Abstract
This study aimed to investigate an unusual case of immature ovarian teratoma with onset of mature glial cells implanted on the contralateral ovary, a challenge in the diagnosis of the second ovarian tumor. We report the case of a 31- yr-old woman, who developed at the age of 16 an immature teratoma in the right ovary that was surgically removed. Six years later mature glial implants were present on the left ovary and six months later at the level of peritoneum that relapsed after other six months. The patient suffered three surgical resections after the initial one. Paraffin sections and immunohistochemical examinations using antibodies against glial and neuronal antigens were performed. In the teratoma, the neuroectodermal tissue expressed Glial fibrillary acidic protein (GFAP), S100 protein, Epithelial membrane antigen (EMA) and Cytokeratin 34 beta E12 (Ck34beta E12), wheares the implants expressed only GFAP and S100 protein. The immature teratoma is the rarest type of ovarian teratomas. Gliomatosis peritonei is an exceptional finding, expecially with onset on the contralaterally ovary. The implant of the mature glial cells has a high risk of relapse, as seen in our case, thus close follow-up of the patient is necessary.
Highlights
The ovarian teratomas are represented by mature, immature, and monodermal types
The immature teratoma (IT) is the currently preferred term for the malignant ovarian teratoma composed of a mixture of embryonal and adult tissues derived from all three germ layers
The difficult evolution comes from the association with glial implants, as seen in our case at the contralateral ovary, and the peritoneal level
Summary
The ovarian teratomas are represented by mature, immature, and monodermal (as struma ovarii, carcinoid tumors, neural tumors) types. They are considered the most common germ cells neoplasm. Teratomas comprise a number of histologic types of tumors, all of which contain mature or immature tissues of germ cell (pluripotential) origin. The immature teratoma (IT) is the currently preferred term for the malignant ovarian teratoma composed of a mixture of embryonal and adult tissues derived from all three germ layers. According to WHO, IT is defined as a teratoma containing a variable amount of immature embryonal type (generally) neuroectodermal tissue [1]. Regarding the aggressive profile of the glial cells from an immature teratoma, another
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