Neurogenic cyst of ovary: an unusual massive monodermal teratoma

Neurogenic Monodermal Teratoma in the Scapula of a Child: A Case Report

Background: Neurogenic monodermal teratomas (NMTs) have been reported in the ovaries but not from bone. Case Report: A 6-year-old girl had an incidentally discovered lesion in the right scapula. Upon removal, it was an NMT with predominant choroid plexus. The disease had not progressed for 31 months. Conclusion: Neurogenic monodermal teratomas can also occur in bone.

Types and Frequency of Neural Elements in Mature Ovarian Teratomas: An 11-Year Study from Rural India

Introduction

Teratomas are those tumors which are derived from the totipotent cells. They may manifest at any site. Ovary is the most common site for teratomas. Ovarian teratomas may be immature and mature depending on the elements they harbor. Mature ovarian teratomas may contain ectoderm, endoderm, and mesoderm. Ectoderm mainly comprises the skin and its adnexa, followed by neural tissue, whereas mesodermal elements are blood vessels, adipose tissue, cartilage, and hematopoietic tissue, similarly, endoderm consists of respiratory tissue, thyroid gland, and gastrointestinal tissue.

Materials and Methods

This study was conducted in the histopathology section from January 2008 to April 2019 and included 54 cases of mature ovarian teratomas. The slides of ovarian tumors were evaluated, and the relationship between clinical and pathological findings was studied with emphasis predominantly on neural elements.

Results

The most common age group among the women with ovarian teratoma was 21-30 (31.48%) years, the youngest patients been 8 years, and oldest of 60 years. The chief complaints were pain in 37 (68.51%), followed by mass per abdomen 25 (46.29%). On gross examination, most of the tumors were unilateral 53 (98.14%), having tufts of hairs with sebaceous material 34 (61.81%). Microscopic examination confirmed the presence of squamous epithelium and its adnexal structure 52 (94.54%). Neural elements were seen in 14 (25.45%) cases. In every case with neural elements, skin, its adnexa, and adipose tissue were also seen.

Conclusion

Teratomas have diversity in the age of presentation, gross findings, and microscopy features. Neural elements are commonly found in 25.45% of ovarian teratoma which is mostly found in association with skin and adipose tissue. The combination of neural elements with adipose tissue signifies an association between them because both arise from different dermal elements.

Hand-assisted laparoscopic surgery for a mesenteric teratoma

The authors report a rare case of mesenteric monodermal teratoma that mimicked an ovarian tumor and was successfully managed with hand-assisted laparoscopic intervention.

Mature cystic teratomas are benign neoplasms of germ cell tumors that occur most frequently in gonadal sites. The tumors usually contain 2 or 3 well-differentiated elements of endodermal, ectodermal, and mesodermal origin. Although relatively uncommon, teratomas can be composed of mature tissue originating from only 1 germ cell layer. This is known as a monodermal teratoma.

Extragonadal teratomas, especially mesenteric teratomas, are extremely rare. Currently, only 21 cases of mesenteric teratoma have been described in the English literature. Mesenteric teratomas are rarely diagnosed preoperatively because pathological examination is necessary to make a definitive diagnosis.

We herein report a rare case of mesenteric monodermal teratoma and review the literature. To the best of our knowledge, this is the first case of mesenteric teratoma treated with hand-assisted laparoscopic surgery.

Germ cell tumors of the ovary: A clinicopathologic study of 121 cases from Nepal

BACKGROUND

Although many reports have been published about germ cell tumors of the ovary in developed countries, there has been no such documentation from Nepal. The retrospective study presented here reports the clinicopathologic profile of germ cell tumors of the ovary studied at B. P. Koirala Institute of Health Sciences, Dharan, Nepal.

METHODS

A retrospective analysis of 121 histopathologically proven cases of germ cell tumor of the ovary operated on at either our institute or somewhere else (but processed in our institute) from November 1995 to April 2001 (5.5 years) was done. Clinical data, histopathologic findings and complications were recorded.

RESULTS

The prevalence of germ cell tumors was 43.36% (121/279) of all ovarian neoplasms. Patient age varied from 8 to 65 years (median 31 years). Tumor occurrence was most frequent in patients aged 21-40 years. Only eight of 121 cases (6.61%) were malignant; the rest (93.39%) were mature teratomas. Of great interest was the unexpectedly high number of cases (47.93%) found in patients who were hill natives such as Rai and Gurung. Pain and abdominal fullness were common symptoms noted in 85.95% and 79.31% of patients, respectively. Seventeen (14%) asymptomatic cases were found either on routine physical examination (12 cases) or during pregnancy (five cases). The left ovary was involved in 39.7% cases and the right in 35.5%. Bilateral involvement was seen in 24.8% of cases. Torsion was noted in 20.66% and was the most common complication. Of all the germ cell tumors 93.39% were cystic and only 6.61% were solid on gross appearance. There were three cases of monodermal benign teratoma, four cases of immature teratoma and one case of malignant transformation.

CONCLUSION

Mature teratoma is the most common germ cell tumor and accounts for 40.50% of all ovarian neoplasms. The high prevalence of germ cell tumors of the ovary found among patients who were hill natives needs to be explored further.