Giant Immature Teratoma of the Ovary with Gliomatosis Peritonei in a 15-Year-Old Girl: A Case Report and Literature Review

Abstract

Background: Ovarian immature teratoma (IMT) with gliomatosis peritonei (GP) is a rare condition. IMT of the ovary represents 1% of all ovarian cancers. The majority of these are 5–31 cm in diameter. This article describes a case of a giant IMT (22.8 kg) in a girl with GP, which is an extremely rare presentation. Case: A 15-year-old girl presented with abdominal distension and pain of insidious onset. On clinical examination, a huge abdominal mass was found. Contrast-enhanced computed tomography (CECT) showed a large solid cystic abdominopelvic mass with multiple areas of calcified foci and fat density, likely to be malignant, and of ovarian origin. Serum alpha-fetoprotein (AFP), CA-125, and CA-15.3 were 1805 international units (IU)/mL, 1475 IU/mL, and 69.6 IU/mL, respectively. Left salpingo-oophorectomy with omentectomy was performed and samples were sent for histopathologic examination. Results: Microscopically, the ovary revealed IMT grade I, and the omentum showed an implant of mature glial tissue (GP). The patient had no complications at her 6-month follow-up. Conclusions: This is the first reported case of IMT of such massive size, with GP. This case demonstrates that IMT can grow to an enormous size (weighing >20 kg) and should be considered whenever gross abdominal distension is seen in young women. With peritoneal implants suspected to be of a teratomatous nature, thorough and extensive sampling is essential to exclude the presence of immature elements that may imply a poor prognosis and require aggressive therapy. (J GYNECOL SURG 30:222)