Mature Cystic Teratoma Of Ovary Research Articles

Imaging in gynecological disease (24): clinical and ultrasound characteristics of ovarian mature cystic teratomas.

To describe the clinical and ultrasound features of ovarian mature cystic teratomas (MCTs). This was a retrospective study. From the International Ovarian Tumor Analysis (IOTA) database, we identified patients with a histologically confirmed diagnosis of MCT who had undergone transvaginal ultrasound examination between 1999 and 2016 (IOTA phases 1, 2, 3 and 5) in one of five centers. Ultrasound was performed by an experienced examiner who used the standardized IOTA examination technique and terminology. In addition to extracting data from the IOTA database, available two-dimensional grayscale and color or power Doppler images were reviewed retrospectively to identify typical ultrasound features of MCT described previously and detect possible new features using pattern recognition. All images were reviewed by two independent examiners and further discussed with two ultrasound experts to reach consensus. Included in the study were 454 patients with histologically confirmed MCT. Median age was 33 (range, 8-90) years and 66 (14.5%) patients were postmenopausal. Most MCTs were described by the original ultrasound examiner as unilocular (262/454 (57.7%)) or multilocular (70/454 (15.4%)) cysts with mixed echogenicity of cystic fluid (368/454 (81.1%)), acoustic shadowing (328/454 (72.2%)) and no or little vascularization on color Doppler (color score 1, 240/454 (52.9%); color score 2, 123/454 (27.1%)). The median largest lesion diameter was 66 (range, 15-310) mm. A correct preoperative diagnosis of MCT was suggested by the original ultrasound examiner in 372/454 (81.9%) cases. On retrospective review of ultrasound images of 334 MCTs that had quality sufficient for assessment, 'dots and/or lines' and/or 'echogenic white ball' (typical features according to the literature) were present in 271/334 (81.1%) masses. We identified four new ultrasound features characteristic of MCT: 'cotton wool tufts', 'mushroom cap sign', 'completely hyperechogenic lesion' and 'starry sky sign'. At least one classical or novel ultrasound feature was present in 315/334 (94.3%) MCTs. Twenty-nine (8.7%) MCTs manifested vascularized solid tissue, of which seven exhibited no typical features. We provide a comprehensive overview of conventional and newly described ultrasound features of MCTs. Only a small proportion of MCTs did not manifest any of the typical features. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

OC14.05: *Imaging in gynecological disease: clinical and ultrasound characteristics of ovarian mature cystic teratomas

OC14.05: *Imaging in gynecological disease: clinical and ultrasound characteristics of ovarian mature cystic teratomas

Dermoid cyst of ovary: A common pathology with an uncommon presentation

Mature cystic teratoma of ovary is the most common germ cell tumour and also the most common tumour of the ovary. It accounts for more than 20% of all the ovarian neoplams. In spite of it being so common, the cut section of such a tumour containing multiple sebaceous balls of varying sizes is quite a rare presentation. Extensive literature search has revealed only few such cases reported in the practice of gynaecology. Here, we present a case of benign cystic teratoma of ovary in a 30-year-old lady with similar presentation.

EP-631 Left Ovarian Teratoma Containing Follicular Thyroid Carcinoma: A case Report

Abstract Introduction A mature cystic teratoma of the ovary is composed of well-differentiated derivatives of the three germ layers, the ectoderm, the mesoderm and the endoderm. About 20% of ovarian teratomas contain thyroid tissues. When thyroid tissue comprises more than 50% of the ovarian teratoma, it is termed; struma ovarii. Patients are usually asymptomatic or predominantly presented with a pelvic mass in 45% of cases or abdominal pain. We represent a rare case of stuma ovarii containing follicular thyroid carcinoma. Case presentation A 56 years old patient presented with a left ovarian mass. The patient had no history of any thyroid abnormalities and no family history of thyroid malignancy. The patient underwent total hysterectomy (TH) and bilateral salpingo-oophrectomy (BSO). Mature cystic teratoma of the left ovary containing highly differentiated follicular carcinoma with omental deposits was discovered. The case was referred for thyroid MDT for discussion of further management. Thyroid US and CT scans showed slightly small thyroid containing multiple hypoechoic nodules with no evidence of distant metastasis. Management The patient had total thyroidectomy and the final histopathology reported incidental multifocal papillary microcarcinomas of follicular variant; stage pT1a. Post-operatively the patient had Radio-iodine ablation. TSH suppression with thyroxin was initiated. The patient had regular radiological and thyroglobulin checks and no recurrence was detected on 5 years of follow-up. Conclusion The treatment for malignant struma ovarii depends on the tumor stage. The initial surgery includes TH and BSO with omentectomy. The adjuvant treatment includes thyroxine, total thyroidectomy with RAI ablation. Long-term follow-up is recommended.

Five-year recurrence pattern of mature cystic teratoma according to operation type in young women.

To find cumulative recurrence rate and risk factors for recurrence in young women with mature cystic teratoma (MCT). Patients aged 10-29 years with MCT confirmed by their first ovarian surgery between 2000 and 2018 were included in the study. To rule out residual lesions, only patients with no MCT-suspected lesions on imaging within 1year after surgery were included in the study. Patients who had not undergone imaging tests from 1year after surgery or had other findings on biopsy were excluded. The present study included 372 (84.2%) patients with cystectomy and 70 (15.8%) patients with oophorectomy. The 5-year cumulative recurrence rates for each patient group were 11.2% and 20.3%, respectively. The hazard rate of recurrence was higher in the oophorectomy group than the cystectomy group within 5 years after surgery. Large tumor size (hazard ratio [HR] 2.59; 95% confidence interval [CI] 1.11-6.08) and bilaterality (HR 2.65; 95% CI 1.27-5.52) were significant predictors of recurrence in the cystectomy group. The 5-year cumulative recurrence rate after surgery in young women with ovarian MCT was 11.2% in the cystectomy group and 20.3% in the oophorectomy group. Risk factors for recurrence after cystectomy were large tumor size and bilaterality.

A rare case of highly differentiated follicular carcinoma in ovary with FGFR4 Gly388Arg polymorphism: a case report and literature review

BackgroundHighly differentiated follicular carcinoma (HDFCO) is a rare form of struma-derived thyroid-type carcinoma in ovary, defined as ovarian struma spreading beyond ovary but consisting of benign thyroid tissues. No more than 30 cases of HDFCO have been reported since it was first recognized in 2008. The clinicopathologic and molecular features of HDFCO remain unclear up till now.Case presentationA 38-year-old, para 1 gravida 5 woman has a long history of recurrent right ovarian cysts. Histological evaluation showed the tumor progressed from ovarian mature cystic teratoma (OMCT) to highly differentiated follicular carcinoma (HDFCO) during three relapses. Whole-exome sequencing revealed the germline FGFR4 Gly388Arg polymorphism. Repeated operations were performed to remove lesions for the first two relapses. On the third recurrence, the patient received radical surgery with subsequent thyroidectomy and radioactive iodine ablation. No evidence of disease was observed by February 2022 (8 months).ConclusionsThe germline FGFR4 Gly388Arg polymorphism may accelerate the malignant transformation of HDFCO, probably by working as a second hit in the developing spectrum.

Well-differentiated cerebellum in an ovarian mature cystic teratoma: a case report and review of the literature

BackgroundMature teratoma is the most common germ cell tumor as it represents 95% of germ cell tumors. Although common in children and young adults, ovarian teratoma can occur at any age. Mature teratomas are composed of mature tissues representing elements derived from more than one embryonic germ layer (ectoderm, mesoderm, and endoderm), with ectodermal derivatives being the usual predominant component; however, the finding of a well-differentiated cerebellum is extremely rare.Case presentationA 20-year-old Saudi female presented to the emergency department with severe abdominal pain of 1-day duration. Pelvic ultrasound showed a large ovoid- to bilobed-shaped cystic pelvic structure extending to the lower abdomen. The patient underwent left ovarian cystectomy. Microscopic examination showed a cyst wall with skin tissue, including adnexal structures (sebaceous glands), a well-differentiated cerebellum, and mature glial tissue. After extensive sampling, no immature component was identified. Thus, the final diagnosis of a mature cystic teratoma with well-differentiated cerebellum was established. The patient was well postoperatively and was discharged in a stable condition.ConclusionWe report this case of well-differentiated cerebellum within ovarian teratoma to expand the pool of cases reported in literature of this extremely rare entity, as only 22 cases with such findings have been reported in literature to the best of our knowledge. This finding poses a diagnostic challenge to the pathologist due to its rarity and its similarity to immature teratoma. We thus emphasize that thorough sampling of ovarian teratoma is of paramount importance and to keep the aforementioned diagnosis in mind and not confuse it with immature elements, especially in intraoperative consultation and frozen sections.

FORENSIC PERSPECTIVES OF PCOS AND ADOLESCENT SUICIDE: A CASE REPORT

Suicide is the second cause of death among adolescents worldwide. Besides neurohormonal changes following puberty, a constellation of risk factors such as academic failure, relationship issues, nancial stress, peer pressure, increasing life responsibilities, and family issues stir up suicidal emotions. However, the impact of polycystic ovary syndrome (PCOS) and gynecological pathologies are rarely encountered and considered in medicolegal autopsies. We present a case of a 16-year-old adolescent girl who committed suicide by swallowing an organophosphate compound following a minor argument with her sister. At autopsy, besides poisoning, dual pathology of the ovary that includes right polycystic ovary and left ovarian mature cystic teratoma was discovered. The psychophysiological characteristics of PCOS and its prospective association with depression vis-à-vis suicidal tendencies are discussed.

30-Year Experience With 22 Cases of Malignant Transformation Arising From Ovarian Mature Cystic Teratoma: A Rare Disease.

ObjectiveTo investigate the clinical characteristics and survival outcomes of patients with malignant transformation arising from ovarian mature cystic teratoma (MT-MCT).MethodsThis retrospective study included patients with ovarian MCTs at Peking Union Medical College Hospital (PUMCH) during 1990.01-2020.12. When the pathologic histology was MT-MCT, detailed information was collected.ResultsOverall, 7229 ovarian MCT patients and 22 patients with MT-MCT were enrolled. The rate of malignant transformation of all ovarian MCTs was 0.30%. Most patients with MT-MCT were 51 (21–75) years old, and the tumor mass size was 10 (3–30) cm. The typical clinical symptoms were mainly abdominal pain and distension. The levels of tumor markers were elevated on preoperative examination. Early diagnosis could be made by ultrasonic examination, pelvic enhanced MRI and CT. Most patients underwent debulking surgery and adjuvant chemotherapy. The most common histological type to exhibit malignant transformation was squamous cell carcinoma (59.1%), followed by adenocarcinoma (13.6%), carcinoid (9.1%), and borderline tumor (18.2%). The 5-year RFS and OS rates were 54.5% and 81.8%, respectively. Patients with FIGO stage I had the best RFS (P=0.047) and OS (P=0.018), followed by those with FIGO stage II-IV.ConclusionMT-MCTs mainly occur in elderly females, are rare and have a poor prognosis. Advanced FIGO stage is a risk factor for survival. Although there is no standard treatment, cytoreductive debulking surgery and adjuvant chemotherapy could be considered. Perimenopausal and menopausal women with MCT should receive surgical treatment.

Rare occurrence of pseudomyxoma peritonei (PMP) syndrome arising from a malignant transformed ovarian primary mature cystic teratoma treated by cytoreductive surgery and HIPEC: a case report

BackgroundPseudomyxoma peritonei (PMP) syndrome is a disease process that typically occurs from ruptured appendiceal mucocele neoplasms. PMP syndrome arising from malignant transformation of an ovarian primary mature cystic teratoma (MCT) is a pathogenesis rarely encountered.Case PresentationHerein, we report a 28-year-old patient evaluated and treated for a right ovarian mass and large volume symptomatic abdominopelvic mucinous ascites. Molecular profiling and genetic analysis revealed mutations in ATM, GNAS, and KRAS proteins while IHC demonstrated gastrointestinal-specific staining for CK20, CDX2, CK7, and SATB2. Peritoneal cytology showed paucicellular mucin. Diffuse peritoneal adenomucinosis (DPAM) variant of PMP arising from a ruptured ovarian primary MCT after malignant transformation to a low-grade appendiceal-like mucinous neoplasm was ultimately confirmed. Treatment included staged therapeutic tumor debulking and right salpingo-oophorectomy followed by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).ConclusionsOur report builds upon the existing literature supporting this aggressive treatment option reserved for advanced abdominal malignancies utilized in this patient with a rare clinical entity.

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.

Multi-Institutional Review of the Preoperative Diagnostic Accuracy for Pediatric Ovarian Mature Cystic Teratomas

Study ObjectiveTo assess the preoperative imaging impression and surgeon diagnostic accuracy for pediatric ovarian mature cystic teratomas (MCTs) DesignRetrospective review SettingEleven pediatric hospitals ParticipantsPatients ages 2 to 21 who underwent surgical management of an ovarian neoplasm or adnexal torsion with an associated ovarian lesion InterventionNone Main Outcome MeasuresPreoperative imaging impression, surgeon diagnosis, tumor markers, and pathology ResultsOur cohort included 946 females. Final pathology identified 422 (45%) MCTs, 405 (43%) other benign pathologies, and 119 (12%) malignancies. Preoperative imaging impression for MCTs had a 70% sensitivity, 92% specificity, 88% positive predictive value (PPV), and 79% negative predictive value (NPV). For the preoperative surgeon diagnosis, sensitivity was 59%, specificity 96%, PPV 92%, and NPV 74%. Some measures of diagnostic accuracy were affected by the presence of torsion, size of the lesion on imaging, imaging modality, and surgeon specialty. Of the 352 masses preoperatively thought to be MCTs, 14 were malignancies (4%). Eleven patients with inaccurately diagnosed malignancies had tumor markers evaluated and 82% had at least 1 elevated tumor marker, compared with 49% of those with MCTs. ConclusionsDiagnostic accuracy for the preoperative imaging impression and surgeon diagnosis is lower than expected for pediatric ovarian MCTs. For all ovarian neoplasms, preoperative risk assessment including a panel of tumor markers and a multidisciplinary review is recommended. This process could minimize the risk of misdiagnosis and improve operative planning to maximize the use of ovarian-sparing surgery for benign lesions and allow for appropriate resection and staging for lesions suspected to be malignant.

Paget’s disease arising within a mature cystic teratoma

Secondary neoplasia arising within a mature cystic teratoma is a well-documented phenomenon. Cutaneous neoplasms such as squamous cell carcinoma are most frequently reported. There are also infrequent reports of neoplasms arising from the cutaneous adnexal structures. Here we present a case of extramammary Paget’s disease arising within an ovarian mature cystic teratoma. There have been four previous case reports of this entity. One of these cases was associated with concomitant invasive carcinoma reminiscent of secondary extramammary Paget’s disease found elsewhere.

Concurrent carcinoid and extramammary Paget’s disease in ovarian mature cystic teratoma: Case report

Introduction: Mature teratomas are defined as a tumour which consists of mature tissues derived from two or three germ layers. Somatic-type malignancy can occur in association with mature teratomas. We report the first case of concurrent ovarian carcinoid and extramammary Paget’s disease (EMPD) in an ovarian mature teratoma.

Uncommon Pathological Presentations of Mature Cystic Teratoma: A Case Series

Mature cystic teratomas are benign tumours of the ovary but rarely certain unusual gross and microscopic findings might complicate their diagnosis or may have an impact on their clinical outcome. Here, we are presenting a case series of five unusual pathological presentations of mature cystic teratomas of ovary. Out of five cases, three cases were of collision tumours, in which combination of mature cystic teratoma is seen with mucinous cystadenoma in two cases, and with serous cystadenoma in one case. True collision tumours are defined as histologically distinct neoplasms in the same tissue or organ without any histologic admixture or intermediate cell population zone between two components. These tumours are located in various organs but ovarian location is rare. Mature cystic teratoma is the most common component of collision combinations in the ovary. All classes of ovarian tumours, benign, borderline and malignant may collide and therefore, clinical outcomesin collision tumours depend on individual tumour characteristics. Fourth case was of a mature cystic teratoma associated with a distinct hemangiomatous component. Mature cystic teratoma associated with prominent hemangiomatous component is a very rare finding with only few case reports in the literature and it should be differentiated from true ovarian hemangioma, lymphangioma and angiosarcoma. Fifth case was of bilateral mature cystic teratomas associated with a well-defined lipomatous lesion in right sided mature cystic teratoma mimicking lipoma. Lipomatous ovarian lesions are very rare and mature cystic teratoma with prominent adipocytic proliferation is also an exceedingly uncommon finding and it should be differentiated from true ovarian lipoma and other atypical lipomatous proliferations. Most of these tumours remain clinically and radiologically unrecognized, therefore their histological recognition is essential for adequate patient management.

Recurrent Squamous Cell Carcinoma Arising from Ovarian Mature Cystic Teratoma with Cardiac Metastases: A Case Report

Recurrent Squamous Cell Carcinoma Arising from Ovarian Mature Cystic Teratoma with Cardiac Metastases: A Case Report

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.

Mature cystic teratoma in a peripubertal girl: Is it uncommon?

Giant ovarian mature cystic teratomas (MCTs) are sparsely reported and that too at extreme of age like in premenarchal or postmenopausal age group. We hereby report a case of huge MCT in a 11-year-old premenarchal girl who presented with abdominal pain and lump. Ovarian tumor in adolescent may have malignant potential and requires appropriate and vigilant preoperative work-up and counseling for optimal management with concern of preservation of fertility and potential for childbearing.

OVARIAN MATURE CYSTIC TERATOMA WITH TRANSFORMATION INTO SQUAMOUS CELL CARCINOMA: REPORT OF TWO CASES

Ovarian mature cystic teratomas are the commonest germ cell tumors of the ovary. Malignant transformation in them is a rare event and is difcult to diagnose preoperatively. Clinicians, pathologists and radiologists should always suspect this if the patient is elderly or when the cyst is large or in presence of a solid foci. Here, we discuss two cases of squamous cell carcinoma arising from a mature cystic teratoma

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.