Mature Cystic Teratoma Of Ovary Research Articles

Original Articles Preoperative Hematological Parameters for Predicting Ovarian Torsion in Patients with Mature Cystic Teratoma.

ObjectiveThe objective of this study is to evaluate the preoperative hematological parameters to predict ovarian torsion in patients with ovarian mature cystic teratoma. We also analyzed the diagnostic value of these makers to predict ovarian necrosis in cases of torsion as well as the effect of torsion on ovarian reserve.Patients and MethodsThis is a retrospective study of 132 patients who received either laparoscopic or laparotomy surgery for OMCT at a single university hospital. Clinical characteristics and preoperative hematological parameters were compared between patients with or without torsion. Patients with torsion were further classified as infarction and non-infarction group. Preoperative parameters were compared between the two groups as well.ResultsWhite blood cell (WBC) count, neutrophil percent, neutrophil count, and neutrophil to lymphocyte ratio (NLR) were higher in the torsion group (n=37) than the non-torsion group (n=95) (p<0.05 for all). Although statistically insignificant, the preoperative anti-Mullerian hormone (AMH) was lower in the torsion group than the non-torsion group (4.07 ± 3.38 vs 6.1 ± 3.6, p=0.122). In cases of torsion, the infarction group showed higher WBC count and lymphocyte count but lower hemoglobin level and platelet to lymphocyte ratio (PLR) than the non-infarction group (p<0.05 for all).ConclusionThe WBC count, neutrophil percent, neutrophil count, and NLR were higher in the cases of OMCT with torsion, and these parameters may be useful to diagnose OMCT with torsion. Also, adnexal torsion may deteriorate ovarian reserved as indicated by decreased AMH in torsion group.

Mucinous Adenocarcinoma Transformation in Ovarian Mature Cystic Teratoma Complicating Pregnancy: A Case Report

Most adnexal masses found in pregnancy are simple benign cysts less than 5 cm in diameter. On the other hand, the majority of persistent adnexal masses 5 cm or greater in diameter are mature teratomas. Malignant transformation occurs in 0.2 to 2 percent of mature teratomas, and squamous cell carcinoma arising from ectoderm is the most common secondary neoplasm. The mucinous cystadenocarcinoma transformation is very rare. We presented a 38-year-old G2Ab1 woman at 32 weeks of gestation with a huge, rapid growth adnexal mass who came to our emergency department due to severe preeclampsia, stage 1 of IUGR, and borderline AFI. After 48 hours of expectant management, a cesarean section associated with unilateral salpingooophorectomy was done, and the histopathology of the cyst revealed mature teratoma that was focally involved with mucinous cystadenocarcinoma. The complete surgical staging was done, and due to the stage of disease (1C1), she received adjuvant chemotherapy, and she has remained disease-free in her last follow up after one year.

An adolescent girl with coexisting ovarian mature cystic teratoma and HAIR-AN syndrome, an extreme subtype of polycystic ovarian syndrome.

SummaryPolycystic ovarian syndrome (PCOS) is associated with menstrual irregularities, ovulatory dysfunction, hirsutism, insulin resistance, obesity and metabolic syndrome but is rarely associated with severe hyperandrogenaemia and virilisation resulting in male pattern baldness and clitoromegaly. Total serum testosterone greater than twice the upper limit of the reference range or free androgen index of over five-fold elevated suggests a diagnosis other than PCOS. We reported a case of a 15 years old obese girl presented with secondary amenorrhoea, virilising signs: frontal baldness, clitoromegaly and prominent signs of insulin resistance and marked acanthosis nigricans. Her total testosterone level was markedly elevated at 9.4 nmol/L (0.5–1.7 nmol/L) and MRI pelvis revealed a right ovarian mass with fat and cystic component and a left polycystic ovary. The patient underwent laparoscopic right ovarian cystectomy and histologically confirmed mature cystic teratoma. Post-operatively, her testosterone level declined but did not normalise, menses resumed but remained irregular. Her fasting insulin was elevated 85.2 mIU/L (3–25 mIU/L) and HOMA-IR was high at 13.1 (>2) with persistent acanthosis nigricans suggesting co-existing HAIR-AN syndrome, an extreme phenotype of polycystic ovarian syndrome.Learning pointsRapid onset of hyperandrogenic symptoms, especially if associated with signs of virilisation must raise the suspicion of an androgen-secreting tumour.Total serum testosterone greater than twofold the upper limit of the reference range or free androgen indices over fivefold suggest a diagnosis other than polycystic ovarian syndrome (PCOS).High levels of testosterone with normal levels of the DHEA-S suggest an ovarian source.Ovarian androgen-secreting tumour and HAIR-AN syndrome, an extreme spectrum of PCOS can co-exist.

Ovarian mature cystic teratoma with malignant transformation: two case reports

BackgroundMature Cystic Teratoma (MCT) is a benign tumor that can lead to malignant transformation (MT) in 1–3% of cases. Management of MT is a big challenge for gynecologic oncologists due to the lack of specific diagnostic and treatment protocols.Case presentationWe reported two Iranian cases of MT of MCT with two different stages and prognosis. Our both cases presented the same symptoms, including chronic abdominal pain and distention, loss of appetite, and weight loss. In case number 1, despite the large size of the tumor, the disease was at stage Ia and had a good prognosis; while, case number 2 was at stage IIIc of the disease with a poor prognosis.ConclusionThe stage of the disease is the most important prognostic factor, and early diagnosis and treatment are very critical for better survival.

Distinctive pattern of left\u2013right asymmetry of ovarian benign teratomas in Chinese population: a 12-year-long cross-sectional study

PurposeGiven the lack of research on the left–right asymmetry of ovarian teratoma among Chinese patients, this study aimed to determine the lateral distribution and related clinical characteristics of Chinese ovarian teratoma patients treated at a single center.MethodsWe conducted a cross-sectional study of surgical patients pathologically diagnosed with ovarian teratomas in the gynecology inpatient department of the International Peace Maternity and Child Health Hospital in Shanghai between July 2006 and July 2018.ResultsOf the 4417 patients with ovarian teratoma, 3835 were finally analyzed. There were 2030 (53.24%) cases of right-sided benign ovarian teratoma versus 1783 (46.76%) cases of left-sided benign teratoma (P < 0.001). The recurrence rate of benign ovarian teratoma was 4.2%; recurrence occurred more often on the left side (left vs. right = 55 vs. 45%, P = 0.033). Compared with the right-sided ovarian teratoma patients, left-sided ones had significantly high recurrence risk (OR 1.430; 95% CI 1.03–1.99). The rate of ovarian torsion in patients with ovarian mature cystic teratomas (MCTs) during intrauterine pregnancy was 3.17 versus 1.72% in non-pregnant MCT patients (P = 0.049). For those MCT patients with intrauterine pregnancy, ovarian torsion occurs more often on the right side (left vs. right = 16.67 vs. 83.33%, P = 0.028).ConclusionThis study confirms a distinctive right-side dominance of benign ovarian teratomas. Compared with the right side, recurrent ovarian teratomas occur more often on the left side, requiring close follow-up. Intrauterine pregnancy may increase the risk of ovarian torsion, particularly on the right side, in MCT patients.

Rapid malignant transformation of mature ovarian cystic teratoma into undifferentiated carcinoma

Abstract Introduction: Malignant transformation of mature cystic teratoma (MCT) is extremely rare and has poor prognosis. We report a case of malignant transformation of ovarian MCT into undifferentiated carcinoma, that showed extremely rapid progression after surgery. Patient concerns: A 51-year-old woman presented with complaints of abdominal swelling, pain and fever. Computed tomography (CT) and transvaginal ultrasonography revealed a cystic mass in the pelvis. Diagnosis: Based on the CT findings, ovarian tumor with possible rupture was provisionally diagnosed. However, post-operative histopathology showed malignant transformation of mature ovarian cystic teratoma into undifferentiated carcinoma. Interventions: Total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy was performed. Outcomes: Positron emission tomography with 18-fluorodeoxyglucose (FDG-PET) after surgery showed multiple FDG uptake in liver, paraaortic lymph nodes and mesentery. Adjuvant chemotherapy was started, but the patient died 3 months after the surgery due to disease progression. Autopsy findings confirmed the metastases of undifferentiated carcinoma in liver, mesentery and left lung. Conclusions: Malignant transformation of MCT into undifferentiated carcinoma can be rapid and has poor outcomes. Pre-operative diagnosis is very difficult. Moreover, limited literature makes it difficult to establish the standardized treatment strategy for these patients. This case report shows that progression of this malignancy can be rapid despite surgery and chemotherapy.

Papillary thyroid carcinoma arising within a mature cystic teratoma of ovary: a rare case report

Mature cystic teratoma is the most common ovarian germ cell tumor with a rare malignant conversion. We report a case of 36 years lady, with an incidental post-operative finding of papillary carcinoma of the thyroid in histopathology of the left ovarian dermoid cyst. Postoperatively she was evaluated for the presence of primary thyroid tumor with thyroid ultrasonography, thyroid function test, and anti-thyroglobulin antibody which revealed normal thyroid gland with euthyroid status and negative anti-thyroglobulin antibody, which had ruled out primary thyroid tumor. There are limited case reports on papillary thyroid carcinoma in a mature cystic teratoma in absence of a struma ovary and specific recommendations on the plan of its management are not available. This study aims to report a rare case of papillary thyroid carcinoma arising in a mature cystic teratoma of the ovary in absence of a struma ovary.

Bilateral mature cystic teratoma of ovary: A rare case presentation

Mature cystic teratomas are ovarian neoplasms derived from two to three germ cell layers i.e. ectoderm, mesoderm and endoderm. Ovarian teratomas are usually benign tumours of the reproductive age group. They usually have right-sided predisposition. However, only 10-20% of these neoplasms may have bilateral presentation. Here, we present a rare case of bilateral mature cystic teratoma of ovaries in a 32 years old multigravida female who presented with pain lower abdomen from one month. Ultrasonography showed bilateral solid-cystic adnexal lesions along with calcifications in the left adnexal mass. Serum level of CA-125 was within normal range. Laparoscopic bilateral oophorectomy was done along with bilateral tubal ligation. The histopathological examination confirmed the diagnosis of bilateral mature cystic teratoma of the ovaries. Keywords: Benign, Cyst, Dermoid, Ovary, Teratoma.

Alternative method for the diagnosis of acid cases of unknown cause: Transvaginal natural orifice transluminal endoscopic surgery.

To evaluate the efficacy and reliability of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) technique in making the diagnosis of ascites with unknown cause. Seven patients with ascites with unknown cause and diagnosed with vNOTES between November 2018 and May 2019 were analyzed retrospectively. The following data were collected retrospectively: body mass index, age, parity, previous abdominal or pelvic surgery, total operating time, perioperative complications and visual analog scale scores for evaluation of postoperative pain. After general anesthesia and disinfection, a 2-3 cm incision was made in the posterior fornix of the vagina. In all of the vNOTES procedures, a handmade glove port system comprised of a glove-wound retractor NOTES port was used. Transvaginal natural orifice transluminal endoscopic surgery for diagnostic peritoneoscopy was successfully performed in seven patients. Following postoperative pathological examination; three patients were established to have peritoneal carcinomatosis, one patient abdominal tuberculous, one patient ovarian fibroma, one patient ovarian mature cystic teratoma and one patient stomach cancer. In 1-year follow-up period after vNOTES procedure, no adverse events occurred in patients. In making histological diagnosis of ascites with unknown cause, vNOTES is a feasible, safe and efficient technique. Due to its high performance in diagnosis, this technique helps to initiate treatment early in some diseases in addition to preventing unnecessary treatment and examination in benign diseases. Besides, via obtaining a detailed and enlarged image of abdominal cavity, this procedure also guides the clinician in the evaluation of the suitability of patient for operation.

Incidence and Associated Risk Factors of Patients with Malignant Transformation Arising in Mature Cystic Teratoma of the Ovary in Rajavithi Hospital

Objectives: To review the incidence and evaluate risk factors associated with malignant transformation in mature cystic teratoma (MCT) of the ovary.Methods: A retrospective medical record review for 571 patients diagnosed as ovarian MCT who were treated at Rajavithi Hospital from January 2005 to June 2017 was performed. The demographics data, preoperative investigations, pathological findings, adjuvant treatments, and follow-up outcomes were obtained and analyzed. Results: Forty patients with malignant transformation in MCT were detected over a period of 12 years. The incidence rate was 7% of all MCT. Squamous cell carcinoma was the most common histologic type (45%) and the most of them were stage I (80%). Patients with malignant transformation were significantly older than those benign MCT (48.4 years vs 37.5 years, p 10 cm. (OR 6.68; 95%CI, 2.39-18.65), solid part from ultrasound findings (OR 5.30; 95%CI, 1.63-17.24), and RMI score ≥200 (OR 8.69; 95%CI, 1.68-44.89) were a significant predictor of malignant transformation arising in MCT. Performance validation with a cut-off level of RMI ≥200 showed the AUC was 0.879, with 47.5% sensitivity, 98.4% specificity, 82.6 % positive predictive value, and 92.2% negative predictive value, respectively. Conclusion: Early detection and complete surgical resection of ovarian cancer are important for a long-term survival. Large tumor size and solid part from ultrasound finding were associated with malignant transformation in MCT. Additionally, calculating RMI score might be a useful diagnostic tool to detect malignancy in this setting, and adequate staging surgery should also be considered.

Ovarian Mature Cystic Teratoma Combined with Mucinous Boderline Tumor-A Case Report with Literature Review

&lt;p&gt;Mature ovarian cystic teratoma with co-existing mucinous borderline tumor is an extremely rare finding in literature. Here, we report a case of bilateral mature cystic teratoma of the ovary with mucinous borderline tumors and intraepithelial carcinoma in a very young, 26-year-old female. The case was diagnosed histologically through immunohistochemical support. The biological behavior of mature ovarian cystic teratoma with mucinous borderline tumor is between those of benign and malignant tumors, having low malignant potential. Since the patient had given birth to a child, a radical operation was performed and no&amp;nbsp;&lt;br /&gt;tumor recurrence was observed after one year follow-up.&lt;/p&gt;

Ovarian Mature Cystic Teratoma Combined with Mucinous Boderline Tumor-A Case Report with Literature Review

Ovarian Mature Cystic Teratoma Combined with Mucinous Boderline Tumor-A Case Report with Literature Review

Mature Ovarian Cystic Teratoma Mimicking a Bladder Diverticulum in a 16-year-old Female

A 16-year-old female was incidentally found to have an abnormal pelvic ultrasound while undergoing evaluation for mild scoliosis. A large, thick-walled, lobular, fluid-filled structure was found at midline in the pelvis that initially resembled bladder diverticula due to its anatomical position and sonographic appearance. Voiding cystourethrogram and computed tomography later revealed a large cystic mass originating from the right ovary. This report outlines a case of a mature cystic teratoma convincingly mimicking bladder anomaly on sonography.

Hydronephrosis associated with a huge ovarian mature cystic teratoma in a 16-year-old girl: A case report

We report the case of a 16-year-old female with a huge mass (40 × 30 × 40 cm) on the left ovary, causing mild bilateral hydronephrosis. Ultrasonography and computed tomography allowed us to diagnose this condition and showed an associated uretero-hydronephrosis. A unilateral salpingo-oophorectomy was performed on the left ovary, and final pathology revealed a mature cystic teratoma. The patient did not experience any problems in the follow-up six months later, and her hydronephrotic appearance disappeared.

Elevated aspartate aminotransferase and alanine aminotransferase in the torsion of ovarian mature cystic teratoma: normalised after operation for torsion

The aim of the study was to report the elevated liver function test levels in torsion of ovarian mature cystic teratoma (MCT). A retrospective review was performed of 116 patients with MCT who underwent surgery in our hospital between 2010 and 2017. Eleven of 116 patients were with torsion of MCT. Of the 11 torsion of MCT cases, 6 of those showed abnormal elevated levels of aspartate transaminase (AST)/alanine aminotransferase (ALT). After operation, AST/ALT levels recovered to normal ranges. Elevated liver function levels require attention to complications associated with anaesthesia and emergency operation. However, the current report shows that emergency surgery should not be delayed to assess other causes of elevated liver function tests. Impact statement What is already known on this subject? Abnormal liver function tests require attention to complications associated with emergency surgery. What do the results of this study add: Our study shows that some patients with torsion of MCT returned to normal levels of AST/ALT after surgery without any medications to improve liver function. What are the implications of these findings for clinical practice and/or further research? This study would offer that in some cases with torsion of MCT, emergency surgery should not be delayed and the assessment of other possible causes of these elevations postponed to postoperative period. Additional studies are required to assess the correlation between elevated AST/ALT levels and torsion of MCT.

Squamous Cell Carcinoma Transformation of Mature Cystic Teratoma of Ovary: A Case Report and Review of Surgical Approach

Mature cystic teratoma of ovary accounts for nearly one-fifth of all benign germ cell tumour of the ovary. Malignant transformation of such tumours is rare, and they are usually present in a post-menopausal women with pain and abdominal distension. The malignant tumor may involve adjoining pelvic organs leading to a dilemma about the primary organ of origin. However, a careful clinical, radiological and pathological analysis can lead us to the diagnosis. Complete tumor resection along with hysterectomy and B/L salpingo oopherectomy and resection of the adjoining viscera, if involved, is the preferred surgery. Adjuvant chemotherapy for advanced tumors has been shown to improve survival.

A Glint of Hope for Treatment of Advanced Malignant Transformations of Ovarian Mature Cystic Teratomas: A Retrospective Analysis of 9 Cases

Objective: Malignant transformation of a mature cystic teratoma (MTMCT) of the ovary is extremely rare; the occurrence rate is ∼1%–3% of all mature cystic teratomas. Because of the rarity of MTMCT,...

The Poké Ball sign in mature ovarian cystic teratoma.

The Poké Ball sign in mature ovarian cystic teratoma.

Recurrence of ovarian squamous cell carcinoma with MET gene copy number variation: a case report and review of literature

BackgroundMalignant transformation such as ovarian squamous cell carcinoma (SCC) in ovarian mature cystic teratoma (OMCT) is a rare tumor. The gene mutation of ovarian SCC remains unclear. We herein report a recurrent case of ovarian squamous cell carcinoma with MET gene copy number variation.Case presentationA 60-year-old woman presented with recurrence of ovarian SCC 8 months after primary surgery. Adhesiolysis, right abdominal wall mass excision, prosthetics, enterectomy, enterostomy and partial cystectomy were performed by laparoscope. Pathologic examination demonstrated metastatic squamous cell carcinoma in ileocecus, rectum and abdominal wall muscle. MET gene copy number was elevated with copy number of six in this case. Postoperatively, the patient was treated with four cycles of combination chemotherapy with docetaxel and carboplatin. The patient was free of disease at 20 months’ follow-up.ConclusionsOptimal cytoreductive surgery combined with platinum-based chemotherapy is recommended currently for not only primary tumor but also recurrence. For patients with malignant transformation in OMCT, prompt diagnosis and individualized treatment are crucial for better prognosis. Increased copy number of MET may be correlated with her poor PFS and can be a potential therapeutic target for this case.

Generation of human androgenetic induced pluripotent stem cells

In humans, parthenogenesis and androgenesis occur naturally in mature cystic ovarian teratomas and androgenetic complete hydatidiform moles (CHM), respectively. Our previous study has reported human parthenogenetic induced pluripotent stem cells from ovarian teratoma–derived fibroblasts and screening of imprinted genes using genome-wide DNA methylation analysis. However, due to the lack of the counterparts of uniparental cells, identification of new imprinted differentially methylated regions has been limited. CHM are inherited from only the paternal genome. In this study, we generated human androgenetic induced pluripotent stem cells (AgHiPSCs) from primary androgenetic fibroblasts derived from CHM. To investigate the pluripotency state of AgHiPSCs, we analyzed their cellular and molecular characteristics. We tested the DNA methylation status of imprinted genes using bisulfite sequencing and demonstrated the androgenetic identity of AgHiPSCs. AgHiPSCs might be an attractive alternative source of human androgenetic embryonic stem cells. Furthermore, AgHiPSCs can be used in regenerative medicine, for analysis of genomic imprinting, to study imprinting-related development, and for disease modeling in humans.