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Journal of Medical Case Reports Jun 2022Mature 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... (Review)
Review
BACKGROUND
Mature 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 PRESENTATION
A 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.
CONCLUSION
We 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.
Topics: Adult; Cerebellum; Child; Dermoid Cyst; Female; Humans; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Teratoma; Young Adult
PubMed: 35642065
DOI: 10.1186/s13256-022-03444-1 -
Modern Pathology : An Official Journal... Apr 2020The origin of primary mucinous ovarian tumors is unknown. We explore the hypothesis that they originate from either Brenner tumors or teratomas and examine differences... (Comparative Study)
Comparative Study
The origin of primary mucinous ovarian tumors is unknown. We explore the hypothesis that they originate from either Brenner tumors or teratomas and examine differences between the tumors that arise in these settings. A total of 104 Brenner tumor-associated mucinous tumors and 58 teratoma-associated mucinous tumors were analyzed. Immunohistochemistry for 21 antigens and fluorescence in situ hybridization for ERBB2 and MYC were performed. Genome-wide copy number analysis and mutation analysis for 56 cancer-related genes was carried out on a subset of mucinous ovarian tumors and their complementary Brenner tumor or teratoma. Patients with teratoma-associated mucinous tumors were significantly younger than patients with Brenner tumor-associated mucinous tumors (43 vs. 61 years). During progression from cystadenoma to atypical proliferative mucinous (borderline) tumor to carcinoma expression of typical gastrointestinal markers was increased in both Brenner tumor-associated and teratoma-associated mucinous tumors. Brenner tumor-associated mucinous tumors showed more frequently calcifications and Walthard cell nests, rarely expressed SATB2 and showed more often co-deletion of CDKN2A and MTAP. Teratoma-associated mucinous tumors were characterized by mucinous stromal dissection, SATB2 expression and RNF43 mutations. Other frequent mutations in both Brenner tumor-associated and teratoma-associated mucinous tumors were TP53 and KRAS mutations. Based on identical mutations or copy number profiles clonal relationships were indicated in two mucinous tumors and their associated Brenner tumor. Teratomas and Brenner tumors give rise to different subtypes of mucinous ovarian tumors. Subsequent progression pathways are comparable since both Brenner tumor-associated and teratoma-associated mucinous tumors develop a gastrointestinal immunophenotype during progression and show early mutations in KRAS and TP53. Teratoma-associated mucinous tumors may more closely resemble true gastrointestinal tumors, indicated by their expression of SATB2 and the presence of RNF43 mutations.
Topics: Adenocarcinoma, Mucinous; Adult; Baltimore; Biomarkers, Tumor; Brenner Tumor; Cystadenoma, Mucinous; Databases, Factual; Disease Progression; Female; Gene Dosage; Genetic Predisposition to Disease; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Matrix Attachment Region Binding Proteins; Middle Aged; Mutation; Netherlands; Ovarian Neoplasms; Phenotype; Proto-Oncogene Proteins c-myc; Proto-Oncogene Proteins p21(ras); Receptor, ErbB-2; Teratoma; Transcription Factors; Tumor Suppressor Protein p53
PubMed: 31695154
DOI: 10.1038/s41379-019-0401-y -
The Journal of Veterinary Medical... Apr 2021This report describes the clinical and histopathological characteristics of a rare mixed germ-cell tumor comprising teratoma and embryonal carcinoma in the left ovary of...
This report describes the clinical and histopathological characteristics of a rare mixed germ-cell tumor comprising teratoma and embryonal carcinoma in the left ovary of a 10-month-old four-toed hedgehog, with chief complaints of loss of appetite and lethargy. Laparotomy revealed a swollen left ovary with small disseminated peritoneal nodules, and bilateral ovariohysterectomy was performed. The left ovary had a mature teratoma with well-differentiated fat, bone, cartilage, salivary gland, trachea, keratin cyst, and nervous tissues, and an embryonal carcinoma consisting of poorly-differentiated epithelial cells arranged in tubular, alveolar, or solid patterns. Immunohistochemically, the embryonal carcinoma cells were positive for placental alkaline phosphatase and c-KIT. This is the first case of mature teratoma with embryonal carcinoma in the ovary of a hedgehog.
Topics: Animals; Carcinoma, Embryonal; Female; Hedgehogs; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Placenta; Pregnancy; Teratoma
PubMed: 33536394
DOI: 10.1292/jvms.20-0591 -
Biomedical Papers of the Medical... Mar 2022We describe early and typical nonendocrine symptoms of Multiple Endocrine Neoplasia type 2B (MEN2B) presented in our patients with de novo M918T mutation in the RET... (Review)
Review
Cystic ovarian teratoma as a novel tumor and growth hormone deficiency as a new condition presenting in Multiple Endocrine Neoplasia type 2B: Case reports and review of the literature.
BACKGROUND
We describe early and typical nonendocrine symptoms of Multiple Endocrine Neoplasia type 2B (MEN2B) presented in our patients with de novo M918T mutation in the RET proto-oncogene in early childhood, however, the diagnosis of MEN2B and medullary thyroid carcinoma (MTC) was confirmed late, in the second decade of life. In this paper, we emphasize the possibility of growth retardation, growth hormone (GH) deficiency and ovarian teratoma as a new symptom of MEN2B.
CASE REPORTS
Advanced MTC with palpable mass on the neck and nonendocrine symptoms such as marfanoid habitus, thickened lips, mucosal neuromas led to the diagnosis in case 1 at the age of 13 years and GH deficiency and nonendocrine symptoms in case 2 at the age of 11 years. The earliest feature of MEN2B was alacrima and constipation. Patient 1 was operated on for a slipped femoral capital epiphysis and for a cystic ovarian teratoma.
CONCLUSIONS
Improved awareness of nonendocrine signs of MEN2B could lead to earlier diagnosis, when surgical cure of MTC is possible. Alacrima is the first sign of MEN2B. We confirmed the possibility of growth retardation and GH deficiency in MEN2B, which had been previously rarely described. We suggest that patients with MEN2B may develop cystic ovarian teratoma, to the best of our knowledge, which has never been described so far in the literature. The results of this study could be used to guide further diagnosing of MENB2 at the early stage for better clinical outcome. We emphasize that MEN2B carries a risk for development of cystic ovarian teratoma as a novel tumor in this disease.
Topics: Adolescent; Child; Growth Hormone; Humans; Multiple Endocrine Neoplasia Type 2b; Proto-Oncogene Proteins c-ret; Teratoma; Thyroid Neoplasms
PubMed: 34446941
DOI: 10.5507/bp.2021.051 -
Open Veterinary Journal Sep 2023Teratomas are rare types of germ cell neoplasms composed of various differentiated or undifferentiated tissues. (Review)
Review
BACKGROUND
Teratomas are rare types of germ cell neoplasms composed of various differentiated or undifferentiated tissues.
CASE DESCRIPTION
A 25-week-old female control FVB /n mouse in a 4-week toxicity study presented abdominal distension and poor body condition. It was euthanized, and the necropsy examination revealed a large mass connected to the tip of the right uterine horn, occupying the entire abdominal cavity. Microscopically, this mass showed areas of epidermal differentiation, with laminated keratin and sebaceous glands, differentiation into respiratory and digestive epithelium, cartilage, bone, and extensive areas of differentiation into the nervous tissue, being classified as an ovarian teratoma.
CONCLUSION
As far as authors know, the occurrence of ovarian teratomas in the FVB/n mouse strain has never been previously described.
Topics: Mice; Female; Animals; Ovarian Neoplasms; Teratoma; Rodent Diseases
PubMed: 37842105
DOI: 10.5455/OVJ.2023.v13.i9.19 -
Journal of Gynecologic Oncology Sep 2017The malignant transformation (MT) of ovarian mature cystic teratoma (MCT) to squamous cell carcinoma (SCC) is very rare. This study analyzed cases from multiple medical... (Review)
Review
OBJECTIVE
The malignant transformation (MT) of ovarian mature cystic teratoma (MCT) to squamous cell carcinoma (SCC) is very rare. This study analyzed cases from multiple medical centers in Taiwan to investigate the clinicopathologic characteristics, treatment, and prognostic factors of this disease and reviewed related literature.
METHODS
Pathological reports of 16,001 patients with primary ovarian cancer who were treated at Taiwan medical centers from 1990 to 2011 were reviewed. In total, 52 patients with MT of MCT to SCC were identified.
RESULTS
Among all ovarian MCTs, the incidence of MT to SCC is 0.2%. The median age of patients was 52 years (range, 29-89 years), and the mean tumor size was 10.5 cm (range, 1-40 cm). We analyzed the patients in our study and those in the literature and determined that early identification and complete surgical resection of the tumor are essential for long-term survival. In addition, adjuvant chemotherapy or concurrent chemoradiotherapy can be used to treat this malignancy. Old age, large tumor size (≥15.0 cm), and solid components in MCTs are suitable indicators predicting the risk of MT of MCT to SCC.
CONCLUSION
Similar to general epithelial ovarian cancers, the early detection of MT of MCT to SCC is critical to long-term survival. Therefore, older patients with a large tumor or those with a tumor containing a solid component in a clinically diagnosed MCT should be evaluated to exclude potential MT to SCC.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Chemoradiotherapy; Chemotherapy, Adjuvant; Diagnostic Imaging; Early Detection of Cancer; Female; Humans; Middle Aged; Ovarian Neoplasms; Prognosis; Taiwan; Teratoma
PubMed: 28657230
DOI: 10.3802/jgo.2017.28.e69 -
Case Reports in Women's Health Jan 2021Ovarian cysts and specifically ovarian teratomas are a common finding in young patients. These cysts display histological cell types from all three cells lines:...
Ovarian cysts and specifically ovarian teratomas are a common finding in young patients. These cysts display histological cell types from all three cells lines: endodermal, ectodermal and mesodermal origins. A 22-year-old woman who displayed classic signs of cortisol excess - excessive weight gain, difficultly losing weight and abdominal striae - was found to have a 10 cm mature teratoma cyst. This patient presented with ovarian torsion, a common complication of ovarian cysts, and was treated surgically. Pathology was significant for an ovarian teratoma with pituitary secreting cells, most significantly cells secreting adrenocorticotropic hormone (ACTH).
PubMed: 33364180
DOI: 10.1016/j.crwh.2020.e00279 -
Taiwanese Journal of Obstetrics &... Oct 2017Benign mature teratoma during pregnancy is common, mostly discovered incidentally by antenatal sonography. However, repeated pregnancy coincident with ovarian mature... (Review)
Review
OBJECTIVE
Benign mature teratoma during pregnancy is common, mostly discovered incidentally by antenatal sonography. However, repeated pregnancy coincident with ovarian mature teratoma is rarely reported. The cases of teratoma with rapid growing characteristics are even more unique.
CASE REPORT
A 17-year-old woman was pregnant at 6 weeks of gestation with a left ovarian teratoma. She underwent artificial abortion followed by surgical removal of the teratoma. However, eleven years after the surgery, a right ovarian teratoma was found incidentally by antepartum sonography at 21 weeks of gestation. The right ovarian teratoma developed uneventfully, with rapid growth during pregnancy. Abdominal delivery at term was accomplished without any complication.
CONCLUSION
Younger patients and patients with bilateral or large size dermoid cysts should be followed up closely. Further studies are needed for better understanding of its natural clinical course and the mechanism of progression. The treatment options should be made individually, weighing the risks of torsion, rupture, or obstruction of labor versus the potential for unnecessary surgical risk to mother and fetus.
Topics: Adolescent; Birth Intervals; Female; Gravidity; Humans; Live Birth; Ovarian Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Teratoma; Ultrasonography, Prenatal
PubMed: 29037561
DOI: 10.1016/j.tjog.2017.08.021 -
Journal of Surgical Case Reports Mar 2021Struma ovarii is an uncommon ovarian tumour, defined by the finding of thyroid tissue in the ovary, and more frequently found in teratomas. Symptoms of struma ovarii are...
Struma ovarii is an uncommon ovarian tumour, defined by the finding of thyroid tissue in the ovary, and more frequently found in teratomas. Symptoms of struma ovarii are nonspecific. The definite diagnosis is made by histological examination. The authors report the case of an asymptomatic 76-year-old female patient, whose ultrasonography, magnetic resonance and computed tomography suggested bilateral ovarian teratoma. Risk of Ovarian Malignancy Assessment score was high. She underwent exploratory laparotomy, peritoneal washing, total hysterectomy, bilateral adnexectomy and intra-operative frozen section. The final pathological report described bilateral mature cystic teratoma with benign struma ovarii. Surgery remains the best treatment.
PubMed: 33732424
DOI: 10.1093/jscr/rjab028 -
BMC Pregnancy and Childbirth May 2021Struma ovarii is a special type of ovarian dermoid cyst and accounts for approximately 2-3 % of all dermoid tumours. Benign struma ovarii may manifest as distant...
BACKGROUND
Struma ovarii is a special type of ovarian dermoid cyst and accounts for approximately 2-3 % of all dermoid tumours. Benign struma ovarii may manifest as distant metastasis, called peritoneal strumosis, which makes it biologically similar to malignancy, and has been reported in limited cases but never discovered during pregnancy.
CASE PRESENTATION
We report a patient with a history of right struma ovarii cystectomy. During pregnancy, pelvic masses with non-specific clinical presentation were found again. During the caesarean section, contralateral struma ovarii with dissemination of nodules in the peritoneal cavity was found, and pathology revealed that the masses were thyroid follicle ovarian goitres. DISCUSSION AND CONCLUSIONS: Recurrent benign struma ovarii with extraovarian dissemination is a rare aggressive clinical manifestation different from malignancy. It is emphasized that adequate assessment and complete resection of suspicious masses are of great importance.
Topics: Adult; Carcinoma, Papillary, Follicular; Cesarean Section; Cystectomy; Disease Progression; Female; Humans; Infant, Newborn; Neoplasm Invasiveness; Ovarian Neoplasms; Peritoneum; Pregnancy; Struma Ovarii; Ultrasonography, Doppler
PubMed: 33934699
DOI: 10.1186/s12884-021-03815-4