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Clinical and Experimental Obstetrics &... 2015To describe the surgical management and diagnoses of mature ovarian teratomas and ovarian strumas in the present centre.
PURPOSE OF INVESTIGATION
To describe the surgical management and diagnoses of mature ovarian teratomas and ovarian strumas in the present centre.
MATERIALS AND METHODS
Descriptive retrospective analysis of cases of mature ovarian teratoma at the present university-associated hospital over ten years.
RESULTS
The mean age was 29 years and in 17 patients the diagnosis was made during other surgery. When surgery was planned, the approach was 80.2% laparoscopic and 16.1% laparotomic. In the laparoscopy group more cases had been diagnosed previously as dermoid cyst by ultrasound and fewer days of hospital admission. In the laparotomy group the authors found higher ultrasound size and the size in the gross pathology description. With regards to treatment, 45.3% of cases underwent ovariectomy and 49.3% a cystectomy. Comparing these two groups, the authors found larger pelvic mass size in the group of ovariectomies. Healthy ovarian tissue in the removed specimen was found more frequently in the ovariectomies group (29.1%) but also in some cystectomies (7.5%).
CONCLUSIONS
The surgical treatment of the ovarian mature teratoma in the present center was directed on the basis of ultrasound diagnosis, ultrasound tumor size, and the existence of associated gynecologic pathology. The authors strongly recommend a laparoscopic approach and a cystectomy in order to preserve fertility especially in young women.
Topics: Adolescent; Adult; Child; Child, Preschool; Dermoid Cyst; Female; Fertility; Hospitalization; Hospitals, University; Humans; Laparoscopy; Laparotomy; Middle Aged; Ovarian Neoplasms; Ovariectomy; Retrospective Studies; Spain; Teratoma; Young Adult
PubMed: 26411224
DOI: No ID Found -
Medicine Aug 2022There are debates on the management of immature ovarian teratoma and its recurrence. This study aimed to report the incidence of pelvic masses after surgery for immature...
There are debates on the management of immature ovarian teratoma and its recurrence. This study aimed to report the incidence of pelvic masses after surgery for immature ovarian teratoma and to identify prognostic factors of disease-free survival after surgery, discussing aspects of primary treatment and postoperative management. Data on the diagnosis and treatment of patients with immature teratomas were collected. Follow-up data were acquired from clinic visits and telephone interviews. Disease-free survival was defined as the time interval between the initial surgery for immature ovarian teratoma and the diagnosis of a new pelvic mass. Survival curves were drawn using the Kaplan-Meire method, and multivariate analysis was performed using the Cox proportional hazard regression model using PASW statistics software. The estimated 5-year disease-free survival and overall survival were 74.3% (95%CI 63.9%-84.7%) and 96.5% (95%CI 91.6%-100.0%), respectively. The incidence of growing teratoma syndrome and immature teratoma relapse at a median follow-up of 46 months were 20.0% and 7.7%, respectively. Two patients died of repeated relapses or repeated growing teratoma syndrome. Rupture of initial lesions (RR 4.010, 95%CI 1.035-5.531), lymph node dissection (RR 0.212, 95%CI 0.051-0.887) and adjuvant chemotherapy (RR 0.143, 95%CI 0.024-0.845) were independent prognostic factors for disease-free survival. The development of growing teratoma syndrome is more prevalent than relapse after treatment of immature ovarian teratomas. Lymph node dissection and chemotherapy are recommended to reduce recurrence. Close surveillance and active surgical intervention are important for the diagnosis and appropriate management of new pelvic masses.
Topics: Digestive System Abnormalities; Disease-Free Survival; Female; Humans; Neoplasm Recurrence, Local; Ovarian Neoplasms; Recurrence; Syndrome; Teratoma
PubMed: 35945757
DOI: 10.1097/MD.0000000000029727 -
Journal of Pediatric Hematology/oncology May 2003A 14-year-old girl had an abdominal mass with the characteristics of an ovarian germ cell tumor on computed tomography scan. The mass, arising from the left ovary, was... (Review)
Review
A 14-year-old girl had an abdominal mass with the characteristics of an ovarian germ cell tumor on computed tomography scan. The mass, arising from the left ovary, was completely resected and found to be osteosarcoma arising from a mature cystic teratoma. A metastatic lesion in the abdomen did not respond to 2 courses of cisplatin, doxorubicin, ifosfamide, and high-dose methotrexate, and was resected. Seven months after completion of chemotherapy, there were simultaneous local recurrence and lung metastases. Previously, 10 cases of ovarian osteosarcoma have been reported in the literature: 5 were primary osteosarcoma of the ovary, 4 were associated with teratomas, and 1 was part of a malignant mixed mesodermal tumor of the ovary. Of the 10, there are only 2 long-term survivors, both of whom were treated with adjuvant chemotherapy following complete resection.
Topics: Adolescent; Female; Humans; Osteosarcoma; Ovarian Neoplasms; Teratoma
PubMed: 12759630
DOI: 10.1097/00043426-200305000-00012 -
International Journal of Gynecological... Jul 1994A patient with multiple peritoneal metastases showing mature (grade 0) glial, epithelial, and endometriotic differentiation occurring 20 years after removal of a grade 1... (Review)
Review
Immature ovarian teratoma with mature peritoneal metastatic deposits showing glial, epithelial, and endometrioid differentiation: a case report and review of the literature.
A patient with multiple peritoneal metastases showing mature (grade 0) glial, epithelial, and endometriotic differentiation occurring 20 years after removal of a grade 1 immature ovarian teratoma is reported. Although previous cases of endometriosis occurring in association with gliomatosis peritonei and a case of epithelial differentiation in metastases from an immature ovarian teratoma have previously been reported, this case would appear to be unique. Attention is drawn to similar, well-differentiated, metastases occurring in testicular teratomas.
Topics: Cell Differentiation; Child; Female; Humans; Ovarian Neoplasms; Peritoneal Neoplasms; Retrospective Studies; Teratoma
PubMed: 7928061
DOI: 10.1097/00004347-199407000-00013 -
Gynecologic Oncology Aug 2019Immature teratomas (IT) are rare and recurrences uncommon. A 12-year-old female with grade 3 (high-grade) ovarian IT underwent surgical resection but experienced early...
Immature teratomas (IT) are rare and recurrences uncommon. A 12-year-old female with grade 3 (high-grade) ovarian IT underwent surgical resection but experienced early recurrences; the first was treated with surgery but the second was metastatic and managed with chemotherapy, resulting in growing-teratoma-syndrome and need for further surgery. She now remains well in uneventful clinical follow-up. We believe chemotherapy could be reserved for very carefully selected recurrent IT cases, which may alter the natural history of disease.
Topics: Chemotherapy, Adjuvant; Child; Female; Humans; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Organ Sparing Treatments; Ovarian Neoplasms; Teratoma; alpha-Fetoproteins
PubMed: 31176555
DOI: 10.1016/j.ygyno.2019.05.032 -
International Journal of Gynecological... May 2012A thorough literature search revealed no previous reports of this entity, and we are the first to describe a case of a high-grade sarcoma arising from a recurrent... (Review)
Review
A thorough literature search revealed no previous reports of this entity, and we are the first to describe a case of a high-grade sarcoma arising from a recurrent immature teratoma misdiagnosed as growing teratoma syndrome. The patient was a 23-yr-old female, diagnosed at the age of 20 with a Stage IIIB immature ovarian teratoma. After surgery and chemotherapy, the patient developed multiple liver and pelvic masses that were diagnosed as mature teratomas based on small samples obtained by computed tomography-guided core biopsy. Three years after diagnosis the patient presented with severe respiratory difficulty and following resection, the final pathology revealed multiple tumors with foci of high grade sarcoma compatible with primitive neuroectodermal tumor/extraskeletal Ewing sarcoma based on morphology and immunohistochemistry (CD99, CD56). However, on the basis of further immunostaining and fluorescent in situ hybridization studies negative for rearrangement of EWSR1, the final pathologic diagnosis was high-grade unspecified (undifferentiated) sarcoma. This case illustrates the pitfalls of biopsying 1 site in a patient with recurrence of a heterogeneous tumor such as immature ovarian teratoma, especially when rendering a benign diagnosis such as growing teratoma syndrome. It is of utmost importance to adequately sample large-volume recurrent teratomas, and we suggest biopsying several different sites, to increase the likelihood of detecting a malignant component.
Topics: Combined Modality Therapy; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Liver Neoplasms; Neoplasm Metastasis; Neoplasms, Second Primary; Ovarian Neoplasms; Recurrence; Sarcoma; Teratoma; Young Adult
PubMed: 22498946
DOI: 10.1097/PGP.0b013e31823ef912 -
Clinical and Experimental Obstetrics &... 2017A 38-year-old female patient experienced groin pain; ultrasound imaging revealed a dermoid cystic mass in the right ovary and a cystectomy was then performed. Unusually,...
A 38-year-old female patient experienced groin pain; ultrasound imaging revealed a dermoid cystic mass in the right ovary and a cystectomy was then performed. Unusually, a mature cerebellum is found in the cyst wall. The pathological diagnosis was 'mature cystic teratoma with well-differentiated cerebral and cerebellar tissue'. Glial tissue is a common neural component of teratomas, but a cerebellum is extremely rare in mature ovarian cystic teratomas. The authors report the case because of its rare component; they acknowledge that a cystic teratoma is the most common neoplasm of ovarian germ cells.
Topics: Adult; Cerebellum; Female; Humans; Ovarian Neoplasms; Teratoma
PubMed: 29949297
DOI: No ID Found -
Gynecologic Oncology Nov 1990Benign cystic teratoma of the omentum is a rare abdominal tumor. Review of the literature describes seven reported cases of omental teratomas in association with ovarian... (Review)
Review
Benign cystic teratoma of the omentum is a rare abdominal tumor. Review of the literature describes seven reported cases of omental teratomas in association with ovarian teratomas. Our patient is a 68-year-old woman who presented with an asymptomatic abdominal mass and uterine prolapse. Ultrasound revealed a right-sided, cystic and solid pelvic mass. CT scan revealed a second mass with calcifications situated along the right iliac crest. This is the first description of an omental teratoma in association with a benign ovarian cystic teratoma coexistent with a malignant neoplasm. Possible etiologies of the present case are discussed and additional literature investigated.
Topics: Aged; Cystadenocarcinoma; Female; Humans; Omentum; Ovarian Neoplasms; Peritoneal Neoplasms; Teratoma
PubMed: 2227597
DOI: 10.1016/0090-8258(90)90433-l -
International Journal of Gynecological... Oct 1996Malignant melanoma may originate from melanocytes in ovarian cystic teratomas (dermoid cysts). Two cases are reported here and an additional 17 cases are found in a... (Review)
Review
Malignant melanoma may originate from melanocytes in ovarian cystic teratomas (dermoid cysts). Two cases are reported here and an additional 17 cases are found in a literature review covering 1903-1995. The review also found cases of benign and malignant melanotic ovarian lesion unassociated with dermoid cyst, including four melanomas, three cases of benign nevus, five cases of benign melanosis, and four cases of benign and malignant retinal anlage tumors. The extremely rare primary ovarian melanoma may be differentiated from the more common melanoma metastatic to the ovaries by its unilaterality, the presence of junctional change, and a detailed history and physical examination to exclude another primary site. Overall, 50% of patients with Stage I dermoid-associated melanoma were alive at 2 years compared with 89% of patients with Stage I dermoid-associated squamous carcinoma at 5 years. In the last 10 years, however, with the application o aggressive chemotherapy, survival has improved.
Topics: Female; Humans; Melanoma; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Ovarian Neoplasms; Teratoma
PubMed: 8886884
DOI: 10.1097/00004347-199610000-00009 -
Oncology Reports Jul 2008Minimal optimal surgery without chemotherapy is often performed for patients with ovarian immature teratoma, which frequently occurs in young women who hope for future...
Minimal optimal surgery without chemotherapy is often performed for patients with ovarian immature teratoma, which frequently occurs in young women who hope for future pregnancies. If tumors recur after the operation, anticancer drug chemotherapy is often administered, although few studies have highlighted differences between the recurrent and the primary tumor cells. Therefore, we have established experimental animal models of recurrent ovarian immature teratoma cells after optimal surgery and characterized the anticancer drug sensitivity and antigenicity of the recurrent tumors. Surgically-excised tumor cells of a grade II ovarian immature teratoma were cultured in vitro and transplanted into nude mice to establish stable cell lines. Differential drug sensitivity and antigenicity of the tumor cells were compared between the primary and the nude mouse tumors. Nude mouse tumor cells showed a normal 46XX karyotype. Cultured primary cells showed a remarkably high sensitivity to paclitaxel, docetaxel, adriamycin and pirarubicin, compared to peritoneal cancer cells obtained from a patient with ovarian adenocarcinomatous peritonitis. The drug sensitivity of teratoma cells to 5-fluorouracil, bleomycin or peplomycin was also significantly higher. However, there was no significant difference in sensitivity to platinum drugs between the primary teratoma and the peritoneal adenocarcinoma cells. As for nude mouse tumor cells, sensitivity to 12 anticancer drugs was significantly lower than that of the primary tumor cells, while there was little difference in sensitivity to carboplatin or peplomycin between the primary and nude mouse tumor cells. Flow cytometry showed that the expression of smooth muscle actin (SMA) significantly decreased in nude mouse tumor cells when compared to cultured primary cells. In conclusion, ovarian immature teratomas with normal karyotypes have a malignant potential to recur after minimal surgery. During nude mouse transplantation, SMA-overexpressing cells appeared to be selectively excluded and nude mouse tumor cells were less sensitive to the majority of anticancer drugs than the primary tumor cells. These results indicate that after optimal surgery for ovarian immature teratoma, recurrent cells can be more resistant to anticancer drugs than the primary tumors. Therefore, it is likely that adjuvant chemotherapy lowers the risk of ovarian immature teratomas recurring after optimal surgery. BEP and PBV regimens are frequently given to teratoma patients. However, paclitaxel/carboplatin or docetaxel/carboplatin, which are the most effective chemotherapy treatments for epithelial ovarian cancer patients, are considered to be an alternative regimen, especially in the prevention of reproductive toxicity.
Topics: Adolescent; Animals; Cell Line, Tumor; Drug Screening Assays, Antitumor; Female; Flow Cytometry; Humans; Karyotyping; Mice; Neoplasm Recurrence, Local; Ovarian Neoplasms; Teratoma
PubMed: 18575713
DOI: No ID Found