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BMJ Case Reports Jul 2021Anti--methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease frequently associated with ovarian teratomas. In cases where an ovarian teratoma is...
Anti--methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease frequently associated with ovarian teratomas. In cases where an ovarian teratoma is identified, treatment involves prompt removal of the ovarian teratoma, resulting in significant clinical improvement and decreased incidence of relapse. We present the case of a 14-year-old female patient admitted for progressively worsening psychiatric and neurological status, diagnosed with anti-NMDAR encephalitis, and negative initial imaging for ovarian pathology. She was in the hospital for 8 months requiring admission to the intensive care unit and multiple courses of immunotherapy before clinical improvement. Three months after discharge, she was readmitted with clinical relapse and repeat imaging showed an ovarian teratoma. Removal of the teratoma resulted in sustained clinical improvement with return to baseline and no further relapse. Our case report highlights the importance of maintaining a high suspicion for an underlying ovarian teratoma in a female patient with anti-NMDAR encephalitis, even when initial imaging is negative. Currently, there are limited data on recommendations for repeat imaging. Therefore, we recommend repeat imaging in patients resistant to multiple lines of treatment or presenting with clinical relapse.
Topics: Adolescent; Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Female; Humans; Immunotherapy; Neoplasm Recurrence, Local; Ovarian Neoplasms; Receptors, N-Methyl-D-Aspartate; Teratoma
PubMed: 34230042
DOI: 10.1136/bcr-2020-236340 -
Journal of Adolescent and Young Adult... Dec 2021To evaluate the clinicopathological characteristics and surgical outcomes in patients with pure ovarian immature teratomas (POITs). In this multicenter study, a...
To evaluate the clinicopathological characteristics and surgical outcomes in patients with pure ovarian immature teratomas (POITs). In this multicenter study, a retrospective review was made of the databases of six Gynecology Oncology Departments in Turkey to identify patients with POITs who had undergone surgery between 1993 and 2019. Evaluation was made of 48 patients with a median age at diagnosis of 22.5 years (range, 15-37 years). In 40 (83%) patients, stage I was determined and in eight patients, an advanced stage (IIIB, IIIC, and IVB) was determined. Tumors were found to be grade I in 17 (35.4%) cases, grade II in 12 (25%), and grade III in 19 (39.6%). Fertility-sparing surgery was applied to 42 (87.5%) patients and radical surgery to 6 (12.5%). The median follow-up was 60 months (range, 3-246 months). Recurrence was seen in seven patients, all with grade III tumors. In the final pathological examination of recurrent tumors, mature teratoma was reported in five patients, and immature teratoma in one patient. Salvage surgery was not performed in one patient as the tumor was unresectable and so a regimen of bleomycin, etoposide, and cisplatin (BEP) was administered. POITs are rare tumors seen at a young age, and benign or malignant relapse can be seen in these tumors. In this cohort, the malignant recurrence rate was 4.1%, and the benign recurrence rate was 10.4%. All the recurrences were in grade III tumors. Benign recurrences can be treated with surgery alone and the malignant group should be treated with surgery followed by chemotherapy.
Topics: Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Ovarian Neoplasms; Retrospective Studies; Teratoma; Turkey
PubMed: 33296263
DOI: 10.1089/jayao.2020.0155 -
International Journal of Gynecological... Nov 2022Teratomas are the most common neoplasm of the ovary, comprising over half of all diagnosed tumors in patients under 50. Most lesions are classified as benign mature...
Teratomas are the most common neoplasm of the ovary, comprising over half of all diagnosed tumors in patients under 50. Most lesions are classified as benign mature teratomas and are histologically defined by the presence of mature tissues from one or more of the embryological germ layers: ectoderm, mesoderm, and endoderm. Neuroectodermal derivatives, including glia, neurons, ependymal cells, and meninges are present in a third to half of mature teratomas. Although teratomatous tissue elements are typically arranged in a haphazard fashion, well-developed and organized embryonic organ structures have been rarely reported and often with limited histologic, clinical, or gross characterization. In this report, we describe the case of an ovarian mature cystic teratoma identified in a pregnant female which exhibited remarkably well-developed posterior fossa structures including lobated and foliated cerebellum with appropriate anatomic organization and associated brainstem, ventricular, and meningeal structures.
Topics: Humans; Female; Pregnancy; Teratoma; Ovarian Neoplasms; Dermoid Cyst; Cerebellum
PubMed: 34954707
DOI: 10.1097/PGP.0000000000000848 -
Korean Journal of Anesthesiology Dec 2022Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a type of autoimmune encephalitis that causes characteristic symptoms through the formation of antibodies...
BACKGROUND
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a type of autoimmune encephalitis that causes characteristic symptoms through the formation of antibodies against NMDA receptors. If ovarian teratomas are detected, surgical removal under general anesthesia is often considered. Many general anesthetic agents inhibit NMDA receptors. As such, anesthetic agents may have unexpected effects on disease progression. For anesthesiologists, providing general anesthesia for these patients is challenging and there are few studies on which anesthetic is most appropriate.
CASE
Two female patients were diagnosed with anti-NMDA receptor encephalitis and ovarian teratomas. Successful teratoma resection was performed under general anesthesia using remimazolam and remifentanil. After the surgery, one patient showed some improvement but died a month later. The other patient progressively improved over time.
CONCLUSIONS
Remimazolam and remifentanil are useful general anesthetic agents for patients with anti-NMDA receptor encephalitis. Further studies are warranted.
Topics: Humans; Female; Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Remifentanil; Teratoma; Receptors, N-Methyl-D-Aspartate; Anesthesia, General; Anesthetics, General
PubMed: 35831038
DOI: 10.4097/kja.22241 -
Fukushima Journal of Medical Science Apr 2023Carcinoid tumors of the ovary are rare tumors, histopathologically classified as monodermal teratomas and somatic-type tumors arising from dermoid cysts. Their...
BACKGROUND
Carcinoid tumors of the ovary are rare tumors, histopathologically classified as monodermal teratomas and somatic-type tumors arising from dermoid cysts. Their malignancy varies from borderline to malignant. Carcinoid tumors can occur in young and elderly women, and are sometimes seen in mature teratoma, struma ovarii, or mucinous cystadenoma as a nodule or tumor. Strumal carcinoid and mucinous carcinoid present as special types of carcinoid tumors of the ovary.
CASE REPORT
This report describes a 56-year-old woman who presented with a large pelvic mass on abdominal ultrasonography during a medical examination. The diameter of the pelvic tumor was approximately 11 cm and was suspected to be ovarian cancer. The values of CA125 and CEA were above their reference intervals on preoperative examination. Abdominal total hysterectomy and bilateral salpingo-oophorectomy were performed. Intraoperative frozen-section histopathology suggested a diagnosis of mucinous adenocarcinoma; therefore, partial omentectomy and pelvic lymphadenectomy were also performed. Permanent-section histopathology led to a final diagnosis of strumal carcinoid of the ovary, stage IA (FIGO 2014). Six years post-operation, the patient had no sign of recurrence.
Topics: Female; Humans; Aged; Middle Aged; Struma Ovarii; Carcinoid Tumor; Ovarian Neoplasms; Teratoma
PubMed: 36878591
DOI: 10.5387/fms.2022-22 -
BMC Women's Health Sep 2023Struma ovarii (SO) is a rare tumor and may transform into ovarian strumal carcinoid (OSC) and/or malignant struma ovarii (MSO), but the incidence, clinical...
BACKGROUND
Struma ovarii (SO) is a rare tumor and may transform into ovarian strumal carcinoid (OSC) and/or malignant struma ovarii (MSO), but the incidence, clinical characteristics, and survival outcomes have not been well defined.
METHODS
We conducted a retrospective study of patients with ovarian strumal diseases treated in the our hospital between 1980 and 2022. Subgroup analyses of SO, OSC, and MSO were subsequently performed.
RESULTS
A total of 275 cases (2.14%) were identified in a cohort of 12,864 patients with ovarian teratomas, where SO, OSC, and MSO accounted for 83.3%, 12.0%, and 4.7% of cases, respectively. There were no significant differences in age, tumor sizes, elevated tumor markers, and ascites among the three subgroups. At initial treatment, all patients with SO or OSC had FIGO stage I disease except one SO patient presenting metastatic disease, ten patients had MSO confined to the ovary, whereas other three patients had metastatic diseases. Two patients with SO respectively relapsed at peritoneum and anterior mesorectum, while none of the OSC patients presented tumor recurrence or death despite different surgical procedures employed. The 5-year recurrence-free survival rate was 88.9%, and only one death occurred at 9.5 years after diagnosis in patients with MSO. Radioiodine therapy showed satisfactory therapeutic efficacy, but these patients showed poor responses to the chemotherapy.
CONCLUSION
2.14% of ovarian teratoma could be classified as SO, of which 12.0% and 4.7% of SO may transform into OSC and MSO, repsectively. The survival outcomes were excellent even after SO transformed into OSC or MSO.
SYNOPSIS
SO occupied 2.14% of ovarian teratoma, where 12.0% and 4.7% of SO may transform into OSC and MSO, respectively, and had excellent survival outcomes.
Topics: Female; Humans; Ovarian Neoplasms; Struma Ovarii; Retrospective Studies; Carcinoid Tumor; Incidence; Iodine Radioisotopes; Neoplasm Recurrence, Local; Teratoma
PubMed: 37726744
DOI: 10.1186/s12905-023-02624-5 -
Veterinary Pathology Nov 1985Primary ovarian neoplasms from 22 cats were described. A single cat had tumors of epithelial origin--bilateral cystadenomas. Seven animals had germ cell...
Primary ovarian neoplasms from 22 cats were described. A single cat had tumors of epithelial origin--bilateral cystadenomas. Seven animals had germ cell tumors--dysgerminomas or teratomas; two cats had bilateral tumors. Fourteen animals had neoplasms of sex cord-stromal origin--granulosa cell tumors and interstitial gland tumors. Four cats with granulosa cell tumors had clinical evidence of hormonal disturbance.
Topics: Animals; Cat Diseases; Cats; Dysgerminoma; Female; Granulosa Cell Tumor; Ovarian Neoplasms; Teratoma
PubMed: 4082383
DOI: 10.1177/030098588502200610 -
Le Journal Medical Libanais. the... 2014Germ cell tumors are derived from the primordial germ cells of the ovary and immature teratoma is the second most common germ cell malignancy. About 50% of pure immature...
Germ cell tumors are derived from the primordial germ cells of the ovary and immature teratoma is the second most common germ cell malignancy. About 50% of pure immature teratomas of the ovary occur in women between the ages of 10 and 20 years, and they rarely occur in pregnancy. A 21-year-old woman, gravid 1, para 0, at 18 weeks of gestation, was incidentally diagnosed with a right ovarian mass 180 mm by 200 mm, 160 mm in diameter, during a prenatal ultrasound scanning. She underwent surgery by unilateral salpingo-oophorectomy and surgical staging. The result of pathology showed a stage 1a grade 1 immature teratoma of ovary. Her pregnancy continued until term. At 38 weeks she delivered with breech presentation a normal 2900 g male newborn by cesarean section. Although immature teratomas of ovary during pregnancy are rare, clinicians should consider their eventuality in younger pregnant women in asymptomatic cases.
Topics: Female; Humans; Incidental Findings; Ovarian Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Teratoma; Young Adult
PubMed: 25807726
DOI: 10.12816/0008297 -
BMJ Case Reports Dec 2022Growing teratoma syndrome (GTS) is a tumour growth, which contains mature teratomatous elements during or after chemotherapy for malignant germ cell tumours. Surgery is...
Growing teratoma syndrome (GTS) is a tumour growth, which contains mature teratomatous elements during or after chemotherapy for malignant germ cell tumours. Surgery is the only potential treatment option for GTS because these growing teratomas are resistant to chemotherapy and radiation therapy. Extensive surgeries may be needed in GTS with multivisceral resections to achieve no residual disease status. This report presents a case of GTS treated with multiple surgical resections in a woman with malignant immature teratoma ovary in her early thirties; she is disease free after 1 year of treatment.
Topics: Female; Humans; Ovarian Neoplasms; Neoplasms, Germ Cell and Embryonal; Teratoma; Antineoplastic Combined Chemotherapy Protocols; Syndrome
PubMed: 36593596
DOI: 10.1136/bcr-2022-251821 -
Pathogenesis of balls in mature ovarian cystic teratoma. Report of 3 cases and review of literature.International Journal of Gynecological... Oct 2006Ovarian cystic teratomas with intracystic balls are rare, and only 11 cases have been reported since 1946. We present 2 new cases and review the literature for the... (Review)
Review
Ovarian cystic teratomas with intracystic balls are rare, and only 11 cases have been reported since 1946. We present 2 new cases and review the literature for the clinical presentation and morphological appearances of the cysts and balls. We also present our histology findings on a third case reported in the international literature. The pathogenesis of balls formation is unknown. We put forward a hypothesis based on the forces which control the production and absorption of the intracystic contents and also recommendations for investigators who may encounter this lesion. We believe that predominance of large secretory and absorptive rather than exfoliative surfaces lining the cysts would favor the absorption of most of the contents into the general circulation, leaving the remaining material to solidify and mould into balls. Still, however, there are many unanswered questions.
Topics: Adult; Female; Humans; Ovarian Neoplasms; Ovary; Teratoma
PubMed: 16990711
DOI: 10.1097/01.pgp.0000209576.46834.34