Cystic Teratoma Of Ovary Research Articles

Diagnosis of a large cystic teratoma of accessory ovary complicated with torsion by ultrasound: A case report.

An accessory ovary complicated by cystic teratoma and torsion is extremely rare and requires prompt diagnosis and surgical treatment. However, evidence for effective preoperative imaging diagnosis has barely been reported. Our study presented a case in which preoperative ultrasound reasonably suspected ovarian tumor torsion and an accessory ovary, and laparoscopic surgery was strategically performed. An 18-year-old girl had persistent pain in the lower right abdomen for over 7 hours accompanied by nausea and vomiting, and she had a 14.1 × 10.1 × 9.0 cm hypo-echoic cystic lesion containing a 6.4 × 4.9 × 3.0 cm solid component accompanied by the whirlpool sign on the right side of the pelvis. Additionally, a hyper-echoic ovary with a size of 2.5 × 1.4 cm and a normal ovary appearance of 2.4 × 0.8 cm were detected on the right side of the adnexal area by ultrasound. The cystic lesion was a large accessory ovarian cystic teratoma, complicated by torsion. The hyperechoic ovary appears as accessory ovarian stromal edema and the normal ovary appearance is eutopic. Single-port laparoscopic resection of the ovarian lesion, release of the ovarian torsion, and oophoroplasty were performed. Postoperative recovery was unremarkable. Antral follicles were detected in both eutopic and accessory ovaries by ultrasound 20 days and 4 months after surgery. In addition, during the second postoperative ultrasound follow-up, the accessory ovary showed no difference in echo compared to the normal ovary, except for a slightly larger volume. Clinical manifestations of accessory ovarian tumors combined with torsion are similar to those of eutopic ovarian torsion, and timely surgery is required.

Papillary thyroid carcinoma arising within a mature ovarian cystic teratoma: a case report

Papillary thyroid carcinoma arising within a mature ovarian cystic teratoma: a case report

Squamous cell carcinoma of the ovary arising from a mature cystic teratoma associated with hypercalcaemia

We present a rare case of a 40-year-old nulliparous lady, with no past medical or surgical history, who was diagnosed with metastatic squamous cell carcinoma of the right ovary that originated from a mature cystic ovarian teratoma. Our patient underwent debulking total abdominal hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy followed by postoperative carboplatin and paclitaxel chemotherapy. Rapid disease progression ensued, complicated by severe parathyroid hormone-related protein-induced hypercalcaemia resistant to medical therapy. The patient was treated in a palliative manner and died five months after her diagnosis.

Autoimmune Hemolytic Anemia Associated with Mature Ovarian Cystic Teratoma Containing Monoclonal Immunoglobulin G: A Case Report and Review of Literature

Background. Autoimmune hemolytic anemia (AIHA) associated with solid tumors such as mature cystic teratomas is rare and poorly understood. Here, we report a successfully treated case of secondary AIHA in a mature cystic teratoma containing antibodies against red blood cells. Case description. A 22-year-old woman was referred to our hospital with progressive anemia. Laboratory findings revealed hemolysis with a positive direct and indirect antiglobulin test. Imaging studies identified a left ovarian mass, suspected to be a mature cystic teratoma, which was later confirmed by histopathology after laparoscopic oophorocystectomy. The patient was treated with prednisolone, resulting in improved anemia. To examine the relationship between the tumor and AIHA, an indirect antiglobulin test was performed on the tumor contents. Stronger aggregations were observed at any concentration diluted by 10 times from 10 to 10,000 times of the tumor contents compared to the patient’s serum. Additionally, immunofixation electrophoresis of the tumor contents revealed the presence of monoclonal immunoglobulin G-κ. Conclusion. The presence of monoclonal IgG-κ in the tumor suggests intratumoral antibody production as a possible mechanism. Further research is necessary to elucidate the pathogenic relationship between such tumors and AIHA. The report also highlights the importance of considering secondary AIHA in patients with unexplained anemia and solid tumors.

MR diagnosis of SCC arising within ovarian cystic teratomas: analysis of mural nodule characteristics

PurposeThis study aims to evaluate and identify magnetic resonance (MR) findings of mural nodules to detect squamous cell carcinoma arising from ovarian mature cystic teratoma (SCC-MCT).MethodsThis retrospective study examined 135 patients (SCC-MCTs, n = 12; and benign MCTs, n = 123) with confirmed diagnoses across five different institutions between January 2010 and June 2022. Preoperative MR images for each patient were independently assessed by two experienced radiologists and analyzed following previously reported findings (PRFs): age, tumor size, presence of mural nodules, size of mural nodule, and the angle between mural nodule and cyst wall (acute or obtuse). Furthermore, this study evaluated four mural nodule features—diffusion restriction, fat intensity, Palm tree appearance, and calcification—and the presence of transmural extension.ResultsThere were significant differences between the SCC-MCT and benign MCT groups in terms of all PRFs and all mural nodule findings (p < 0.01). Among the PRFs, “tumor size” demonstrated the highest diagnostic performance, with a sensitivity of 83.3% and a specificity of 88.6%. A combination of the aforementioned four mural nodule findings showed a sensitivity and specificity of 83.3% and 97.6%, respectively, for the diagnosis of SCC-MCT. Regarding diagnosis based on a combination of four mural nodule findings, the specificity was significantly higher than the diagnosis based on tumor size (p = 0.021). Based on these mural nodule findings, three SCC-MCT patients without transmural invasion could be diagnosed.ConclusionMural nodule MR findings had a higher diagnostic performance than PRFs for SCC-MCT and can potentially allow early detection of SCC-MCTs.Graphical abstract

P-80 A rare case of papillary thyroid carcinoma within a mature cystic ovarian teratoma

Abstract Introduction Mature teratoma is the most common ovarian germ cell neoplasm. Teratomas can contain various tissue groups, such as skin, hair, and thyroid tissue. Teratomas in which more than 50% of the tumor tissue is composed of thyroid tissue are defined as Struma Ovarii. Malignant transformation of Struma Ovarii has been reported at a rate of 0.5-5%, most commonly presenting as thyroid papillary and follicular carcinomas. Metastasis is observed in 5% of malignant cases. Clinical Case A 45-year-old female with a history of Hashimoto's thyroiditis presented in July 2022 with complaints of abdominal pain. Abdominal contrast-enhanced tomography revealed a hypo dense lesion 5 cm in diameter the right adnexal region, and in the magnetic resonance images 5 cm mass was observed in the right adnexal area. Serum Ca-125 level was 212 U/mL (0-35) at admission. Due to high suspicion of malignancy ovarian cystectomy has been performed. Pathology of specimen revealed a 0.5 cm thyroid papillary carcinoma with follicular variant in infiltrative features but no lymphovascular invasion. Subsequently, the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy due to the unverifiable risk of malignancy. Pathological examination showed no malignancy. The patient presented to our clinic in June 2023, neck ultrasound revealed a 13×12 mm heterogeneous hypoechoic thyroid nodule with thick and thin septations and occasional internal vascularity in the left thyroid lobe. Fine-needle aspiration biopsy of the thyroid was performed, and cytology results were reported as benign. The serum thyroglobulin level was found to be 83.7 ng/mL. In terms of the treatment plan, BRAF and K-RAS gene analysis was planned based on the pathology preparations. The patient will be evaluated for total thyroidectomy/radioactive iodine ablation/no treatment based on the results. Follow-up is ongoing, and test results are awaited. Conclusion Malignant transformation of mature teratoma is rare and thyroid papillary carcinoma being the most frequently seen malignancy. There is no consensus on treatment and follow-up, but it is recommended to classify patients based on their risks and consider options such as total thyroidectomy/radioactive iodine ablation/no treatment for follow-up. Literature suggests the need for guidelines and treatment algorithms for the management of malignant struma ovarii. Some authors recommend whole-body iodine scanning in determining risk and follow-up, asserting that iodine-based treatment and follow-up methods would be meaningless without thyroidectomy. There is also an approach advocating for only salpingo-oophorectomy in low-risk patients and subsequent follow-up. Thus, a consensus on guidelines and treatment algorithms for malignant struma ovarii is needed.

A rare complication of brucellosis: Superinfection of a mature ovarian cystic teratoma.

A rare complication of brucellosis: Superinfection of a mature ovarian cystic teratoma.

SAT588 Cushing’s Syndrome Due To Ectopic ACTH Secretion From Ovarian Teratomas

Abstract Disclosure: Y. Kang: None. M.S. Gildenberg: None. B.J. Quade: None. R.A. Blair: None. Background: Approximately 9-18% of Cushing’s syndrome (CS) cases are secondary to ectopic ACTH secretion, most commonly from sources in the lung or mediastinum. However, ACTH-producing tumors are rarely found in distant organs, occasionally making the localization and management challenging. Clinical Case: A 32-year-old woman with class 3 obesity, hidradenitis suppurativa, anxiety, and depression experienced atraumatic pelvic and sacral fractures. DXA scan result showed Z-scores of -3.1 in the lumbar spine, -2.6 in the femur neck, and -0.5 in the total hip. She reported a steady weight-gain of 250 lbs over 7 years despite lifestyle modifications and liraglutide. On examination, she had a round face with plethora, acne, violaceous abdominal striae, and dorsocervical fat pad. Laboratory findings revealed elevated midnight salivary cortisol levels of 453 and 424 ng/dL (n: &amp;lt;100 ng/dL), elevated 24-hour urine cortisol levels of 254 and 741 (n: 3.5-45 mcg), and an abnormal 1 mg dexamethasone suppression test (DST) result at 15.1 ug/dL. AM plasma ACTH and cortisol levels were 190 pg/mL and 18.5 ug/dL, suggesting ACTH-dependent hypercortisolism. The plasma cortisol level after an 8 mg DST was unsuppressed at 13.1 ug/dL with a dexamethasone level of 3,380 ng/dL (n: &amp;gt;800 ng/dL). Abdominal CT and MRI scans showed large bilateral adnexal masses measuring up to 13.7 cm on the left and 9.3 cm on the right, with heterogeneous solid and cystic components, consistent with mature cystic ovarian teratomas. DOTATE-PET scan did not show any areas of increased uptake. The patient underwent a laparoscopic right cystectomy and left oophorectomy, with immediate drop in cortisol (1.6 ug/dL) and signs of adrenal insufficiency post-operatively, requiring hydrocortisone replacement. After holding hydrocortisone for 24 hours prior to laboratory assessment one week post-operatively, her ACTH and cortisol were undetectable, reflecting successful source removal. Pathology report showed neuroendocrine tumor with pituitary differentiation with positive ACTH immunohistochemical staining and Ki-67 proliferative index of 22.6% on the left adnexal mass, and a mature cystic teratoma on the right. Conclusion: Although rare, pituitary differentiation of ovarian teratomas should be considered as a possible source of ectopic ACTH secretion in CS patients without obvious sources identified in commonly involved organs. Presentation: Saturday, June 17, 2023

The Mature Ovarian Teratoma: Sign of the Poké Ball

The "Poké Ball sign" is a distinctive radiological feature observed in mature cystic ovarian teratomas. It is characterized by the presence of a spherical structure floating at the interface between fat and fluid, resembling a Poké Ball (Figure 1) [1]. In the Pokémon® series, a Poké Ball is a spherical device utilized for capturing and containing Pokémon [2].

Mature ovarian teratoma in a newborn: A case report

Mature cystic ovarian teratomas, also called dermoid cysts, are one of the most frequent ovarian tumors and are suggested when a fat-containing cystic tumor is identified on imaging. Knowledge of the imaging features of these tumors allows for a confident diagnosis to be made in most cases. Treatment is usually based on surgical resection, which is preferably carried out by laparoscopic way.

Mature Cystic Ovarian Teratoma in an Arabian Mare

Mature Cystic Ovarian Teratoma in an Arabian Mare

A rare case of extremely large mature ovarian cystic teratoma

Mature ovarian cystic teratoma, also known as the dermoid cyst, is one of the most common benign ovarian neoplasms that can occur in different age groups and could appear in various sizes. Diagnosing this problem as soon as possible is essential due to complications that can coincide, such as torsion, rupture, internal hemorrhage and malignant transformation. In this article, we reported a 66-year-old female patient with a single huge mature ovarian cyst teratoma who presented to the surgical ward with abdominal pain and swelling but did not see any doctor during that period and disregarded her problems for 4 years.

Successful pregnancy with primary infertility as a result of simultaneous bariatric intervention and laparoscopic oophorectomy in women with large cystic ovarian teratoma and morbid obesity

The article presents a clinical observation of a patient with primary infertility on the background of morbid obesity (BMI – 64.6 kg/sq.m.) and large cystic teratoma of the right ovary, who underwent bariatric surgery – laparoscopic minigastric bypass and simultaneous laparoscopic right-sided oophorectomy. Along with the true gynecological causes of female infertility, which include, among others, benign formations of the uterine appendages, obesity is a proven significant factor in its development. The use of various infertility treatment options in obese women is ineffective, and pregnancy outcomes are often disappointing. The only proven effective treatment for morbid obesity is bariatric surgery. The implementation of bariatric intervention, and, as a result, a significant decrease in body weight, directly positively affects fertility rates. However, the polyetiological nature of primary infertility in women dictates the need for an integrated approach to treatment. A feature of the presented case is the simultaneous elimination of both etiological factors of infertility – gynecological and endocrine after one surgical intervention. The goal was achieved – after 10 months, the patient was diagnosed with a progressive uterine pregnancy for a period of 11 weeks, with a decrease in body weight by 49.9% of overweight. The course of pregnancy was uneventful. Childbirth independent, newborn full-term boy without deviations. After the birth of the child, the patient continued to reduce body weight and, 29 months after surgery, she achieved a loss of 67% of her excess weight. The presented case clearly demonstrates the advantages of simultaneous elimination of the most likely causes of primary infertility. However, the implementation of such interventions by laparoscopic access requires extensive surgical experience, technical equipment and comprehensive readiness of the medical institution.

CASE REPORT ON MATURE CYSTIC TERATOMA OF OVARY WITH RUDIMENTARY UTERUS

Mature ovarian cystic teratoma of ovary with rudimentary uterus is a rare clinical condition. It is congenital malformation of female genital tract during embryonic development. Ovarian tumors are commonly seen in reproductive age group. This condition might be present with wide variety of presentation and symptoms along with associated conditions. Here we describe a young patient with acute presentation. Mature cystic teratoma is benign tumor that can lead to malignant transformation in 1 to 3 % of cases. Introduction- It is rare anomaly and due to wide variation of the presentation this clinical condition remains an interesting point of study regarding diagnosis and management. Evolution of rudimentary uterine horn in young patient is very less reported among the published literature. Mature cystic teratoma is benign tumor commonly called as dermoid cyst. It Is most common ovarian germ cell tumor. 80% of cases present in reproductive periods especially in women under 40 years of age, Malignant transformation occurs in 1- 3 % of cases. 80% of histopathological type of malignant transformation is squamous cell carcinoma.

Concurrent Primary Follicular Lymphoma and a Mature Cystic Teratoma of the Ovary: A Case Report and Review of Literature

Primary lymphoma concurrent with teratoma of the ovary is exceedingly rare. Based on our review of the literature, there are only 8 case reports describing concurrent primary diffuse large B-cell lymphoma and teratoma. Here, we report the first case of primary follicular lymphoma concurrent with mature ovarian cystic teratoma, which, to our knowledge, has not been described in the literature.

A rare case of pseudomyxoma peritonei caused by borderline mucinous tumor arising from primary mature cystic ovarian teratoma

Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by diffuse intraperitoneal mucinous spread originating from mucinous neoplasms. The most common cause of PMP is a mucinous epithelial tumor of the appendix, but may also develop from other abdominal organs such as the ovaries, colon, and pancreas. Here, we describe the case of a patient with a prior history of appendectomy, in whom the appendix was easily excluded as the primary site of PMP. Previous studies have reported that only 3–8% of ovarian mucinous tumors may arise from mature cystic teratoma. In addition, borderline ovarian malignancies from mature cystic teratoma are not common, and the occurrence of PMPs from these borderline ovarian mucinous tumors is very rare. We report a rare case of PMP with clinicopathological features between PMP and borderline mucinous tumors arising in a mature cystic teratoma of the ovary.

Adnexal Torsion During the Second Trimester of Pregnancy: Mc Burney Incision and Management Strategy

A 33-year-old pregnant woman at 26 weeks gestation presented with abdominal pain in the right iliac fossa. She had a history of a left ovarian cyst. The current pregnancy was normal. The patient was apyretic. Laboratory testing revealed no inflammatory syndrome (leukocyte count of 10G/L and pro c reactive levels were 8 mg/L). In the absence of a diagnosis and given a non-contributory abdominal ultrasound, MRI was requested and revealed a right ovarian teratoma measuring 55 × 73 mm. A surgical exploration of the abdominal cavity (Mc Burney point) using tocolytic treatment with atosiban and after fetal maturation by intramuscular injection of betamethasone 12 mg was made. Pelvic exploration performed under general anesthesia found a right adnexal torsion. Anatomopathology found a 6 cm right ovarian cystic mature teratoma with no signs of malignancy. The rest of the pregnancy went smoothly. The patient gave birth at 39 SA + 4 days to a healthy boy weighing 3080 g

Mature cystic ovarian teratomas: Relationship between histopathological contents and clinical features

Objectives: Mature cystic teratomas (MCT) originate from three germ layers: ectoderm, mesoderm and endoderm. The predictive significance of tumor markers in mature cystic teratomas is still unclear. In this study, we aimed to evaluate the predictive value of tumor markers in ovarian MCTs and histopathological contents of tumor. Materials and Methods: The data of 106 patients who were operated for ovarian MCT between 2015 and 2020 were analyzed retrospectively. In addition, slides in the pathology archive were re-examined under a microscope to evaluate their histopathological contents. Results: The average age of the patients was 35.7; 26.7 in the cystectomy group and 42.1 in the oophorectomy group (p = 0.000). The ratio of tumor markers exceeding the cut off value for carbohydrate antigen (CA 19-9), lactate dehydrogenase (LDH), cancer antigen (CA 125), carcinoma antigen (CA 15-3), carcinoembryonic antigen (CEA) were 45.2%; 47.7%; 8.15%; 12.3%; 6.9%, respectively. Histopathological examination of MCTs revealed 99.1% ectoderm, 45.3% mesodermal, 39.6% endodermal origin. Conclusion: Mature cystic teratoma is a benign tumor of the reproductive age that contains three germ layers in various proportions. LDH and CA 19-9 can be a helpful tool in predicting mature cystic teratomas.

“Black Ovaries”: An Uncommon Case of First Systemic Recurrence of Melanoma

Here we describe a rare case of a 48-year-old woman with a previous history of malignant melanoma (pT2a pathological stage, IB clinical stage) occurring about five years previously. She complained of abdominal pain and pelvic discomfort, diagnosed as a consequence of a bilateral ovarian solid masses completely occupying the recto-uterine space. She underwent laparotomy surgery with total hysterectomy and bilateral salpingo-oophorectomy. Gross examination of the excised material revealed an unusual grey-black bilateral ovarian tumor; a histopathological diagnosis of ovarian bilateral metastatic melanoma was made. Imaging study (CT/MRI) did not reveal metastasis in other zones of the body. Melanoma metastasis usually affects the skin, liver, brain and lungs, and rarely gynecological localizations. On the other hand, most bilateral ovarian tumors are comprised of serous carcinoma, mature teratoma and gastrointestinal carcinoma metastasis. Exceptionally, primary ovarian melanoma may arise in mature ovarian cystic teratomas.

Rare case of BRAF V600E mutant anaplastic pleomorphic xanthroastrocytoma in a 5-year survivor of acute lymphoblastic leukaemia

A 20-year-old woman with a history of acute lymphoblastic leukaemia treated at 13 years old with radiation and chemotherapy and a benign cystic mature ovarian teratoma diagnosed at 18 years...