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Kori M, Tsunematsu M, Yao R, Hamura R, Yoda A, Endo H, Horiuchi T, Abe K, Hisa T, Onda S. Successful laparoscopic resection for giant mature cystic teratoma of the pancreas: a case report and surgical refinements. Surg Case Rep 2024; 10:115. [PMID: 38722483 PMCID: PMC11082099 DOI: 10.1186/s40792-024-01918-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a case of a giant mature cystic teratoma of the pancreas that was successfully resected via complete laparoscopic distal pancreatectomy (LDP). CASE PRESENTATION A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor. Three years of follow-up revealed that the tumor had increased in size to 18 cm, with hyperintense solid components on diffusion-weighted magnetic resonance imaging. Considering the possibility of malignancy, we decided to perform an LDP. The capsule appeared solid enough to withstand the retraction of the endoscopic forceps. Tumor size made it difficult to dissect the dorsal side of the tumor from the caudal to the cranial side. Early transection of the pancreas and additional ports facilitated dissection of the dorsal side of the tumor. We completed the LDP without intraoperative cyst rupture. On pathological examination, the tumor was diagnosed as a mature cystic teratoma originating from the pancreatic tail. The patient was discharged on postoperative day 13 with no complications. CONCLUSION LDP may be an option for surgical procedures in patients with large cystic lesions of the pancreatic body or tail. Intraoperative observation of the tumor and surgical refinement are necessary to complete the laparoscopic procedure without tumor rupture.
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Affiliation(s)
- Mayuko Kori
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Masashi Tsunematsu
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan.
| | - Ran Yao
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Ryoga Hamura
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Atsushi Yoda
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Hidetoshi Endo
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Takashi Horiuchi
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Kyohei Abe
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Takeshi Hisa
- Department of Gastroenterology, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Shinji Onda
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
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Sanap AS, Davile MD, Kamath AA, Mundle SR. Frozen in Time: Intraoperative Diagnosis and Management of Malignant Transformation in Mature Cystic Teratoma. J Midlife Health 2024; 15:115-118. [PMID: 39145267 PMCID: PMC11321514 DOI: 10.4103/jmh.jmh_253_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 08/16/2024] Open
Abstract
Malignant transformation (MCT) of ovary is rare complications affecting elderly, squamous cell carcinoma being the most common. The prognosis worsens with extraovarian spread. We present two cases of MCT-derived SCC. Patients exhibited abdominal lump, pain, bowel symptoms, sometimes with weight loss; imaging revealed MCT. Age (51-60), postmenopausal status, large size (>20 cm), bilaterality, and complex ovarian lesions raised suspicion of malignancy. Elevated tumor markers (e.g., cancer antigen-125 and lactate dehydrogenase) were noted in one case. Intraoperative frozen section confirmed malignancy, guiding staging laparotomy. One case was advanced stage on histopathology. Intraoperative frozen section aids optimal staging.
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Affiliation(s)
| | - Medha D. Davile
- Department of Obstetrics and Gynecology, AIIMS, Nagpur, Maharashtra, India
| | - Anusha A. Kamath
- Department of Obstetrics and Gynecology, AIIMS, Nagpur, Maharashtra, India
| | - Shuchita R. Mundle
- Department of Obstetrics and Gynecology, AIIMS, Nagpur, Maharashtra, India
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Ataikiru UO, Iacob ER, Heredea ER, Stănciulescu MC, Galinescu MC, Popoiu CM, Boia ES. A 10-year retrospective study of the risks and peculiarities in pediatric patients with (para)gonadal tumors and cysts. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2024; 65:225-241. [PMID: 39020537 PMCID: PMC11384043 DOI: 10.47162/rjme.65.2.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
INTRODUCTION Gonadal pediatric tumors are rare, ranking fourth (6%) among pediatric tumors, by Surveillance, Epidemiology, and End Results Program (https:∕∕seer.cancer.gov∕). They have vague symptoms, leading to late discovery, but early detection and identifying its risk factors result in favorable prognosis and reduction of its incidence respectively. PATIENTS, MATERIAL AND METHODS A 10-year retrospective study identified peculiarities and risk factors in 210 children till age 17 with (para)gonadal tumors. RESULTS Stress, pollution (agricultural chemicals, insecticides and metal mine), obesity, breastfeeding ≤5 months, malformations [mainly non-genetic related 67∕87 (77%), especially eye malformation - 64%], hormone, smoking, positive heredo-genetic history, rural residence area, abnormal birth weight, and menstruation disorders showed an increased gonadal malignancy risk; relative risk ratio (RR): 1.33, 1.30, 1.34, 1.11, 1.65, 1.16, 1.36, 1.10, 1.00, 1.08 and 1.15 folds, respectively. RR for histopathological subtypes: immature teratoma (IT) (pollution - 1.75, Rhesus positive - 3.41), dysgerminoma (menstruation disorders - 2.80), granulosa cell tumor (stress - 2.10, menstruation disorders - 2.80), mucinous cystadenomas (obesity - 2.84, no postnatal vaccine - 3.71), mature teratomas (stress - 2.35, malformations - 2.18) and serous cystadenomas (breastfeeding ≤5 months - 2.53), dependent variables being mixed germ cell tumors (GCTs) and cysts. Children presenting with bleeding (73%), abdominal distention (62%), elevated tumor markers (91%), (multilocular) solid tumor (88% and 100%), tumor size >10 cm (65%), GCTs (74%), death (100%), metastases (100%), viruses (77%), loss of appetite (68%), and weight (85%), had gonadal malignant tumors, especially mixed GCTs and IT. CONCLUSIONS Avoiding these risk factors will prevent and reduce gonadal pediatric tumors. Investigating children presenting with the listed peculiarities, especially if exposed to the mentioned risk factors, will enable early gonadal tumor identification, successful patient management, and favorable prognosis.
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Affiliation(s)
- Usiwoma Okeroghene Ataikiru
- Department of Pediatric Surgery and Orthopedics, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania; ,
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Liang Y, Ruan H, Yu M, Lü B. Ovarian squamous cell carcinoma associated with teratoma: a report of six cases with genomic analysis. Pathology 2023; 55:966-973. [PMID: 37739924 DOI: 10.1016/j.pathol.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/29/2023] [Accepted: 08/08/2023] [Indexed: 09/24/2023]
Abstract
Ovarian squamous cell carcinoma (SCC), particularly the sarcomatoid variant, arising from teratoma is a rare malignant tumour with unfavourable clinical outcomes. Its molecular genetic alterations have not been well-documented to date. This study aims to characterise the molecular features and to provide potential therapeutic targets in this rare entity. We analysed the clinicopathological and immunohistochemical features of six primary ovarian SCC. These cases were subject to targeted next-generation sequencing to detect genomic features. We found that all six ovarian SCC (four conventional and two sarcomatoid SCC) were associated with mature cystic teratomas. Patient 3 (FIGO stage IIIa) and Patient 4 (stage IIb) died of disease at 10 and 11 months, respectively. The remaining patients (three with stage I and one with IIc) including the two with sarcomatoid SCC, were alive with no evidence of disease at 28-72 months. All patients showed PD-L1 expression (tumour proportion score: range 10-78%, median 41%; combined positive score: range 12-85, median 42) and a high tumour mutation burden (range 13.4-25.7 mutations/Mb, median 16.5). The most frequently recurrent mutations included PIK3CA (4/6), TP53 (4/6), TERT promoter (4/6), CDKN2A (3/6). Mutations in homologous recombination repair pathway genes (BLM, ATM, BRCA1, BRIP1 and ATM) were found in 5/6 patients. The sarcomatoid SCC shared a similar mutational profile with conventional SCC, and no recurrent genetic mutations exclusively in sarcomatoid SCC were identified. Our study suggests the potential benefits of immune checkpoint inhibitors and/or PARP inhibitors in patients with primary ovarian SCC on account of PD-L1 expression and genomic features. Ovarian sarcomatoid SCC may be clonally related to the conventional SCC. A multiple-institutional, clinical and molecular study will consolidate these findings in the future.
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Affiliation(s)
- Yun Liang
- Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, China
| | - Huajuan Ruan
- Center for Uterine Cancer Diagnosis & Therapy Research of Zhejiang Province, China
| | - Minghua Yu
- Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, China
| | - Bingjian Lü
- Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, China; Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Hangzhou, Zhejiang Province, China.
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Chen H, Wang F, Hu X, Dai X, Wang Y. Preoperative clinical characteristics for differentiating malignant transformation from torsion of mature cystic teratoma. J OBSTET GYNAECOL 2023; 43:2151357. [PMID: 36519361 DOI: 10.1080/01443615.2022.2151357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This retrospective study was conducted in 27 patients with malignant transformation of mature cystic teratoma(MT-MCT)and 125 ovarian teratoma patients with torsion who underwent surgery in the First Affiliated Hospital of Wenzhou Medical University from 2008 to 2019. The incidence of MT-MCT in this study was 0.79%. The 3-year overall survival (OS) rate was 69.6 ± 9.6%. The 3-year progression-free survival (PFS) rate was 58.3 ± 9.6%. Kaplan-Meier survival analysis indicated that patients with squamous cell carcinoma (SCC) had significantly shorter OS compared with non-SCC patients. Older age (OR 1.076, 95% CI 1.041-1.111), higher platelet (PLT) level (OR 1.012, 95% CI 1.005-1.020) and lower neutrophil-to-lymphocyte ratio (NLR) level (OR 0.794, 95% CI 0.647-0.915) were independent predictors of MT-MCT. The area under the curve (AUC) for the combined use of age, PLT count and NLR was 0.921 (95% confidence interval 0.877-0.964; p < 0.001), with a sensitivity of 92.6% and a specificity of 80.8%.
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Affiliation(s)
- Huijun Chen
- Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Fang Wang
- Department of Pathology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Xiaoli Hu
- Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Xinyue Dai
- Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Yuanqiu Wang
- Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China
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Arab M, Ashtiani AJ, Faghih N, Ghavami B, Nouri B, Ardabili SN. Malignancy Arising in Dermoid Cysts: A Case Report and Literature Review. J Family Reprod Health 2023; 17:264-268. [PMID: 38807623 PMCID: PMC11128734 DOI: 10.18502/jfrh.v17i4.14599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
Objective Malignant transformation in dermoid cysts is rare, and Squamous Cell Carcinoma (SCC) is the most common form. This event often occurs in large tumors and middle-aged women. Case report In this study, two cases are presented. They were menopause, and abdominal pain and adnexal mass was a common manifestation in both. Case 1 with adenocarcinoma arising in mature cystic teratoma had abnormal tumor markers and was diagnosed with a frozen section during surgery, but case 2 with SCC transformation had normal tumor markers, and the frozen section was not helpful in the first surgery. Both underwent complete staging surgery, and due to stage IC1 in case 1, she received chemotherapy, and in case 2, no adjuvant treatment was needed because of stage IA. Conclusion Considering the rarity of malignant transformation in the dermoid cyst, the best surgical approach and adjuvant therapy indications need further research.
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Affiliation(s)
- Maliheh Arab
- Department of Gynecology Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Jafari Ashtiani
- Department of Obstetrician and Gynecologist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nafiseh Faghih
- Department of Obstetrician and Gynecologist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnaz Ghavami
- Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Nouri
- Department of Obstetrician and Gynecologist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Al Harthi S, Al Kalabni M, Al Qassabi B, Al Ajmi R. Mucinous Adenocarcinoma and Carcinoid Tumor Arising Within an Ovarian Mature Cystic Teratoma: A Case Report. Oman Med J 2023; 38:e538. [PMID: 37587986 PMCID: PMC10425607 DOI: 10.5001/omj.2023.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/30/2022] [Indexed: 08/18/2023] Open
Abstract
The coexistence of both mucinous adenocarcinoma and carcinoid tumor within an ovarian mature cystic teratoma is extremely rare. We report a case of an 18-year-old Omani woman with a left ovarian cyst. After laparotomy with left salpingo-oophorectomy, omentectomy, and peritoneal washings, the excised cyst had the typical morphology of mature cystic teratoma with grade I mucinous adenocarcinoma and a focus of carcinoid tumor.
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Affiliation(s)
- Sara Al Harthi
- Departments of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Moza Al Kalabni
- Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Badriya Al Qassabi
- Department of Radiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Radiya Al Ajmi
- Departments of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
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Irena Batog W, Riain CÓ, Abu Saadeh F. The dilemma of managing thyroid gland after incidental diagnosis of malignant struma Ovarii. Is radical thyroidectomy and radioactive iodine Necessary? A case report and literature review. Gynecol Oncol Rep 2023; 47:101189. [PMID: 37128251 PMCID: PMC10147963 DOI: 10.1016/j.gore.2023.101189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/27/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023] Open
Abstract
•Struma ovarii is a rare ovarian teratoma which consists of at least 50% thyroid tissue.•In 0.5-1% of cases the thyroid tissue in the struma ovarii undergoes a malignant transformation.•Patients should be divided into low and high-risk groups for synchronous thyroid carcinoma.•Patients with abnormalities on thyroid imaging should be considered as high-risk.•A thyroidectomy and radioactive iodine treatment can decrease the risk of recurrence.
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Affiliation(s)
- Wiktoria Irena Batog
- Trinity College Dublin, Dublin 2, Ireland
- Corresponding author at: Gynecological-Oncology Department, St. James’s Hospital, Dublin 8, Ireland.
| | - Ciarán Ó Riain
- Department of Histopathology, St. James’s Hospital, Dublin 8, Ireland
- Trinity St. James’s Cancer Institute, Dublin 8, Ireland
| | - Feras Abu Saadeh
- Trinity College Dublin, Dublin 2, Ireland
- Department of Gynecology, St. James’s Hospital, Dublin 8, Ireland
- Trinity St. James’s Cancer Institute, Dublin 8, Ireland
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High-Grade Endometrioid Stromal Sarcoma of the Ovary: Malignant Transformation of Ovarian Mature Cystic Teratoma. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101501. [PMID: 36295661 PMCID: PMC9610105 DOI: 10.3390/medicina58101501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/30/2022]
Abstract
We report an extremely rare case of ovarian high-grade endometrioid stromal sarcoma arising from a mature cystic teratoma with clinicopathologic features, and then we briefly review the pertinent literature. A 62-year-old nulliparous woman presented with lower abdominal pain that had begun 6 months earlier. Magnetic resonance imaging showed two adnexal masses with fat components, which suggested that they were mature cystic teratomas. The eccentric thick rim of the left mass showed irregular invasion of the uterus, which was suggestive of malignancy. Positron emission tomography/computed tomography demonstrated high fluorodeoxyglucose uptake in the corresponding area. The patient underwent debulking cytoreductive surgery. The diagnosis was of an International Federation of Obstetrics and Gynecology stage IIIC high-grade endometrioid stromal sarcoma arising from a mature cystic teratoma. After surgery, the patient received adjuvant chemotherapy with three courses of doxorubicin regimen. The cancer recurred 3 months after surgery, and the patient died of progressive disease. It might be helpful for clinicians to be aware of this rare disease and the poor prognosis when it is at an advanced stage.
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Djokic M, Hadzialjevic B, Rankovic B, Dezman R, Tomazic A. Neuroendocrine Tumor Arising within Mature Cystic Teratoma of the Pancreas: Literature Review and Case Report. Curr Oncol 2022; 29:4717-4724. [PMID: 35877234 PMCID: PMC9322391 DOI: 10.3390/curroncol29070374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Cystic teratomas are germ cell tumors most commonly found in the ovaries and testes. The pancreas, however, is very rare as a site of occurrence. Moreover, only two cases of cystic teratoma with concomitant neuroendocrine tumor have been reported to date. We report the case of a 33-year-old female who presented with abdominal pain. Computed tomography and magnetic resonance imaging of the upper abdomen revealed an 85 mm cystic tumor in the head of the pancreas. Cystic teratoma and mucinous cystadenoma were suggested as differential diagnoses. Cytopathologic analysis of endoscopic ultrasound-guided fine needle aspiration was consistent with mucinous cystadenoma. Therefore, the patient underwent surgical resection. Histologic analysis revealed a mature cystic teratoma of the pancreas with a concomitant neuroendocrine tumor. The patient is in great condition at 8 months follow-up. Cystic teratoma of the pancreas with a concomitant neuroendocrine tumor is an extremely rare condition. Surgical resection remains the mainstay of treatment as it provides a definitive diagnosis and no recurrences have been reported to date.
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Affiliation(s)
- Mihajlo Djokic
- Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia; (M.D.); (B.H.)
- Department of Surgery, Faculty of Medicine, University of Ljubljana, Zaloska Cesta 7, 1000 Ljubljana, Slovenia
| | - Benjamin Hadzialjevic
- Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia; (M.D.); (B.H.)
| | - Branislava Rankovic
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Korytkova Ulica 2, 1000 Ljubljana, Slovenia;
| | - Rok Dezman
- Department of Radiology, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia;
| | - Ales Tomazic
- Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia; (M.D.); (B.H.)
- Department of Surgery, Faculty of Medicine, University of Ljubljana, Zaloska Cesta 7, 1000 Ljubljana, Slovenia
- Correspondence:
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Li Y, Qin M, Shan Y, Wu HW, Liu XD, Yin J, Gu Y, Wang W, Wang YX, Chen JY, Ma L, Jin Y, Pan LY. 30-Year Experience With 22 Cases of Malignant Transformation Arising From Ovarian Mature Cystic Teratoma: A Rare Disease. Front Oncol 2022; 12:842703. [PMID: 35615156 PMCID: PMC9124836 DOI: 10.3389/fonc.2022.842703] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the clinical characteristics and survival outcomes of patients with malignant transformation arising from ovarian mature cystic teratoma (MT-MCT). Methods This 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. Results Overall, 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. Conclusion MT-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.
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Affiliation(s)
- Yan Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Meng Qin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Ying Shan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Huan-wen Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-ding Liu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Yin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yu Gu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Wei Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yong-xue Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Jia-yu Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Li Ma
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Jin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
- *Correspondence: Ying Jin,
| | - Ling-ya Pan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
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