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Watanabe H, Kanauchi N, Suzuki J, Matsuo S, Shiono S. Asymptomatic mature intrapericardial teratoma in an adult: a case report of a rare condition. Surg Case Rep 2024; 10:103. [PMID: 38678494 PMCID: PMC11056345 DOI: 10.1186/s40792-024-01902-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/18/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Benign mature teratomas are the most common type of anterior mediastinal germ cell tumor. Mature intrapericardial teratomas are generally diagnosed during infancy because of symptoms of cardiac compression. In contrast, mature adult intrapericardial teratomas are extremely rare, accounting for less than 1% of mature intrapericardial teratomas. We describe herein a case of a mature intrapericardial teratoma in an asymptomatic adult. CASE PRESENTATION A 52-year-old woman was found by computed tomography during a health checkup to have an anterior mediastinal mass. She was asymptomatic and hemodynamically stable with no evidence of heart failure. The preoperative provisional radiological diagnosis was a mature intrapericardial teratoma. A median sternotomy revealed an approximately 5-cm diameter protruding intrapericardial mass with a smooth surface. The mass was completely resected. Histopathological examination resulted in a diagnosis of a mature intrapericardial teratoma. The patient did well and has no evidence of recurrence 5 years after surgery. CONCLUSIONS Mature intrapericardial teratomas in adults are extremely rare. Given the risks of malignant transformation, rupture, compression of the heart, and infection, excision is indicated to prevent development of serious manifestations.
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Affiliation(s)
- Hikaru Watanabe
- Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, Yamagata, Japan.
- Department of General Thoracic Surgery, Nihonkai General Hospital, Sakata, Yamagata, Japan.
| | - Naoki Kanauchi
- Department of General Thoracic Surgery, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Jun Suzuki
- Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, Yamagata, Japan
| | - Soumei Matsuo
- Department of General Thoracic Surgery, Nihonkai General Hospital, Sakata, Yamagata, Japan
| | - Satoshi Shiono
- Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, Yamagata, Japan
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Rouabeh W, Chrigui R, Imen M, Nawwar N, Cherif T, Radhia BB. Cardiopulmonary bypass for anesthetic management anterior medistinal teratoma: Case report. Int J Surg Case Rep 2024; 119:109575. [PMID: 38759398 DOI: 10.1016/j.ijscr.2024.109575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Perioperative anesthetic management in cases of severe airway obstruction with positional symptoms can be associated with difficulties in ventilation or intubation, with a risk of acute respiratory decompensation at every stage of anesthesia. CASE PRESENTATION Here we describe the anesthetic management of an 18-year-old woman with a mature teratoma who presented with progressive exertional dyspnea that was aggravated in the supine position in the operating room. After tracheal intubation, the tidal volume decreased, airway pressure increased, and pet CO2 grew beyond 105 mmHg without oxygen desaturation, prompting a femoro-femoral cardio-pulmonary bypass. CLINICAL DISCUSSION Cardio-pulmonary bypass (CPB) can facilitate tumor dissection by safely deflating the lungs and retracting the heart, enhancing exposure and reducing risks of hemodynamic or respiratory complications. However, systemic heparinization may increase complications, necessitating a preoperative risk assessment. CONCLUSION Preoperative management of large mediastinal masses requires careful attention to tumor anatomical details and relationships with surrounding structures. Preoperative preparation includes multimodality imaging and multidisciplinary team discussions to assess MMS risk, requiring specialized center management.
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Affiliation(s)
- Wissal Rouabeh
- Cardiovascular and Thoracic Surgery Department, Sahloul University Hospital, Tunisia
| | - Raoudha Chrigui
- Department of Aneasthesiology, Sahloul University Hospital, Tunisia
| | - Mgarrech Imen
- Cardiovascular and Thoracic Surgery Department, Sahloul University Hospital, Tunisia
| | - Nizar Nawwar
- Department of Aneasthesiology, Sahloul University Hospital, Tunisia
| | - Taieb Cherif
- Cardiovascular and Thoracic Surgery Department, Sahloul University Hospital, Tunisia
| | - Bechir Ben Radhia
- Cardiovascular and Thoracic Surgery Department, Sahloul University Hospital, Tunisia
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Gil LA, Knaus ME, Stanek JR, Srivatsa S, Patterson KN, Wood RJ, Minneci PC, Ranalli MA, Aldrink JH. Variability in Surveillance Strategies Following Resection of Sacrococcygeal Teratoma. J Surg Res 2024; 295:423-430. [PMID: 38070256 DOI: 10.1016/j.jss.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/17/2023] [Accepted: 11/12/2023] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Surveillance following sacrococcygeal teratoma (SCT) resection varies. The purpose of this study was to describe the clinical characteristics and outcomes of patients undergoing SCT resection and examine current institutional practices to detect recurrence. METHODS A single-institution retrospective review of children who underwent resection of an SCT from January 1, 2010 to December 31, 2020 was performed. Data were summarized and surveillance strategies compared between histopathologic subtypes using nonparametric methods. RESULTS Thirty six patients (75.0% female) underwent SCT removal at a median age of 8 d. Histopathology revealed 27 mature teratomas (75.0%), eight immature teratomas (22.2%), and one malignant germ cell tumor (2.8%). Median postoperative follow-up was 3.17 y (interquartile range [IQR]: 2.31-4.38 y). Patients had a median of 2.32 clinic visits per year (IQR: 2.00-2.70), alpha-fetoprotein levels were obtained at a median of 2.01 times per year (IQR: 0-1.66), and surveillance imaging was performed at a median of 2.31 times per year (IQR: 0-2.84). Patients with immature teratomas had alpha-fetoprotein laboratories obtained more frequently than patients with mature teratomas (3.10 times/year versus 0.93 times/year, P = 0.001). There was no significant difference in the number of imaging studies obtained between groups. Two patients (5.6%) developed recurrence, which were identified on magnetic resonance imaging at 191 and 104 d postresection, respectively. CONCLUSIONS Postoperative surveillance practices varied widely. Recurrence was noted in a single malignant case in the first year following resection. Multi-institutional studies are needed to determine the optimal surveillance strategy to detect recurrence of SCT.
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Affiliation(s)
- Lindsay A Gil
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Maria E Knaus
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Joseph R Stanek
- Department of Pediatric Hematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio
| | - Shachi Srivatsa
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Kelli N Patterson
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Richard J Wood
- Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio; Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Peter C Minneci
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Mark A Ranalli
- Department of Pediatric Hematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer H Aldrink
- Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
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Mohammed SA, Kazali BA, Ibrahim BM, Mohammed HY, Gebrechristos S, Mersha MK. Primary retroperitoneal mature teratoma in a young female: Case report. Int J Surg Case Rep 2024; 115:109321. [PMID: 38306872 PMCID: PMC10850739 DOI: 10.1016/j.ijscr.2024.109321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/04/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Teratomas are nonseminomatous germ cell tumor. Retroperitoneal teratoma is uncommon, especially in adults. Surgical excision the main stay of therapy for mature teratoma and also it the way for defnitive diagnosis. CASE PRESENTATION This case report discuss a 20 year old female patient who presented with long standing abdominal pain. On abdominal examination there was firm, immobile huge mass irregular mass involving left lower and upper abdomen crossing the midline. The ultrasound and CT scan was suggestive of retroperitoneal teratoma. Preoperative CA19.9 was elevated, which drop significantly postoperatively. Patient was explored and complete tumor resection is done. The biopsy confirms mature teratoma. The postoperative follow up was unremarkable. CLINICAL DISCUSSION Retroperitoneal teratomas are very rare in adults and only few cases have been reported in literature. Primary retroperitoneal teratomas (PRT) are rare, with incidence of 1 %-11 %. Imaging has vital role for diagnosis of retroperitoneal. Tumor markers can be elevated in PRT. Most mature teratomas are benign in nature. Surgical excision is necessary for definitive diagnosis and it is main stay of management for retroperitoneal teratoma. CONCLUSION Preoperative Imaging is important not only for diagnosis but also for preoperative planning. Surgical resection is the main stay of management for mature retroperitoneal teratoma. Despite its benign nature mature retroperitoneal teratoma need close follow up, because of its low risk of malignant transformation.
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Affiliation(s)
- Sadam Aliye Mohammed
- Department of Surgery, Urology Unit, School of Medicine, Po Box: 9086, Addis Ababa University, Ethiopia.
| | - Bedri Ahmed Kazali
- Department of Surgery, Urology Unit, School of Medicine, Po Box: 9086, Addis Ababa University, Ethiopia
| | - Burhan Mohammed Ibrahim
- Department of Surgery, Urology Unit, School of Medicine, Po Box: 9086, Addis Ababa University, Ethiopia
| | - Hidaya Yahya Mohammed
- Department of Surgery, Urology Unit, School of Medicine, Po Box: 9086, Addis Ababa University, Ethiopia
| | - Selam Gebrechristos
- Department of Surgery, Urology Unit, School of Medicine, Po Box: 9086, Addis Ababa University, Ethiopia
| | - Mahlet Kifle Mersha
- Department of Surgery, Urology Unit, School of Medicine, Po Box: 9086, Addis Ababa University, Ethiopia
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Belayachi B, Fenane H, Msougar Y. Surgical management of mediastinal mature cystic teratoma of the elderly remaining asymptomatic. J Cardiothorac Surg 2024; 19:28. [PMID: 38281986 PMCID: PMC10822176 DOI: 10.1186/s13019-024-02503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/14/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Mediastinal teratoma is an uncommon disease, nevertheless they represent the most common mediastinal germ cell tumors. It may grow silently for several years and remain undiagnosed until the occurrence of a complication. AIM The main aim of this article is to illustrate the silent evolution of an anterior mediastinal teratoma for over 70 years without presenting any notable complications. CASE PRESENTATION We present the case of a 70-year-old female, treated for hypertension referred to our department for managing a voluminous mediastinal mass, discovered fortuitously by a general practitioner in a chest X-ray. The anamnesis didn't relate any chest pain, cough, dyspnea nor hemoptysis. The clinical examination, in particular pleuropulmonary, was unremarkable. The workup (Chest X-Ray and CT scan) demonstrated a voluminous pleural mass at the expense of the right mediastinal pleura, rounded in shape, with calcified wall and fluid content. Blood tests did not demonstrate eosinophilia, and hydatid IgG serology was negative. serum human chorionic gonadotropin (hCG) and alpha fetoprotein (AFP) levels were found to be normal. The patient subsequently underwent a right posterolateral thoracotomy with resection of the lesion. The mass was dissected very carefully and then resected in toto. The macroscopic and microscopic histological examination demonstrated a mature cystic teratoma. Surgical resection was an adequate treatment and the prognosis was excellent for the patient. CONCLUSION Cystic mature teratomas are rare thoracic tumors, often recognized by radiological examination. This article relates the silent evolution that a teratoma could have, and the late appearance of symptoms that it could have.
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Affiliation(s)
- Badreddine Belayachi
- Department of Thoracic surgery, Mohammed VI University Hospital, Marrakesh, Morocco.
| | - Hicham Fenane
- Department of Thoracic surgery, Mohammed VI University Hospital, Marrakesh, Morocco
| | - Yassine Msougar
- Department of Thoracic surgery, Mohammed VI University Hospital, Marrakesh, Morocco
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Theiveegan D, Tanwar M, Kulkarni P, Mohan S, Kim U. Orbital tooth - not always a teratoma : a case report. Orbit 2023; 42:650-653. [PMID: 35581700 DOI: 10.1080/01676830.2022.2072900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/24/2022] [Indexed: 06/15/2023]
Abstract
A 7-year-old girl presented with a painless firm to cystic mass in the infero-temporal quadrant of her right orbit since birth. The mass had recurred with a cutaneous sinus after initial surgery. Right eye vision was affected by mass induced astigmatism. The anterior and posterior segments were normal. Magnetic Resonance Imaging of the orbit suggested a mature teratoma within the orbital bone. Mass excision showed a fully developed molar tooth within a cyst associated with a cutaneous sinus. Histopathological examination reported odontogenic choriostoma. We report this unique case of orbital odontogenic choristoma in an unusual location, associated with a cutaneous sinus, emphasizing the need for complete excision to prevent recurrence.
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Affiliation(s)
- Dhaanyashri Theiveegan
- Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthetics, Aravind Eye Hospital, Madurai, India
| | - Meghana Tanwar
- Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthetics, Aravind Eye Hospital, Madurai, India
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Hmidi A, Sahraoui G, Charfi L, Hassine A, Aloui H, Mrad K. Unexpected finding: Papillary thyroid carcinoma arising in a mature ovarian teratoma - A case report and literature review. Int J Surg Case Rep 2023; 112:108944. [PMID: 37852093 PMCID: PMC10667761 DOI: 10.1016/j.ijscr.2023.108944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Malignant transformation within mature cystic teratomas is a rare occurrence, with an estimated risk ranging from 0.17 % to 2 %. Squamous cell carcinoma is the most common malignancy associated with this condition, while papillary thyroid carcinoma rarely presents within ovarian teratomas. This transformation predominantly affects postmenopausal women but can, albeit rarely, manifest in younger women. CASE PRESENTATION We present a case of a 37-year-old woman who was incidentally found to have a right ovarian cyst measuring 20 × 20 × 10 mm during a cesarean section, displaying characteristic features of a teratoma. Histological examination confirmed the presence of papillary thyroid carcinoma originating within the ovarian mature cystic teratoma. Immunohistochemical analysis demonstrated positive staining for specific thyroid differentiation markers, including TTF1 and Thyroglobulin. The patient was in good health otherwise, with normal clinical and radiological evaluations of the thyroid, and no additional treatment was administered. Currently, seven years after surgery, the patient remains free of recurrence. DISCUSSION/CONCLUSION Given the rarity of this condition, established treatment protocols are lacking, and its histogenesis remains uncertain. To advance our understanding of pathogenesis, prognosis, and therapeutic strategies for this malignant transformation, the publication of additional cases with similar presentations would be highly valuable.
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Affiliation(s)
- Amira Hmidi
- Pathology Department, Salah Azaiz Institute, Tunis, Tunisia.
| | - Ghada Sahraoui
- Pathology Department, Salah Azaiz Institute, Tunis, Tunisia
| | - Lamia Charfi
- Pathology Department, Salah Azaiz Institute, Tunis, Tunisia
| | - Abouda Hassine
- Gynecology Department, Wassila Bourguiba Hospital, Tunis, Tunisia
| | - Haithem Aloui
- Gynecology Department, Wassila Bourguiba Hospital, Tunis, Tunisia
| | - Karima Mrad
- Pathology Department, Salah Azaiz Institute, Tunis, Tunisia
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Nakamori A, Tsuyoshi H, Tsujikawa T, Orisaka M, Kurokawa T, Yoshida Y. Evaluation of calcification distribution by CT-based textural analysis for discrimination of im mature teratoma. J Ovarian Res 2023; 16:179. [PMID: 37635241 PMCID: PMC10464244 DOI: 10.1186/s13048-023-01268-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Mature and immature teratomas are differentiated based on tumor markers and calcification or fat distribution. However, no study has objectively quantified the differences in calcification and fat distributions between these tumors. This study aimed to evaluate the diagnostic potential of CT-based textural analysis in differentiating between mature and immature teratomas in patients aged < 20 years. MATERIALS AND METHODS Thirty-two patients with pathologically proven mature cystic (n = 28) and immature teratomas (n = 4) underwent transabdominal ultrasound and/or abdominal and pelvic CT before surgery. The diagnostic performance of CT for assessing imaging features, including subjective manual measurement and objective textural analysis of fat and calcification distributions in the tumors, was evaluated by two experienced readers. The histopathological results were used as the gold standard. The Mann-Whitney U test was used for statistical analysis. RESULTS We evaluated 32 patients (mean age, 14.5 years; age range, 6-19 years). The mean maximum diameter and number of calcifications of immature teratomas were significantly larger than those of mature cystic teratomas (p < 0.01). The mean number of fats of immature teratomas was significantly larger than that of mature cystic teratomas (p < 0.01); however, no significant difference in the maximum diameter of fats was observed. CT textural features for calcification distribution in the tumors showed that mature cystic teratomas had higher homogeneity and energy than immature teratomas. However, immature teratomas showed higher correlation, entropy, and dissimilarity than mature cystic teratomas among features derived from the gray-level co-occurrence matrix (GLCM) (p < 0.05). No significant differences were observed in the CT features of fats derived from GLCM. CONCLUSION Our results demonstrate that calcification distribution on CT is a potential diagnostic biomarker to discriminate mature from immature teratomas, thus enabling optimal therapeutic selection for patients aged < 20 years.
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Affiliation(s)
- Akari Nakamori
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Hideaki Tsuyoshi
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan.
| | - Tetsuya Tsujikawa
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Makoto Orisaka
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Tetsuji Kurokawa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-Cho, Yoshida-Gun, Fukui, 910-1193, Japan
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Martel RA, Marsh L, Lai T, Rodriguez-Triana VM, Moatamed NA, Cohen J. Use of platinum-based chemotherapy and pembrolizumab to treat squamous cell carcinoma arising in a mature teratoma of the ovary in a pre-menopausal woman with negative response: A case report. Gynecol Oncol Rep 2023; 47:101192. [PMID: 37131341 PMCID: PMC10149262 DOI: 10.1016/j.gore.2023.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 05/04/2023] Open
Abstract
Squamous cell carcinoma of the ovary (SCC) is a rare and aggressive disease and optimal treatment is unknown. Here we report the case of a 29- year-old woman who presented with abdominal pain and was ultimately found to have a multi-septate, gas containing pelvic mass with mixed fat, soft tissue, and calcified components concerning for a ruptured teratoma with fistulization to the distal ileum and cecum on imaging. Operative findings included a 20 cm pelvic mass arising from the right ovary with frank invasion into the ileum and cecum and dense adhesion to the anterior abdominal wall on surgical exploration. Pathologic specimens were remarkable for stage IIIC SCC of the ovary arising in a mature teratoma, with a tumor proportion score of 40%. She progressed on first line treatment with cisplatin, paclitaxel and pembrolizumab as well as second line treatment with gemcitabine and vinorelbine. She died nine months after her initial diagnosis.
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Affiliation(s)
- Rachel A. Martel
- Ronald Reagan UCLA Medical Center Department of Obstetrics and Gynecology, United States
- Corresponding author at: 10833 Le Conte Avenue, CHS 27-139, Los Angeles, CA 90095, United States.
| | - Leah Marsh
- Ronald Reagan UCLA Medical Center Department of Obstetrics and Gynecology, United States
| | - Tiffany Lai
- Ronald Reagan UCLA Medical Center Department of Obstetrics and Gynecology, United States
| | | | - Neda A. Moatamed
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, United States
| | - Joshua Cohen
- Department of Surgery Division of Gynecologic Oncology, City of Hope, United States
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Sharma R, Bora S, Sulaiman M, Garg A, Laythaling RK. Ossified upper thoracic intradural mature teratoma in a teenager - A technical case report with special emphasis on surgical strategy. J Neurosci Rural Pract 2023; 14:349-354. [PMID: 37181192 PMCID: PMC10174177 DOI: 10.25259/jnrp_21_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 01/11/2023] Open
Abstract
Spinal teratomas are heterogeneous neoplasms and are extremely rare in the upper thoracic spine. They are sub-classified as mature, immature, or malignant. They may be calcified or rarely ossified; the latter posing a major surgical challenge due to surgical difficulties in safe removal. Clinicoradiologico-pathological and operative experience of ossified spinal intradural mature teratomas is extremely rare. We present a case of ossified upper thoracic intradural mature teratoma managed by microsurgical drilling and resection under neuromonitoring.
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Affiliation(s)
| | - Santanu Bora
- Department of Neurosurgery, AIIMS, New Delhi, India
| | | | - Ajay Garg
- Department of Neuroradiology, AIIMS, New Delhi, India
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Knaus ME, Onwuka AJ, Abouelseoud NM, Bergus KC, Breech LL, Brito KS, Dekonenko C, Hertweck SP, Hong HY, Menon S, Merritt DF, Schikler AG, Senapati N, Smith YR, Strickland JL, Truehart AI, Minneci PC, Hewitt GD. Recurrence Rates for Pediatric Benign Ovarian Neoplasms. J Pediatr Adolesc Gynecol 2023; 36:160-6. [PMID: 36496105 DOI: 10.1016/j.jpag.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
STUDY OBJECTIVE To examine the recurrence rates of pediatric benign ovarian neoplasms METHODS: A retrospective review of females up to 21 years of age who underwent surgery for a benign ovarian neoplasm at 8 pediatric hospitals from January 2010 through December 2016 was conducted. Data include primary operation details, follow-up imaging, and reoperation details. RESULTS Four hundred and twenty-six females were included in our cohort, with a median age of 15 years at the time of the primary operation. Of the patients, 69% had a mature teratoma, 18% had a serous cystadenoma, and 8% had a mucinous cystadenoma. Two-thirds of patients underwent ovarian-sparing surgery. There were 11 pathologically confirmed recurrences (2.6%) at a median follow-up of 12.8 months. The pathologically confirmed recurrence was 10.5 per 100 person-months at 12 months (SE = 5.7) for mucinous cystadenomas and 0.4 months (SE = 0.4) for mature teratomas (P = .001). For half of the patients, the pathologically confirmed recurrences occurred by 12.8 months, and for 75%, they occurred by 23.3 months. There were no differences in reoperation or recurrence on the basis of initial procedure (ovary-sparing surgery vs oophorectomy). CONCLUSION We measured the pathologically confirmed recurrence rate for pediatric benign ovarian neoplasms in a large cohort. Oophorectomy was not protective against recurrence. Mucinous cystadenomas were at a greater risk of pathologically confirmed recurrence.
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Ghareeb A, Al Sharif F, Alyousbashi A, Dawarah M, Ghareeb A, Dalati H. Mediastinal mature cystic teratoma in a child: A case report study. Int J Surg Case Rep 2023; 103:107904. [PMID: 36669319 PMCID: PMC9869470 DOI: 10.1016/j.ijscr.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION A mediastinal teratoma is a very rare disease, in which a relatively large mass grows in the space between the two lungs. Although it is a congenital abnormality, it is diagnosed late in the second or third decade. It could be benign or malignant, symptomatic or asymptomatic. PRESENTATION OF CASE A five-year-old child presented with an acute respiratory distress episode due to an acute infection, unresponsive to first-line antibiotics and had a history of similar recurrent pulmonary infections. On imaging, the patient showed an abnormal mediastinal mass which was speculated to be a hydatid cyst or abscess; however, it was later diagnosed during surgery as a mature mediastinal cystic teratoma. DISCUSSION Mediastinal tumors are slow-growing tumors that are mostly benign and asymptomatic, but sometimes they may grow, reaching a state where they can affect the neighboring anatomical structures, causing symptoms, which may lead to misdiagnosis. CONCLUSION Teratomas, as a differential diagnosis, should be considered in children with recurrent pulmonary infection and radiological findings that resemble masses in the chest. This emphasizes on the importance of performing detailed radiological and lab investigations to set an appropriate diagnosis to ensure a better treatment and prognosis.
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Affiliation(s)
- Ayham Ghareeb
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Fawaz Al Sharif
- Pediatric Surgery Department, Children's University Hospital, Damascus University, Damascus, Syria
| | | | - Methad Dawarah
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Amjad Ghareeb
- Faculty of Medicine, Damascus University, Damascus, Syria.
| | - Husam Dalati
- Pediatric Surgery Department, Children's University Hospital, Damascus University, Damascus, Syria
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Nguyen PH, Nguyen T, Pham CM. A rare case of synchronous follicular thyroid carcinoma arising within a mature cystic ovarian teratoma and stage IV differentiated thyroid cancer in iodine-deficient area in Viet Nam. Rare Tumors 2023; 15:20363613231161940. [PMID: 36895525 PMCID: PMC9989423 DOI: 10.1177/20363613231161940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Well-differentiated thyroid carcinoma rarely spreads to soft tissues. Thyroid carcinoma arising within a mature cystic teratoma is even rarer. We report an extremely rare case of synchronous follicular thyroid carcinoma arising within a mature cystic ovarian teratoma and stage IV differentiated thyroid carcinoma. A 62-year-old woman who lived in an iodine-deficient area was accidentally diagnosed with an ovarian cyst during a radiological metastatic work-up for thyroid cancer. Following laparoscopic left salpingo-oophorectomy, histopathological examination revealed a follicular thyroid carcinoma arising within a mature cystic teratoma. After that, total thyroidectomy and surgical resection of the soft tissue lesion in the supraclavicular fossa were performed, and the patient received subsequent 131I ablation therapy, but the disease progression was recorded 3 months later. We believe that iodine deficiency plays a role in the malignant transformation of thyroid tissues within a mature cystic teratoma. In elderly individuals with significant metastases, radioactive iodine therapy is ineffective.
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Affiliation(s)
- Phong Hong Nguyen
- Department of Pathology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Thang Nguyen
- Science - Technology & External Relations Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Chien Minh Pham
- Department of Oncology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
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Velayos M, Serradilla J, Estefanía-Fernández K, Muñoz-Serrano AJ, Ramírez Amorós C, San Basilio Berenguer MC, Vilanova-Sánchez A, López-Santamaría MV, Hernández-Oliveros F. Sequential teratoma in pediatric patients: causation or coincidence? Cir Pediatr 2023; 36:40-43. [PMID: 36629348 DOI: 10.54847/cp.2023.01.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We describe the unusual case of a female patient with a history of two mature teratomas non-correlated in terms of location and occurrence. A 12-year-old girl presented at our consultation as a result of a growing tumor in the hypogastric region, with no further clinical signs. She had undergone surgery neonatally due to a mature cystic sacrococcygeal teratoma, which was fully removed. No clinical sequelae were noted and no additional treatment was required over a 10-year follow-up. Radiological examination showed a large 20 × 12 × 18 cm cystic mass extending from the pelvic region to the lower hemiabdomen, associated with two similar small formations adjacent to the right ovary. Tumor markers were negative, and a laparoscopic right salpingoophorectomy was carried out, with an excellent postoperative progression. Pathological examination revealed it was, again, a mature cystic teratoma. The genetic study ruled out causation in this respect.
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Affiliation(s)
- M Velayos
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | - J Serradilla
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | | | - A J Muñoz-Serrano
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | - C Ramírez Amorós
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | | | - A Vilanova-Sánchez
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
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15
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Tasis N, Prountzopoulou AA, Skafida E, Arnaouti M, Tsirlis T, Plastiras A, Manatakis DK, Arnogiannaki N, Korkolis DP. Giant teratoma of the pancreas expanding to the mediastinum: Rare tumor and literature review. Rare Tumors 2022; 14:20363613221147470. [PMID: 36601383 PMCID: PMC9806373 DOI: 10.1177/20363613221147470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
Pancreatic mature cystic teratomas are very rare with limited cases found in the literature. These lesions raise a diagnostic challenge and complicate the surgical approach not only because of their anatomic position but also because of their ever-growing size. An elusive diagnosis, usually leads to the operative theatre where surgical resection takes place. We present a rare case of a large pancreatic cystic teratoma extending into the mediastinum in a 29-year-old woman which was succesfully managed with en-bloc distal pancreatectomy and spleenectomy.
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Affiliation(s)
- Nikolaos Tasis
- Department of Surgical Oncology, St Savvas Cancer
Hospital, Athens, Greece,2nd Department of Surgery, Athens Naval and Veterans
Hospital, Athens, Greece,Nikolaos Tasis, Department of Surgical
Oncology, St Savvas Cancer Hospital, Dimitsanas 1, Athens 11522, Greece.
| | | | | | - Maria Arnaouti
- Department of Pathology, St Savvas Cancer
Hospital, Athens, Greece
| | - Theodoros Tsirlis
- Department of Surgical Oncology, St Savvas Cancer
Hospital, Athens, Greece
| | - Aris Plastiras
- Department of Surgical Oncology, St Savvas Cancer
Hospital, Athens, Greece
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16
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Knaus ME, Onwuka AJ, Abouelseoud NM, Breech LL, Brito KS, Dekonenko C, Hertweck SP, Hong HY, Lawrence AE, Menon S, Merritt DF, Schikler AG, Senapati N, Smith YR, Strickland JL, Truehart AI, Minneci PC, Hewitt GD. Failure of Operative Therapy after Ovarian-Sparing Surgery for Pediatric Benign Ovarian Neoplasms: A Retrospective Review. J Pediatr Adolesc Gynecol 2022; 35:702-6. [PMID: 36031113 DOI: 10.1016/j.jpag.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/10/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022]
Abstract
STUDY OBJECTIVE To evaluate failure of initial operative therapy (incomplete tumor removal) of ovarian-sparing surgery for pediatric benign ovarian neoplasms. METHODS A retrospective review of patients up to 21 years of age who underwent ovarian-sparing surgery for a benign ovarian neoplasm from 2010 to 2016 at 8 pediatric hospitals was conducted. Failure of initial operative therapy is defined as a radiologically suspected or pathologically confirmed ipsilateral lesion with the same pathology as the primary neoplasm within 12 weeks of the initial operation. RESULTS Forty patients received imaging within 12 weeks of their primary operation. Sixteen (40%) patients had a radiologically identified ovarian abnormality ipsilateral to the primary lesion, and 5 patients were suspected to have the same lesion as their primary neoplasm. Three of the 5 patients (7.5%) underwent reoperation with pathologic confirmation of the same lesion, resulting in a pathologically confirmed failure of therapy rate of 7.5%. The other 2 patients had serial imaging that subsequently demonstrated no recurrence with lesion resolution. Age, race/ethnicity, laparoscopy vs laparotomy, presence of torsion, pathology, size of lesion, and surgeon specialty were not associated with failure of therapy. CONCLUSION In most patients who received imaging within 12 weeks of the primary operation for resection of a benign ovarian neoplasm, ovarian-sparing surgery was successful in complete tumor removal, with a low failure of therapy rate. Selected patients with suspected failure of therapy on initial imaging could be serially monitored to determine the need for repeat surgical intervention.
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17
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Mazhoud I, Skhiri W, Hafsa C, Toumi D, Maatouk M, Ben Salem A. Ruptured mature ovarian teratoma: A case report. Int J Surg Case Rep 2023; 102:107788. [PMID: 36516595 DOI: 10.1016/j.ijscr.2022.107788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dermoid cysts, or also known as mature cystic teratomas, are one of the most common benign ovarian tumors. Spontaneous rupture of this tumor is rare and can be suspected on imaging. CASE REPORT we report a case of ruptured mature ovarian teratoma. A 21 years old previously healthy woman presented with recurrent pelvic pain, the diagnostic of rupture was made by imaging. The patient underwent surgery with a good follow up. DISCUSSION Dermoid cysts are the most common benign ovarian neoplasm and its rupture is rare due to its thick capsule. Imaging has a major role in the diagnosis of dermoid cyst and in the detection of its rupture. CT scan is the most requested modality imaging especially in acute abdominal pains. MRI can performed for further characterization. CONCLUSION the aim of the study is to report a new case of ruptured mature ovarian teratoma and to describe the imaging signs suggesting dermoid cysts rupture.
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18
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Liu JL, Sun PL. Rectal mature teratoma: A case report. World J Clin Cases 2022; 10:7883-7889. [PMID: 36158485 PMCID: PMC9372856 DOI: 10.12998/wjcc.v10.i22.7883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/24/2021] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rectal mature teratoma is rare and has been reported as a case report in this study. Herein, clinical presentation, magnetic resonance imaging findings, and immunohistochemistry showed a pelvic rectal mature teratoma. The case report and the surgical treatment procedure have been discussed below.
CASE SUMMARY A 29-year-old Chinese female showed up with over a 1-mo history of perianal mass that emerged after defecation. Physical examination indicated that the mass was 4 cm × 3 cm × 3 cm. The intraoperative procedure involved ligation of the sigmoid colon 10 cm above the upper edge of the tumor, followed by ligation of the rectum 3.5 cm above the upper edge of the tumor, and subsequent complete removal of the mass. The histopathology confirmed the mature teratoma.
CONCLUSION The tumor can be completely removed using surgery to prevent its recurrence.
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Affiliation(s)
- Jia-Li Liu
- Department of Anorectal Surgery, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Ping-Liang Sun
- Department of Anorectal Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, Guangxi Zhuang Autonomous Region, China
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Liu J. Malignant transformation of primary mature teratoma of colon: A case report. World J Clin Cases 2022; 10:7076-7081. [PMID: 36051144 PMCID: PMC9297396 DOI: 10.12998/wjcc.v10.i20.7076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/21/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mature teratoma is a common benign ovarian germ cell tumor, accounting for about 20% of ovarian tumors. The malignant transformation of this tumor is less than 2%. The most common type is squamous cell carcinoma, followed by adenocarcinoma. Malignant transformation of colonic mature teratoma is extremely rare. We here report a case of malignant transformation of primary mature teratoma of the colon. The type of malignant transformation was adenocarcinoma.
CASE SUMMARY A 63-year-old woman was admitted to our hospital due to persistent pain in her right lower abdomen for 1 mo, and she had no nausea, vomiting, blood in the stools, or other symptoms. Preoperative colonoscopy showed uplift of the sigmoid colon mucosa and submucosa. The biopsy showed squamous epithelium. However, contrast-enhanced computed tomography of abdomen and pelvis showed a localized thickening of the sigmoid wall, suggesting colon cancer. Endoscopic ultrasonography (EUS) revealed that the structure of the intestinal wall at the base of the lesion was destroyed, and the boundary between the lesion and the surroundings was unclear. According to the findings of the EUS, the patient did not undergo endoscopic submucosal dissection, but underwent radical resection of the tumor. Histologically, squamous epithelium was seen on the mucosal surface of the colon wall, cartilage and glands were seen under the epithelium, and adenocarcinoma was seen on the muscular layer and serous surface. The final pathological diagnosis was malignant teratoma of the colon. We have followed up the patient for 2 mo since the operation, and the patient recovered well.
CONCLUSION This case suggests the possibility of mature teratoma in the colon and recognition of malignant types, and it should not be considered as an exclusively ovarian tumor.
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Affiliation(s)
- Jie Liu
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
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20
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Zhang J, Zhu X, Jiang M, Lv Y. A ruptured giant mediastinal mature teratoma mimicking an encapsulated empyema. Interact Cardiovasc Thorac Surg 2022; 34:159-161. [PMID: 34999805 PMCID: PMC8782231 DOI: 10.1093/icvts/ivab222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/01/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022] Open
Abstract
A female patient with a right-sided encapsulated pleural effusion was misdiagnosed preoperatively as having an encapsulated empyema. However, a giant mass in the anterior mediastinum was found via thoracoscopy, and a mature teratoma was detected based on the pathological result. Herein we report this case and provide lessons for cardiothoracic surgeons.
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Affiliation(s)
- Junjie Zhang
- Department of Cardiothoracic Surgery, Wujin Hospital
Affiliated with Jiangsu University, Changzhou, China
- The Wujin Clinical college of Xuzhou Medical
University, Changzhou, China
| | - Xiaobo Zhu
- Department of Cardiothoracic Surgery, Wujin Hospital
Affiliated with Jiangsu University, Changzhou, China
- The Wujin Clinical college of Xuzhou Medical
University, Changzhou, China
| | - Minyan Jiang
- Department of Cardiothoracic Surgery, Wujin Hospital
Affiliated with Jiangsu University, Changzhou, China
- The Wujin Clinical college of Xuzhou Medical
University, Changzhou, China
| | - Yajun Lv
- Department of Cardiothoracic Surgery, Wujin Hospital
Affiliated with Jiangsu University, Changzhou, China
- The Wujin Clinical college of Xuzhou Medical
University, Changzhou, China
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21
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Estevez-Cerda S, Cabral-Nunes M, Villegas-Elizondo JF, Sepulveda-Malec R. Intrapulmonary mature teratoma: an unusual finding. Indian J Thorac Cardiovasc Surg 2022; 38:80-3. [PMID: 34898881 DOI: 10.1007/s12055-021-01180-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 01/03/2023] Open
Abstract
Teratomas are tumors consisting of tissues derived from more than one germ cell line. Usual locations are sacrococcygeal region, intracranial, mediastinum, and gonads. Entirely intrapulmonary teratomas, with no mediastinal component, are rarely reported. We present the case of a 37-year-old man who presented for evaluation due to persistent and progressive intermittent cough. There was no sputum or hemoptysis. Computed tomography (CT) revealed an irregular, cystic lesion in the upper lobe of his left lung, which raised suspicion for aspergilloma. The patient underwent a left thoracotomy and, after finding a completely collapsed and hypoplastic left lung almost entirely occupied by an irregular mass, a total left pneumonectomy was performed. Pathological review reported an entirely intrapulmonary mature teratoma. Intrapulmonary mature teratomas are extremely rare, although several have been reported. Trichoptysis (expectoration of hair) is a specific finding that may help distinguish this entity from mediastinal teratomas.
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22
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Kovalenko YA, Zharikov YO, Kiseleva YV, Goncharov AB, Shevchenko TV, Gurmikov BN, Kalinin DV, Zhao AV. Rare primary mature teratoma of the liver: A case report. World J Hepatol 2021; 13:2192-2200. [PMID: 35070019 PMCID: PMC8727195 DOI: 10.4254/wjh.v13.i12.2192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/29/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary liver teratoma is an extremely rare tumor usually affecting children under the age of 3 years. Specific signs of teratoma on ultrasound, computed tomography (CT) or magnetic resonance imaging are lacking, which makes morphology the only diagnostic tool. Misdiagnosis of a mature teratoma may lead to excessive liver resection, whereas misdiagnosis of an immature teratoma may result in spread, causing a life-threatening condition. Consequently, a careful tumor examination is important, and the rarest types of tumors must be accounted for.
CASE SUMMARY We describe a 52 years old female who presented with a solid mass in the left liver lobe. Contrast-enhanced CT and magnetic resonance imaging (MRI) revealed a round, heterogeneous lesion containing a number of fluid areas and areas of calcification in the middle, and the provisional diagnosis was cholangiocarcinoma. The patient underwent resection of liver segment I. Immunohistochemistry analysis of the resected lesion indicated thyroid follicular epithelium; however, the thyroid gland was intact. 10 years prior to presentation the patient underwent a surgery due to mature teratoma of the right ovary, nevertheless the tumor was benign and could not spread to the liver, in addition teratoma of the liver was also benign. This led to the final diagnosis of primary mature liver teratoma.
CONCLUSION Primary hepatic teratoma, including heterotopia of the thyroid gland in the liver, is an extremely rare condition in adults that needs to be considered in the differential diagnosis of solid-cystic neoplasms in the liver and cholangiocarcinoma. This case adds to the limited literature on the patient presentation, clinical workup and management of liver teratomas.
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Affiliation(s)
- Yury A Kovalenko
- Department of Surgical Oncology and Chemotherapy, A.V. Vishnevsky National Medical Research Center of Surgery of the Russian Ministry of Healthcare, Moscow 115093, Russia
| | - Yury O Zharikov
- Department of Human Anatomy, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119048, Russia
| | - Yana V Kiseleva
- International School “Medicine of the Future”, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119048, Russia
| | - Anton B Goncharov
- Department of Surgical Oncology and Chemotherapy, A.V. Vishnevsky National Medical Research Center of Surgery of the Russian Ministry of Healthcare, Moscow 115093, Russia
| | - Tatyana V Shevchenko
- Department of Surgical Oncology and Chemotherapy, A.V. Vishnevsky National Medical Research Center of Surgery of the Russian Ministry of Healthcare, Moscow 115093, Russia
| | - Beslan N Gurmikov
- Department of Surgical Oncology and Chemotherapy, A.V. Vishnevsky National Medical Research Center of Surgery of the Russian Ministry of Healthcare, Moscow 115093, Russia
| | - Dmitry V Kalinin
- Pathology Department, A.V. Vishnevsky National Medical Research Center of Surgery of the Russian Ministry of Healthcare, Moscow 115093, Russia
| | - Alexey V Zhao
- Department of Surgical Oncology and Chemotherapy, A.V. Vishnevsky National Medical Research Center of Surgery of the Russian Ministry of Healthcare, Moscow 115093, Russia
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Awad AK, Fatima A, Khurana S, Elbadawy MA, Elseidy SA. Right upper lobe intrapulmonary mature cystic teratoma. An unusual location with unusual associations and a review of the literature. Int J Surg Case Rep 2021; 90:106683. [PMID: 34954626 DOI: 10.1016/j.ijscr.2021.106683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Teratomas are rare neoplasms made up of mature embryonic germ cell layers. Extra-gonadal teratomas are rare and primarily in the mediastinum. Mature cystic teratomas (MCT) are slow-growing benign tumors accounting for a small number of mediastinal germ cell tumors. Patients with MCT are often asymptomatic, and even most symptomatic intrapulmonary teratomas present with vague and non-specific symptoms such as cough, hemoptysis, and chest pain. Case presentation and discussion A Yemeni patient presented for two years with dry cough, shortness of breath, and stitching right-sided chest pain. Plain X-ray showed pleural thickening associated with two opacities in the right lung- one located centrally in the upper lobe and another peripherally- which were confirmed with a CT scan. During right-sided decortication with resection of the two masses, extensive adhesions were found between the right pleura and the chest wall. The adhesions were released, and right-sided decortication led to the removal of the peripheral cystic mass attached to the pleura. Histopathology reported the presence of squamous epithelium lining with ectodermal components such as hair follicles, sebaceous glands, keratin debris, fatty, and fibromuscular tissue. Conclusion Intrapulmonary teratomas are rare tumors, with less than 100 cases reported in the past few years. All the reported cases are in the left lung lobes, yet our case is on the right side. Although the right-sided mature cystic teratoma is even scarcer, physicians should have a high index of suspicion for teratoma when encountering abnormal lesion in the right side of the lung confirming it either by CT or MRI. Teratomas are rare neoplasms made up of two or more mature embryonic germ cell layers Mature cystic teratomas (MCT) are benign, slow-growing tumors and account for a small number of mediastinal germ cell tumors. Most symptomatic intrapulmonary teratomas present with vague and non-specific symptoms such as cough, hemoptysis, and chest pain. Mediastinal mature teratomas are often well-defined on CT showing internal heterogeneous appearances.
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Lin TC, Chen TH, Huang RH, Tsai HD, Chen M. Pre-operative diagnosis of a primary uterine mature teratoma. Taiwan J Obstet Gynecol 2021; 59:586-589. [PMID: 32653134 DOI: 10.1016/j.tjog.2020.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Mature cystic teratoma is a common benign ovarian tumor. But extragonadal teratomas are very rare. They mainly occur in the midline structure of the body. Uterine teratomas are extremely rare with only few reports. The diagnosis was mainly based on the operative findings. We report a case of uterine mature teratoma in a 37 year-old woman who was diagnosed before the operation. We also review the literature about this exceptional presentation. CASE REPORT We report a case of uterine teratoma that was initially diagnosed as a uterine tumor under ultrasound examination. But teratoma was highly suspected preoperatively by the abdominal CT scan. She underwent tumor excision via laparotomy. The operative finding and the histological examination confirms the diagnosis of primary uterine teratoma. CONCLUSION Preoperatively diagnosis of uterine teratoma was difficult. Although there are no gold standard to treat the uterine teratoma, the majority of the treatment choice is surgery. The prognosis of this unusual disease is relatively good in benign lesions.
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Affiliation(s)
- Tzu-Chi Lin
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Tze-Ho Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ren-Hong Huang
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
| | - Horng-Der Tsai
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, 50046, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, 50046, Taiwan; Department of Medical Research, Changhua Christian Hospital, Changhua, 50006, Taiwan; Department of Molecular Biotechnology, Da-Yeh University, Changhua, 51591, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 10041, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, 10041, Taiwan; Department of Life Science, Tunghai University, Taichung, 40704, Taiwan.
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25
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Bata BM, Salvi SM. Choroidal Metastasis Secondary to Testicular Mature Teratoma: A Case Report. Ocul Oncol Pathol 2021; 7:85-90. [PMID: 33981691 DOI: 10.1159/000511597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/14/2020] [Indexed: 01/04/2023] Open
Abstract
We report a case of a choroidal metastasis secondary to testicular mature teratoma, a subtype of non-seminoma germ cell tumours, in a young adult male. The choroidal metastasis was treated successfully with bleomycin, etoposide, and cisplatin chemotherapy without the need for adjuvant radiotherapy. This represents a rare case of mature teratoma metastasizing to the choroid and one of very few reported testicular germ cell tumours to achieve normal or near normal visual acuity with chemotherapy alone despite severe macular disease at presentation.
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Affiliation(s)
- Bashar M Bata
- Sheffield Ocular Oncology Service, Department of Ophthalmology, Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - Sachin M Salvi
- Sheffield Ocular Oncology Service, Department of Ophthalmology, Sheffield Teaching Hospitals, Sheffield, United Kingdom
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Kavagutti MS, Marques EBC, da Silva FDS, Trabulsi MFM, Marini BRG. Mature splenic teratoma: A rare case report. Int J Surg Case Rep 2021; 78:397-400. [PMID: 33412409 PMCID: PMC7803625 DOI: 10.1016/j.ijscr.2020.11.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Teratomas are germ cell neoplasms that can be malignant or benign. Their occurrence is more prevalent in gonads, but there are rare extragonal reports, and splenic teratomas are exceptionally uncommon. CASE REPORT A 44-year-old woman with a report of abdominal pain on the left flank for 12 h, was evaluated with TC that visualized spleen showing an oval, intraparenchymal, hypodense image with dense areas, submitted to conventional splenectomy, what identified mature cystic teratoma. DISCUSSION Dermoid cysts have nonspecific symptoms, usually related to extrinsic compression of other structures or rupture of the splenic capsule; the diagnosis is complex, since the alterations in imaging exams are not very specific. Thus, the confirmation is made through anatomopathological analysis. CONCLUSION Mature splenic cystic teratomas are rare and treatment should be evaluated according to the presence or absence of symptoms and diagnostic certainty.
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Affiliation(s)
- Mayume Silva Kavagutti
- Hospital Santa Casa de Misericórdia de São José do Rio Preto, St. Fritz Jacobs, 1236 - São José do Rio Preto, 15025-500, Brazil.
| | | | - Felipe de Seixas da Silva
- Hospital Santa Casa de Misericórdia de São José do Rio Preto, St. Fritz Jacobs, 1236 - São José do Rio Preto, 15025-500, Brazil.
| | | | - Bruno Roberto Gianini Marini
- Hospital Santa Casa de Misericórdia de São José do Rio Preto, St. Fritz Jacobs, 1236 - São José do Rio Preto, 15025-500, Brazil.
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Mateo-Sánez HA, Mateo-Madrigal D, Dávalos-Álvarez A, Domínguez-Dorame F, Ku-González J. Preservación de la fertilidad en una paciente con teratoma bilateral. Reporte de un caso y revisión de la literatura. CIR CIR 2020; 88:84-89. [PMID: 33284263 DOI: 10.24875/ciru.20000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Los tumores de células germinales son una variante de los tumores ováricos, siendo el teratoma el más frecuente. Del total de los tumores ováricos diagnosticados, el 12% se encontrarán en pacientes en edad fértil. Se presenta el caso de una paciente de 22 años que acude a consulta con un diagnóstico presuntivo de teratoma bilateral en búsqueda de alternativas terapéuticas, ya que se le planteó originalmente ooforectomía bilateral. Tras un abordaje completo se corroboró el diagnóstico y se procedió a la resección tumoral, logrando la enucleación completa de ambos teratomas y preservando el tejido ovárico, su funcionalidad y su fertilidad. Germ cell tumors are a variant of ovarian tumors, with teratoma being the most frequent. Of the total number of diagnosed ovarian tumors, 12% are found in patients of childbearing age. In this case, we present a 22-year-old patient who comes to a consultation with a presumptive diagnosis of bilateral teratoma in search of therapeutic alternatives, since she was originally presented with a bilateral oophorectomy. After a complete approach, the diagnosis was corroborated and tumor resection was carried out, achieving complete enucleation of both teratomas, preserving the ovarian tissue, thus its functionality and fertility.
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Affiliation(s)
- Henry A Mateo-Sánez
- Departamento de Ginecología y Obstetricia, Hospital Santa Rosa de Lima, Ensenada, Baja California. México
| | | | | | - Fernanda Domínguez-Dorame
- Servicio de Ginecología y Obstetricia, Hospital Santa Rosa de Lima, Ensenada, Baja California. México
| | - Jeanneth Ku-González
- Servicio de Ginecología y Obstetricia, Hospital Santa Rosa de Lima, Ensenada, Baja California. México
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Morikawa K, Tatsuno S, Misumi S. Rapid growth of a mature mediastinal teratoma in a middle-aged woman: A case report. Radiol Case Rep 2020; 15:1870-1874. [PMID: 32817779 PMCID: PMC7426325 DOI: 10.1016/j.radcr.2020.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 07/18/2020] [Accepted: 07/19/2020] [Indexed: 10/27/2022] Open
Abstract
A mediastinal mass was incidentally detected in a 42-year-old Japanese woman during a routine medical checkup. Computed tomography revealed a 7-cm, well-circumscribed multilocular cystic mass consistent with a mature cystic teratoma; however, no solid or cystic lesion had been detected at a voluntary complete medical checkup 1.5 years earlier. An anterior mediastinal tumor resection was performed, and the histopathological findings were compatible those of a mature teratoma. Although the mechanisms that underlie rapid growth of all tridermic components in a mature teratoma remain unclear, it is presumed that the mechanisms involve hemorrhage, rupture, inflammation caused by pancreatic enzymes, and estrogen hormone activity. We presented a rare case of a rapid formation of a mediastinal teratoma, which revealed that a mediastinal teratoma with all tridermic components could develop in a relatively short period.
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Affiliation(s)
- Kazuhiko Morikawa
- Department of Radiology, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Satoshi Tatsuno
- Department of Radiology, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Shigeki Misumi
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
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Saridakis N, Koumantzia C, Libard S, Marklund N, Eleftheriou A. Intramedullary holocord mature teratoma in an adult- case report and review of the literature. Clin Neurol Neurosurg 2020; 195:105925. [PMID: 32473578 DOI: 10.1016/j.clineuro.2020.105925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Nikolaos Saridakis
- Department of Neurology in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - Christina Koumantzia
- Primary Health Care Center in Tannefors and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Sylwia Libard
- Department of Immunology, Genetics and Pathology, Uppsala University, Sweden; Department of Pathology, Uppsala University Hospital, Sweden.
| | - Niklas Marklund
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurosurgery, Lund, Sweden.
| | - Andreas Eleftheriou
- Department of Neurology in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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Murakami K, Hamaji M, Yoshizawa A, Date H. Sub-centimeter adenocarcinoma arising from mature mediastinal teratoma during 11 years of follow-up. Gen Thorac Cardiovasc Surg 2020; 68:1543-1546. [PMID: 32157611 DOI: 10.1007/s11748-020-01327-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/06/2020] [Indexed: 11/28/2022]
Abstract
A 54-year-old male presented with exertional dyspnea, right massive pleural effusion, and an anterior mediastinal tumor (6.5 × 6.2 × 7.6 cm) which continued to grow during the 11-year follow-up period. Fluorodeoxyglucose positron emission tomography demonstrated a focal but remarkable uptake within the tumor mass. After chest tube drainage, the patient underwent surgical resection via a right thoracotomy. The final pathology was determined to be a mature cystic teratoma with malignant transformation to adenocarcinoma. Teratomas with somatic-type malignancy are challenging to diagnose using only preoperative evaluations. Intra-operative findings, histopathological findings, and postoperative management techniques are discussed in this report and emphasize the importance of early resection for treatment of mature teratomas, as well as the recommendation of careful inspection of pathological specimens of long-standing teratomas.
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Affiliation(s)
- Kotaro Murakami
- Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masatsugu Hamaji
- Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Demir MK, Yapıcıer O, Karakaya OF, Mert B, Seker A. A primary third ventricle mixed germ cell tumor with leptomeningeal dissemination of im mature teratoma component. Childs Nerv Syst 2020; 36:629-633. [PMID: 31418081 DOI: 10.1007/s00381-019-04351-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022]
Abstract
A 17-year-old male patient presented to the clinic with a headache, nausea, and vomiting. Magnetic resonance imaging demonstrated a fat-containing and -enhancing heterogeneous tumor in the third ventricle, and fat droplets within the ventricles and the subarachnoid space. Obstructive hydrocephalus was also present. Emergency subtotal removal of the mass was performed via interhemispheric transcallosal approach. The histopathological diagnosis was a mixed germ cell tumor that was composed of embryonal carcinoma, yolk-sac tumor, germinoma, and immature teratoma containing a large amount of mature elements. The patient was referred for postoperative chemoradiotherapy. A mixed germ cell tumor is a rare type of nongerminomatous germ cell tumor that is made up of at least two different types of germ cell tumors. These may include germinoma, choriocarcinoma, embryonal carcinoma, yolk sac tumor, mature teratoma, immature teratoma, or teratoma with malignant degeneration. As far as we know, this is the first reported case of a primary third ventricle mixed germ cell tumor with leptomeningeal dissemination of the immature teratoma component that contains grossly visible mature elements at admission.
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Affiliation(s)
- Mustafa Kemal Demir
- Department of Radiology, Bahçeşehir University School of Medicine, Göztepe Medical Park Training and Education Hospital, Istanbul, Turkey.
| | - Ozlem Yapıcıer
- Department of Pathology, Bahçeşehir University School of Medicine, Göztepe Medical Park Training and Education Hospital, Istanbul, Turkey
| | | | - Başak Mert
- Bahçeşehir University School of Medicine, Istanbul, Turkey
| | - Askın Seker
- Department of Neurosurgery, Altınbas University Faculty of Medicine, Bahçelievler Medical Park Hospital, Istanbul, Turkey
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Abstract
PURPOSE Mature pineal region teratomas differ from other pineal tumors in terms of their characteristic radiological appearance and their clinical outcome after gross total excision. Our aim is to share our clinical experience and treatment outcomes in pediatric patients with mature pineal region teratoma. METHODS In this retrospective study, we reviewed clinical, radiological, and surgical data of ten patients who had radiologically predicted diagnosis of pineal region teratoma and pathologically confirmed diagnosis of mature pineal region teratoma between years 2004 and 2017 in our clinic. Statistical analysis was performed with SPSS 20. RESULTS All patients were male. Ages of patients ranged between 5 and 17 (median age was 9.5). All of them presented with headache. Magnetic resonance imaging showed characteristic appearance of teratomas with variable degree of hydrocephalus. All patients had negative results for AFP and b-HCG levels. All patients had gross total resection of pineal tumor through occipital transtentorial approach with no permanent neurological deficit. Pathological results of all tumor samples were consistent with mature teratoma. None of them had adjuvant chemotherapy or radiotherapy. Follow-up periods ranged between 3 and 170 months (median follow-up period was 60.5 months). All patients are alive with no tumor recurrence. CONCLUSIONS Pediatric mature pineal region teratomas are benign tumors with characteristic MRI appearance and negative tumor markers. Their definitive treatment is gross total surgical excision. Occipital transtentorial approach is a safe procedure for treatment of pediatric mature pineal teratomas.
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Omura K, Nakao M, Ninomiya H, Iwamoto N, Ozawa H, Kawaguchi Y, Kondo Y, Ichinose J, Matsuura Y, Okumura S, Mun M. A rapidly growing mature mediastinal teratoma with a testicular epidermoid cyst and familial Mediterranean fever. Respir Med Case Rep 2019; 29:100988. [PMID: 32257784 PMCID: PMC7118410 DOI: 10.1016/j.rmcr.2019.100988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022] Open
Abstract
Anterior mediastinal teratomas are common and are generally characterized as slow growing tumors. Very few reports documenting rapidly growing tumors exist. Here, we describe a case of a mature teratoma showing rapid growth in 1 year treated with complete surgical resection. A 25-year-old man was diagnosed with teratoma in the anterior mediastinum. Additionally, he had testicular epidermoid cyst and familial Mediterranean fever. Both tumors were surgically resected. The postoperative course was uneventful with no evidence of recurrence.
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Affiliation(s)
- Kenshiro Omura
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masayuki Nakao
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hironori Ninomiya
- Division of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoya Iwamoto
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroki Ozawa
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yohei Kawaguchi
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuto Kondo
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Ichinose
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yosuke Matsuura
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sakae Okumura
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mingyon Mun
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Sakakura K, Muroi A, Tsurubuchi T, Takano S, Ishikawa E, Matsumura A. Pure germinoma occurring 11 years after total pineal mature teratoma removal: a case report and review of the literature. Childs Nerv Syst 2019; 35:2423-6. [PMID: 31385089 DOI: 10.1007/s00381-019-04332-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/28/2019] [Indexed: 10/26/2022]
Abstract
Intracranial mature teratomas have good prognoses and are usually treated by total tumor resection. We report a rare case of a germinoma that occurred 11 years after total removal of a pineal mature teratoma. A 5-year-old boy presented with headache and nausea and was diagnosed with a pineal tumor and obstructive hydrocephalus on MRI. He underwent total removal of the lesion, which was pathologically diagnosed as a mature teratoma without any other germ cell tumor components. MR images after 11 years showed a newly developed pineal tumor, which was confirmed as a germinoma after neuroendoscopic biopsy. Chemoradiotherapy resulted in complete remission, without any symptoms. This case demonstrated possible late occurrence of germinoma even after total removal of a mature teratoma had been achieved. A long-term follow-up of 10 years or more should be planned for these patients.
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Tsuyuguchi S, Sugiyama K, Kinoshita Y, Kolakshyapati M, Takayasu T, Usui S, Takano M, Yonezawa U, Taguchi A, Amatya VJ, Takeshima Y, Kurisu K, Yamasaki F. Primary and Recurrent Growing Teratoma Syndrome in Central Nervous System Nongerminomatous Germ Cell Tumors: Case Series and Review of the Literature. World Neurosurg 2019; 134:e360-e371. [PMID: 31751614 DOI: 10.1016/j.wneu.2019.10.074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND The term "growing teratoma syndrome (GTS)" has been used as follows: patients with germ cell tumor (GCT) who present with enlarging original/metastatic masses during or after appropriate systemic chemotherapy despite normalized serum markers. In other words, the definition of the term GTS is not fully established. We analyzed and reviewed our case series regarding GTS that developed after the treatment of central nervous system (CNS) nongerminoatous germ cell tumors (NGGCTs). METHODS Our institutional review board approved this retrospective study. Between 2003 and 2018, we treated 16 patients (16 males; age ranging from 5.4 to 51.9 years, median 13.8) with CNS-NGGCT at our institution. We reviewed those patients and also reviewed the literature about GTS of CNS. We defined primary GTS (p-GTS) as the enlargement of cyst size and/or solid tumor occurred during treatment in the absence of marker elevation, and recurrent GTS (r-GTS) as the enlargement of teratoma after complete response of initial tumors. RESULTS Among 16 patients with CNS-NGGCT, we surgically confirmed mature/immature teratoma components in 15 patients. Two patients underwent surgical removal of tumor before neoadjuvant therapy, and among the rest 14 patients, 6 developed p-GTS, and 2 patients underwent salvage surgery during chemo-/chemoradiotherapy. Those with histologic diagnosis of immature teratoma during salvage surgery had a shorter interval from the initiation of chemoradiotherapy compared with mature teratoma (P < 0.05). One patient developed r-GTS. In the literature review, most of the p-GTS consisted of enlargement with the multicystic component. Histologic diagnosis of immature teratoma during salvage surgery was observed in earlier stages of chemoradiotherapy (P < 0.05, log-rank test). Previous history of p-GTS might be a risk factor of r-GTS. CONCLUSIONS The incidence of p-GTS, enlargement of the cystic component during treatment, is not rare. Physicians need to be aware of this important phenomenon.
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Affiliation(s)
- Sayuru Tsuyuguchi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology & Neuro-oncology Program, Hiroshima University Hospital, Hiroshima, Japan
| | - Yasuyuki Kinoshita
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Manish Kolakshyapati
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Neurosurgery, B & B Hospital, Gwarko, Lalitpur, Nepal
| | - Takeshi Takayasu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Usui
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Motoki Takano
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ushio Yonezawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Vishwa Jeet Amatya
- Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Takeshima
- Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kaoru Kurisu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
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Wang L, Hirano Y, Ishii T, Kondo H, Hara K, Ishikawa S, Okada T, Obara N, Yamaguchi S. Laparoscopic surgical management of a mature presacral teratoma: a case report. Surg Case Rep 2019; 5:144. [PMID: 31535236 PMCID: PMC6751240 DOI: 10.1186/s40792-019-0702-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 09/02/2019] [Indexed: 12/15/2022] Open
Abstract
Background Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery. Case presentation A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas. Conclusions Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.
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Affiliation(s)
- Liming Wang
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
| | - Yasumitsu Hirano
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Toshimasa Ishii
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Hiroka Kondo
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Kiyoka Hara
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Shintaro Ishikawa
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Takuhisa Okada
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Nao Obara
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
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Kamdem B, Sgroi A, Yan P, Herren G. Caecal dermoid cyst presenting as an appendicular mucocele on abdominal imaging. Radiol Case Rep 2019; 14:1352-5. [PMID: 31516651 DOI: 10.1016/j.radcr.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Dermoid cysts are benign tumors rarely arising from the cecum. Also, including this report, 10 cases have been described in the literature, to our knowledge. Dermoid cysts are benign tumors rarely found in the cecum. A literature research has found only 9 other cases. Case: We describe the case of a healthy 44-year-old man with no surgical history, in whom a well-defined cystic-mass was incidentally found on abdominal computed tomography, presenting as an appendicular mucocele. An hemicolectomy was performed and pathological analysis revealed a dermoid cyst of the cecum. This paper describes the case of a healthy 44-year-old male with no prior surgical history, with a well-defined cystic mass found incidentally on abdominal computed tomography, thought to be an appendicular mucocele. After hemicolectomy and pathological analysis, this was revealed to be a dermoid cyst of the cecum. Conclusion: Although dermoid cysts are a rare tumor of the cecum, they should be considered in the differential diagnosis of a nontender palpate mass in right lower quadrant (RLQ) or cecal mass on imaging. Although rarely found in the cecum, a dermoid cyst should be included in the differential diagnosis of nontender palpable masses of the RLQ, or if revealed by imagery.
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Prasad GL, Divya S. A comprehensive review of adult onset spinal teratomas: analysis of factors related to outcomes and recurrences. Eur Spine J 2019; 29:221-237. [PMID: 31227969 DOI: 10.1007/s00586-019-06037-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 06/16/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Spinal teratomas are rare tumours noted in adults and are commonly located in the thoracolumbar region. Currently, there appears to be a lack of clear consensus regarding the management and prognosis of these lesions. A comprehensive review along with an illustrative case managed at the author's institute has been presented. MATERIALS AND METHODS Online database search was performed for literature review. RESULTS A 26-year-old male presented with acute onset neurological deficits and imaging revealed features of conus teratoma. Subtotal resection was performed and patient achieved fair recovery. Including the present one, a total of 146 cases have been reported and were analysed. Mean age was 39.6 years (range 18-85 years) and males predominated. Limb weakness and backache were the commonest symptoms. Majority of the lesions were intramedullary and located in the thoracolumbar region. Complete resection (CR) was achieved in 45% of cases. All, except one, were mature teratomas. Recurrences were noted in nine (6.1%) cases. Outcome was good/excellent in 86 (60%) and fair/poor in 26 (18%) cases. The presence of pain, absence of limb weakness and CR were significantly associated with good outcomes. Furthermore, subtotal resection (STR) had significantly higher recurrence rates than CR. Four deaths (2.7%) were noted. CONCLUSIONS Total surgical resection is the standard treatment and appears to be beneficial both in terms of outcomes and recurrences. Overall, recurrences are rare and may be managed by re-surgery. In addition, the present report is the eighth case of adult spinal teratoma with an acute onset presentation. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- G Lakshmi Prasad
- Department of Neurosurgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
| | - S Divya
- Department of Orthodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
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Sharma R, Kumar A, Borkar SA. Mature Teratoma of Petrous Temporal Bone in an Infant: A Rare Clinical Entity. World Neurosurg 2019; 128:209-10. [PMID: 31048042 DOI: 10.1016/j.wneu.2019.04.171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 11/24/2022]
Abstract
Laterally located intracranial mature teratomas are rare entities. We report an extremely rare case of an extra-axial mature teratoma of the left petrous temporal bone in an infant who was managed surgically. This is the second reported case of a mature teratoma of the petrous temporal bone in an infant.
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Abstract
INTRODUCTION Teratomas are derived from all three germ layers and make up 3% of all childhood tumors. They are histologically classified as mature or immature. We present a case that was operated on when 30 days old for a sacrococcygeal mature teratoma and then showed long segment involvement in the thoracolumbar region 9 months after the surgery. The MRI (magnetic resonance imaging) showed a mass starting at the thoracal 4 level and extending to the lumbar 3 level with significant spinal cord compression in the extradural space. RESULT The laminae between thoracal 4 and lumbar 3 levels were removed en bloc at a single surgical session and laminoplasty was performed after tumor resection. We also removed the tumor growing into the extrapleural space at the thoracal 5, 6, and 9, 10, 11, 12 levels using the costotransversectomy procedure. CONCLUSIONS We emphasize with this case that mature teratomas can show aggressive growth following surgery and that the development of spinal deformities can be prevented with laminoplasty.
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Yamamoto A, Asakura T, Nakano K, Okada T, Nakata W, Nin M, Tsujihata M. [A Case of Retroperitoneal Mature Teratoma with Combined Resection of Left Kidney]. Hinyokika Kiyo 2017; 63:395-8. [PMID: 29103251 DOI: 10.14989/ActaUrolJap_63_10_395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 37-year-old woman with the complaint of stomachache was referred to our hospital because a retroperitoneal tumor was detected in an ultrasound study at another hospital. Magnetic resonance imaging showed a poorly enhanced 14 cm tumor in the left retroperitoneal space suggesting a cyst that contained fat and showed calcification. Abdominal dynamic computed tomography revealed left renal vein stenosis and left ovarian vein dilation caused by tumor compression of the renal vein. The tumor was excised together with the left kidney because the renal vein was adhered to the tumor. The resected specimen weighed 1,300 g, and the histological diagnosis was mature teratoma. The patient has experienced no recurrence at eight months after surgery.
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Takagi K, Maekawa Y, Minoshima K, Yamaha M, Kato T, Yokoi S, Horie M. [A Case of Adult Mature Teratoma Located in Retroperitoneum]. Hinyokika Kiyo 2017; 63:475-8. [PMID: 29232799 DOI: 10.14989/ActaUrolJap_63_11_475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 35-year-old man wasreferred to our hospital for treatment of a right adrenal tumor detected by ultrasonography during a physical check-up. Contrast-enhanced abdominal computed tomography revealed a poorly enhanced 74 mm tumor situated adjacent to the upper pole of the right kidney. The tumor consisted of fat with peripheral calcification. Magnetic resonance imaging also revealed a right retroperitoneal tumor with fatty contents and well-circumscribed capsule. The endocrine examination revealed the tumor as non-functioning. These findings were suggestive of a right adrenal myelolipoma. We performed laparoscopic right adrenalectomy because of its large size and malignant potency. The pathological examination revealed the retroperitoneal tumor asa mature teratoma existing apart from the adrenal gland. Primary retroperitoneal teratomasare relatively rare. Herein, we report thiscas e of adult mature teratoma occurring in the retroperitoneum.
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Razi E, Imani A, Ansari I, Khamechian T, Davoodabadi A. Pleural effusion as a rare manifestation of mediastinal teratoma: A case report. Respir Med Case Rep 2017; 22:142-144. [PMID: 28794967 PMCID: PMC5545821 DOI: 10.1016/j.rmcr.2017.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 10/26/2022] Open
Abstract
Pleural effusion as one of the most common manifestations of pulmonary diseases is a rare symptom of anterior mediastinal teratoma that might mislead general physicians. In this study we report a rare case of pleural effusion and anterior mediastinal teratoma accompanying each other. The patient was a 21-year-old woman who suffered from dyspnea, cough, fever and manifestations of pleural effusion were obvious in chest X Ray (CXR). Computed tomography scan showed a cystic mass with lipid component. After thoracotomy, a mass was taken out from medial lobe of right lung and the results of pathology showed the mature mediastinal teratoma. The patient remained well with no evidence of recurrence on follow-up CXRs 6 months after the surgery.
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Affiliation(s)
- Ebrahim Razi
- Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Aida Imani
- Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Iman Ansari
- Medical Students Research Committee, Shahed University, Tehran, Iran
| | - Tehereh Khamechian
- Department of Pathology, Kashan University of Medical Sciences, Kashan, Iran
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Omar M, El-Gharabawy M, Samir A, El Sherif E, Monga M. Mature Cystitic Teratoma of the Bladder Masquerading as a Distal Ureteral Stone. Urol Case Rep 2017; 13:94-96. [PMID: 28462168 PMCID: PMC5408143 DOI: 10.1016/j.eucr.2017.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 01/10/2017] [Indexed: 11/25/2022] Open
Abstract
A 27-year woman presented with irritative lower urinary tract symptoms and alleged small right distal ureteric stone that had been diagnosed with KUB and non-contrast spiral CT. Patient was scheduled for ureteroscopic lithotripsy, revealing absence of the presumed stone, while cystoscopy showed unexpected 2 cm pedunculated grayish white lesion, situated on the right lateral wall of the bladder with sparse hairs covering it. An incomplete TURBT was done; the histological findings correlated with the gross picture seen on cystoscopy. Following CT urography, the patient went an open partial cystectomy and right oophorectomy; the histopathology was consistent with mature bladder teratoma.
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Affiliation(s)
- Mohamed Omar
- Glickman Urology & Kidney Institute - Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Ahmed Samir
- Menofya Urology Department - Menofya University, Menofya, Egypt
| | - Eid El Sherif
- Menofya Urology Department - Menofya University, Menofya, Egypt
| | - Manoj Monga
- Glickman Urology & Kidney Institute - Cleveland Clinic Foundation, Cleveland, OH, USA
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Goldberg HR, Allen L, Kives S. Fetiform Teratoma in the Ovary of a 7-Year-Old Girl: A Case Report. J Pediatr Adolesc Gynecol 2017; 30:256-258. [PMID: 27769689 DOI: 10.1016/j.jpag.2016.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/10/2016] [Accepted: 10/11/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fetiform teratoma, a highly differentiated mature cystic teratoma resembling a fetus, is rare and typically found in the ovaries of women of reproductive age. In this report we describe, to our knowledge, the youngest case of ovarian fetiform teratoma. CASE A 7-year-old girl presented with acute abdominal pain. Radiological examinations revealed a 5.2-cm ovarian complex cystic mass with fetal-like components in favor of fetus in fetu and teratoma. After surgical removal, the mass resembled a fetus consisting of a head, two eye slits, two small upper limb projections, and hair. Pathology indicated mature cystic teratoma supporting the diagnosis of fetiform teratoma. SUMMARY AND CONCLUSION Although not commonly found in children, fetiform teratoma must be considered in the diagnosis of a child who presents with an adnexal mass resembling a fetus.
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Affiliation(s)
- Hanna R Goldberg
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Allen
- Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Ontario, Canada
| | - Sari Kives
- Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Ontario, Canada.
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Trabzonlu L, Durmaz G, Vural C, Muezzinoglu B, Corakci A. Malignant tumors associated with ovarian mature teratoma: A single institution experience. Pathol Res Pract 2017; 213:518-521. [PMID: 28214217 DOI: 10.1016/j.prp.2017.01.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 01/04/2017] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aims of this study are to present demographical features of cases diagnosed with malignant tumor associated with ovarian mature teratoma and to analyze histopathological features and clinical follow up of these tumors. STUDY DESIGN Single-institution retrospective charts were reviewed to identify all cases of ovarian mature teratoma diagnosed from 1998 to 2015. Clinicopathological parameters that were analyzed include age, tumor size, tumor stage, histological type, laterality, IOC diagnosis and whether or not patient has received adjuvant chemotherapy. RESULTS A total of 218 ovarian mature teratoma cases were identified during the study period. Of the 218 ovarian mature teratoma specimens, eight (3.7%) exhibited malignant tumors. The average age for cases of malignancy associated with ovarian mature teratoma was 44.6 years. The average size of tumors was 10.36cm. On final pathology, histological types of tumors were as follows: two cases each of squamous cell carcinoma and papillary thyroid carcinoma; one case each of mucinous adenocarcinoma, metastatic adenocarcinoma, sebaceous carcinoma and oligodendroglioma. Only one patient with Stage IIB tumor died of disease. One patient was alive with metastatic disease two months after initial diagnosis. Mean and median follow-up times were 64.1 and 49 months, respectively. CONCLUSION An ovarian mass that has characteristics of a teratoma in a postmenopausal patient should alert for malignancy -regardless of tumor size. IOC is a valuable tool for the detection of malignancy and should be requested to determine the modality of surgical approach.
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Affiliation(s)
- Levent Trabzonlu
- Department of Pathology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
| | - Guray Durmaz
- Medical Student, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Cigdem Vural
- Department of Pathology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Bahar Muezzinoglu
- Department of Pathology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Aydin Corakci
- Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
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David S, András F, Endre K, Balint K, Árpad K, Csaba P, Karoly S, Tamás T. More Cases of Benign Testicular Teratomas are Detected in Adults than in Children. A Clinicopathological Study of 543 Testicular Germ Cell Tumor Cases. Pathol Oncol Res 2016; 23:513-517. [PMID: 27796764 DOI: 10.1007/s12253-016-0120-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 09/28/2016] [Indexed: 01/06/2023]
Abstract
Benign testicular teratomas are always thought to be pediatric neoplasms and previously all the teratoid tumors in the adult testis regarded as malignant. Recently, three publications reported benign testicular teratomas in adulthood and the latest WHO classification refers them as "prepubertal type of teratomas" which rarely appear in adulthood. These neoplasms behave benign and seemingly analogous independently whether they appear in pre- or postpubertal patients. The aim of our study was to investigate the frequency of benign testicular teratomas both in children and adults. 593 cases of testicular neoplasms were found in a period of 17 years ranging from 1998 to 2014 in the archive of our department (Department of Pathology, Medical Center, Pécs University). 543 cases diagnosed as germ cell tumor which have all been further evaluated in conjunction with the clinical data available. Of all germ cell tumor cases 14 (2.5 %) were pure teratomas. Ten out of 14 were the WHO-defined "conventional" teratoma, 4 of the 14 were the "benign or the so called prepubertal type" from which three occurred in adult patients. Only one of the 14 occurred in childhood, indicating that benign prepubertal type teratomas -which are regarded generally as childhood tumors- are more frequently detected in adults than in children. Benign adult testicular teratomas comprised 21 % of all pure teratoma cases in our series. Practicioners in the field have to be aware of its existence also in adulthood to avoid overtreatment and not to expose their patients to unnecessary chemotherapy, retroperitoneal lymphadenectomy (RLA) and the potential complications of these interventions.
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Affiliation(s)
- Semjén David
- Faculty of Medicine, Department of Pathology 2nd Diagnostic Laboratory, Rákóczi u 2, PÉCS, H-7624, Hungary.
| | - Farkas András
- Faculty of Medicine, Department of Paediatrics, Pécs University, József Attila u.7, Pécs, H-7623, Hungary
| | - Kalman Endre
- Faculty of Medicine, Department of Pathology 2nd Diagnostic Laboratory, Rákóczi u 2, PÉCS, H-7624, Hungary
| | - Kaszas Balint
- Faculty of Medicine, Department of Pathology 2nd Diagnostic Laboratory, Rákóczi u 2, PÉCS, H-7624, Hungary
| | - Kovács Árpad
- Faculty of Health Sciences, Department of Diagnostic, Pécs University, Vörömarty u. 4, Pécs, H-7621, Hungary
| | - Pusztai Csaba
- Faculty of Medicine, Department of Urology, Pécs University, Munkácsy M. u. 2, Pécs, H-7621, Hungary
| | - Szuhai Karoly
- Department of Molecular Cell Biology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2300RC, The Netherlands
| | - Tornóczky Tamás
- Faculty of Medicine, Department of Pathology 2nd Diagnostic Laboratory, Rákóczi u 2, PÉCS, H-7624, Hungary
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Shin HJ, Kim KA, Kim BH, Lee JK, Park YS, Lee J, Choi JW, Lee CH, Park CM. Benign enhancing components of mature ovarian teratoma: magnetic resonance imaging features and pathologic correlation. Clin Imaging 2016; 40:1156-1161. [PMID: 27568071 DOI: 10.1016/j.clinimag.2016.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/10/2016] [Accepted: 08/02/2016] [Indexed: 11/17/2022]
Abstract
The purpose of this work was to evaluate cases of benign ovarian mature teratoma (MT) with enhancing solid components on pelvic magnetic resonance imaging (MRI) and to correlate the MRI findings with the pathology reports. We retrospectively reviewed MRI findings and pathologic reports of 126 patients with pathologically confirmed ovarian MT. Enhancing solid components were observed in 24 (18.8%) of 128 benign MTs. The largest diameter ranged from 5.9 to 42.2 mm. The appearance was variable. Of 24 tumors, 19 (79.2%) had regular borders. On pathologic analysis, solid components of benign MTs were identified as glial tissue, thyroid tissue, fibrous stroma, or vessels.
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Affiliation(s)
- Hoon Jung Shin
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Kyeong Ah Kim
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea.
| | - Baek-Hui Kim
- Department of Pathology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Jae Kwan Lee
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Yang Shin Park
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Jongmee Lee
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Jae Woong Choi
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Chang Hee Lee
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
| | - Cheol Min Park
- Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, South Korea
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Brudie LA, Khan F, Radi MJ, Yates MM, Ahmad S. Malignant melanoma arising in a mature teratoma: A case report with review of the recent literature. Gynecol Oncol Rep 2016; 16:47-50. [PMID: 27331138 PMCID: PMC4899417 DOI: 10.1016/j.gore.2016.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/15/2016] [Accepted: 04/24/2016] [Indexed: 12/05/2022] Open
Abstract
Mature cystic teratomas constitute 10–20% of all ovarian neoplasms. Malignant transformation is very rare occurring in only 0.1–2% of mature teratoma cases. Malignant melanoma is among the least common transformations. Herein, we describe a case of young woman initially undergoing evaluation for infertility who was found to have malignant melanoma arising in a mature dermoid cyst. She subsequently underwent unilateral salpingo-oophorectomy with staging procedure with benign pathology. There was no need for adjuvant therapy and the patient is without disease to date (nearly 10-months in follow-up now). We reviewed the existing literature and this is one of only a few cases documented in the last decade. We describe a young woman case who initially underwent evaluation for infertility. Later she was found to have malignant melanoma arising in a mature dermoid cyst. She subsequently underwent USO with staging procedure with benign pathology. There was no need for adjuvant therapy and the patient is without disease to date. We reviewed the existing literature and this is one of only a few cases documented.
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Affiliation(s)
- Lorna A. Brudie
- Florida Hospital Gynecologic Oncology, Orlando, FL 32804, USA
- Corresponding authors at: Florida Hospital Gynecologic Oncology, Florida Hospital Cancer Institute, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA.Florida Hospital Gynecologic OncologyFlorida Hospital Cancer Institute2501 N. Orange Ave., Suite 786OrlandoFL32804USA
| | - Faizan Khan
- Florida Hospital Gynecologic Oncology, Orlando, FL 32804, USA
| | | | - Melissa M. Yates
- Advanced Reproductive Endocrinology Specialists, Florida Hospital Cancer Institute, Orlando, FL 32804, USA
| | - Sarfraz Ahmad
- Florida Hospital Gynecologic Oncology, Orlando, FL 32804, USA
- Corresponding authors at: Florida Hospital Gynecologic Oncology, Florida Hospital Cancer Institute, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA.Florida Hospital Gynecologic OncologyFlorida Hospital Cancer Institute2501 N. Orange Ave., Suite 786OrlandoFL32804USA
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Patil PS, Kothari P, Gupta A, Dikshit V, Kamble R, Kekre G, Deshmukh S. Retroperitoneal Mature Cystic Teratoma in a Neonate: A Case Report. J Neonatal Surg 2016; 5:15. [PMID: 27123399 PMCID: PMC4841371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/13/2016] [Indexed: 11/22/2022] Open
Abstract
We report a case of retroperitoneal mature cystic teratoma in a 2-day-old neonate. Diagnostic and surgical procedure including its complexity and relevant literature review has been discussed.
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Affiliation(s)
- Prashant Sadashiv Patil
- Correspondence: Prashant Sadashiv Patil, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
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