A Case Series of Transformation of Teratoma to Primitive Neuroectodermal Tumor: Evolving Management of a Rare Malignancy

Dunne, Richard F.; Sahasrabudhe, Deepak M.; Messing, Edward M.; Jean-Gilles, Jerome; Fung, Chunkit

doi:10.4081/rt.2014.5268

Cited by 13 publications

(7 citation statements)

References 11 publications

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“…Long-term close monitoring even after GTS diagnoses should be emphasized due to the potential possibility of malignant transformation in unresected GTS. Although rare, sarcoma, carcinoid, adenocarcinoma, and primitive neuroectodermal tumor (PNET) have previously been described as malignant transformation patterns in GTS [ 21 , 22 , 23 ]. Older age and larger tumor size are associated with an increased risk of malignant transformation [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Jia

et al. 2022

Current Oncology

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Coexistent growing teratoma syndrome (GTS) and gliomatosis peritonei (GP) arising during chemotherapy of ovarian immature teratoma (IMT) is extremely rare and can be misdiagnosed as recurrent or progressive disease. We present a 33-year-old woman diagnosed with GTS with synchronous GP during chemotherapy of IMT. She underwent ovarian cystectomy due to ovarian immature teratoma and chemotherapy were administered. The α-fetoprotein (AFP) concentration decreased from 28.7 ng/mL to normal after the second cycle. Four days after the third cycle of chemotherapy, ultrasound and CT revealed an 8-cm mass with negative tumor markers in the pouch of Douglas. An exploratory laparotomy was conducted, and a smooth round cystic-solid 8-cm mass was noted in the pouch of Douglas. Extensive peritoneal seeding glial nodules were also observed on the surface of the uterus, peritoneum, and omentum. The patient underwent a partial omentectomy, intact resection of the tumor, and resection of most of the glial nodules. Postoperative pathology demonstrated a pure mature cystic teratoma component in the mass, as well as diffuse GP involving the uterine serosa, peritoneum, and omentum; this diagnosis of GTS with synchorous GP should be considered in IMT patients with mass newly identified during chemotherapy while tumor markers are normal after treatment.

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Section: Discussionmentioning

confidence: 99%

Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Jia

et al. 2022

Current Oncology

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“…Rarely, primary or metastatic testicular germ cell tumors may involve PNET, a pathologic diagnosis that are classically divided into central PNET as in medulloblastoma or medulloepithelioma and peripheral PNET as in Ewing sarcoma. 2 As making a definitive diagnosis of PNET is difficult given its deviation from elements of GCT and non-specific pathologic findings, 3 our pathologist did not make such a distinction between the subtypes.…”

Section: Discussionmentioning

confidence: 98%

Primitive Neuro Ectodermal Tumor Arising in a Testicular Teratoma with Retroperitoneal Metastasis: A Case Report and Review of Literature

Guo-dong

Wang

et al. 2017

Urology Case Reports

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A 38-year-old man presenting with left testicular mass and extensive retroperitoneal lymphadenopathy underwent radical orchiectomy and specimen showed a germ cell tumor of primarily primitive neuroectodermal tumor mixed with mature teratoma. He then underwent RPLND, followed by adjuvant CAV (cyclophosphamide, doxorubicin, vincristine) and IE (ifosfamide, etoposide) alternating chemotherapy given the high rate of recurrence and high rate of response to the PNET-specific chemotherapy.

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“…Ovarian mature cystic teratoma of germ cell deviation consists of tissues derived from all three germ-cell layers. PNET arising from a germ cell tumor can develop from malignant transformation of mature teratoma along ectodermal lines [8,14]. Transformation of a cystic benign teratoma of the ovary into a "carcinosarcoma" has very rarely been reported [9,15].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there is a unique tumor type, called "teratoid carcinosarcoma" [5,6] or "teratocarcinosarcoma" [7]. Additionally, it is known that mature teratoma can transform to carcinoma [1], a primitive neuroectodermal tumor (PNET) [8], sarcoma [1], or carcinosarcoma [9]. Ovarian tumors can be derived from somatic or germ cells [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Ovarian Clear Cell Carcinoma and Mature Cystic Teratoma Transformed to PNET and Carcinosarcoma: A Case Report with an Immunohistochemical Investigation

et al. 2022

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Ovarian tumors include neoplasms derived from somatic cells and germ cells, including teratoma. Sometimes, tumors of the somatic cell type may develop from teratoma, causing diagnostic perturbation. We experienced a case of a tumor composed of several types of tissue in the ovary with a teratoma. When findings of teratoma and somatic tumor coexist in an ovary, it is difficult to differentiate whether a somatic tumor was mixed with a teratoma or a teratoma unitarily caused transformation to a somatic cell tumor. A 72-year-old Japanese woman (gravida, 3; para, 1) presented to our hospital with severe constipation and frequent urination, and a large intrapelvic tumor was detected by computed tomography (CT). Soon after admission, ultrasonography (US) and magnetic resonance imaging (MRI) revealed a large multilocular cystic tumor on her left ovary. Based on the clinical diagnosis of ovarian cancer, she underwent a left ovariectomy, appendectomy, and partial omentectomy. We observed an ovarian tumor consisting of teratoma, primitive neuroectodermal tumor (PNET), adenocarcinoma, various types of sarcomas, and clear cell carcinoma on the H and E-stained sections. The component of clear cell carcinoma showed a nuclear positive reaction against PAX8 and napsin A, as well as a loss of ARID1A, suggesting typical endometriosis-derived clear cell carcinoma. On the other hand, the expression of ARID1A was maintained in teratoma, PNET, non-specific adenocarcinoma, and various types of sarcomas, suggesting that these tumors had an origin different from that of clear cell carcinoma. These findings indicated that the ovarian tumor of this patient contained a clear cell carcinoma derived from a somatic cell and a teratoma that transformed to a wide variety of somatic cell types of tumors, which coexisted on one ovary. The appropriate use of immunohistochemistry was diagnostically effective in this case.

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A Case Series of Transformation of Teratoma to Primitive Neuroectodermal Tumor: Evolving Management of a Rare Malignancy

Cited by 13 publications

References 11 publications

Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Primitive Neuro Ectodermal Tumor Arising in a Testicular Teratoma with Retroperitoneal Metastasis: A Case Report and Review of Literature

Ovarian Clear Cell Carcinoma and Mature Cystic Teratoma Transformed to PNET and Carcinosarcoma: A Case Report with an Immunohistochemical Investigation

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