Aggressive Gliomatosis Peritonei Arising from Ovarian Mature Teratoma with NF1 Mutation: A Case Report and Literature Review

Background

GP arising from ovarian mature teratoma is a rare disease, and no confirmed pathogenesis signature genes are reported. The progress of GP is seen as relatively slow. Rare aggressive GP cases with poor prognosis were reported and no guidelines to follow for treatment.

Case Presentation

Herein, we report a 17-year-old girl with a 3-year-history of GP arising from ovarian mature teratoma. Surgeries and drug therapy were used to treat the aggressively growing tumour. Genetic profiling revealed the pathogenic mutation with potential therapeutic approaches. We firstly reported the NF1 mutations in GP secondary to teratomas and may cause bad prognosis.

Conclusion

GP arising from ovarian mature teratoma is rare; we found NF1 mutation could be the trigger of GP. The study may provide new insights into a better understanding of this rare disease.

Ovarian squamous cell carcinoma

Ovarian squamous cell carcinoma is a rare and aggressive ovarian neoplasm, where most of the cases arise from mature teratoma, which represents up to 20% of all ovarian tumors. Moreover, primary squamous cell carcinoma is considered to be related to human papillomavirus infection. The diagnosis is difficult and metastasis from bladder, genital tract, lung, and digestive tract cancers must be ruled out. There are no guidelines for treatment, however, radical surgery combined with adjuvant chemotherapy and radiation therapy, are the most common approach. We present the case of a young women diagnosed with a de novo ovarian squamous cell carcinoma, as well as the treatment and follow-up that she received.

Mature ovarian teratoma with gliomatosis peritonei: A rare case report

Gliomatosis peritonei (GP) is rarely observed along with mature ovarian teratoma. However, it is important to recognize the benign nature of GP when associated with mature ovarian teratoma. Treatment for primary tumor and long-term follow-up is vital.

Primary juxtaovarian yolk sac tumor concurrent with an ipsilateral ovarian mature teratoma in an adult woman: a rare association

OBJECTIVES

Yolk sac tumor (YST) is a rare neoplasm that primarily occurs in the ovary in children and young women. Previously, it has been reported that the teratomatous components can be recognized in part of YSTs or appear in the contralateral ovary. Here, we report a rare case of an adult woman with a juxtaovarian YST concurrent with an ipsilateral ovarian mature teratoma.

METHODS

A 47-year-old woman found a pelvic mass for nine days and subsequently underwent debulking operation. The specimens were evaluated for detailed characterizations through gross examination, microscopy and immunohistochemistry. A literature review was performed and the pathogenesis was briefly discussed about the generation of an extraovarian YST concurrent with a teratoma.

RESULTS

The right juxtaovarian tumor showed typical histological patterns of YST. Immunostaining demonstrated the YST nature of Gly-3 and AFP positive tumor cells. The ipsilateral ovarian tumor was a common mature cystic teratoma with chronic fibrotic changes. According to the differences of the origin and the differentiation of the two germ cell tumors, we suspect that the occurrence of the teratoma is earlier than the YST.

CONCLUSIONS

To our knowledge, this is the first report of an adult woman with a juxtaovarian YST concurrent with an ipsilateral ovarian mature teratoma.

[Peritoneal gliomatosis]

BACKGROUND

Peritoneal gliomatosis is characterized by the presence of miliary implants of mature glia on the peritoneum of patients with ovarian teratomas, usually immature.

CLINICAL CASE

We report the case of a woman operated on 5 years earlier due to a right mature ovarian teratoma. When she was operated on due to left ovarian tumor she presented a miliary glial dissemination in omentum and peritoneum.

CONCLUSION

The association of peritoneal gliomatosis ovarian teratomas is rare. Although the primary treatment and patient monitoring is focused on the teratoma, control should be maintained of peritoneal implants because of the possibility of malignancy. We believe it would be beneficial to establish a protocol for monitoring these lesions.