patients with larger diameter adnexal masses (9.1±2.9 cm) and in those of postmenopausal age. Tumor markers were within the normal range for patients who developed malignancy. Malignant degeneration was not present among infertile patients with endometriosis.Results:Although MCTs do not seem to negatively affect the ovarian reserve, infertility is prominent in patients with concurrent endometriosis. During assessment, concurrent endometriosis should be considered. Imaging findings, large adnexal masses, and postmenopausal period are important for the assessment of MCT concerning malignant degeneration. It should not be overlooked because tumor markers may be normal.Conclusion:MCTs can be present concurrent with endometriomas. In such cases, infertility is more distinct. In MCT malignant degeneration, mass diameter, complex mass internal structure, and postmenopausal status are important factors.
Highlights
Mature cystic teratomas (MCTs) are the most common benign germ cell tumors during the adolescent and reproductive period
Concerning the evaluation of MCT, which is observed during the reproductive period and in a wide spectrum ranging from a simple ovarian cyst to a complex adnexal mass, tumor markers are laboratory tests that are frequently used
Neither CA19-9 nor CA125 is diagnostic for MCT, they are frequently used in the evaluation of adnexal masses of the reproductive period
Summary
Mature cystic teratomas (MCTs) are the most common benign germ cell tumors during the adolescent and reproductive period. They may include tissues differentiated from each of the three germ layers (ectoderm, mesoderm and endoderm). They are seen predominantly in the reproductive period; they are seen in childhood and the postmenopausal period. Complications occur in 20% of patients with MCT [2] These complications include torsion, rupture, infection, and malignant transformation. Malignant transformation is quite rare and predominantly detected in the postmenopausal period, whereas other complications may cause undesirable reproductive outcomes concerning the age period when they occur. Our purpose in this article was to examine the cases of MCT that were diagnosed and treated in our clinic regarding the effects on fertility, rates of malignant transformation, and clinicopathologic features
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