An Adolescent With Ovarian Osteosarcoma Arising in a Cystic Teratoma

Abstract

A 14-year-old girl had an abdominal mass with the characteristics of an ovarian germ cell tumor on computed tomography scan. The mass, arising from the left ovary, was completely resected and found to be osteosarcoma arising from a mature cystic teratoma. A metastatic lesion in the abdomen did not respond to 2 courses of cisplatin, doxorubicin, ifosfamide, and high-dose methotrexate, and was resected. Seven months after completion of chemotherapy, there were simultaneous local recurrence and lung metastases. Previously, 10 cases of ovarian osteosarcoma have been reported in the literature: 5 were primary osteosarcoma of the ovary, 4 were associated with teratomas, and 1 was part of a malignant mixed mesodermal tumor of the ovary. Of the 10, there are only 2 long-term survivors, both of whom were treated with adjuvant chemotherapy following complete resection.

Pulmonary-type adenocarcinoma and signet ring mucinous adenocarcinoma arising in an ovarian dermoid cyst: report of a unique case

“…Malignant transformation is rare, probably occurring in less than 1% of these neoplasms and by far the most frequent somatic malignancy to develop within these tumors is squamous cell carcinoma, which accounts for approximately 75% of cases of malignant transformation [1,2] Less common tumor types include adenocarcinoma, undifferentiated carcinoma, sebaceous carcinoma, thyroid-type tumors, carcinoid tumor, various sarcomas, glial neoplasms, and malignant melanoma [9][10][11][12][13][14][15][16]. Most adenocarcinomas are of intestinal mucinous type, sometimes with associated benign and borderline elements (the full range of mucinous neoplasms from benign to borderline to malignant can arise in association with a dermoid cyst), but more uncommon variants of adenocarcinoma reported include a single case of a prostatic-type adenocarcinoma [17].…”

Primary osteosarcoma of the ovary

“…When feasible, surgery is the same as for epithelial ovarian carcinoma with the aim of optimal cytoreductive surgery which means with no residual disease including hysterectomy with bilateral salpingo-oophorectomy, omentectomy, pelvic and para-aortic lymphadenectomy but, because this tumor is rapidly progressing with diagnosis at FIGO stages III or IV, the most frequent scheme is biopsy, neoadjuvant chemotherapy, surgical resection and adjuvant therapy. Therapeutic approaches differ in the literature [5][6][7][8][9][10][11][12][13][14][15]. Six patients had surgery (radical in only 2 cases) and then received adjuvant chemotherapy in various ways.…”

A clinicopathologic evaluation of 230 cases of mature cystic teratomas

“…5 Complications associated with dermoid cysts include torsion, rupture and infection. 5,6 Malignant transformation of MCT is an uncommon complication occurring in approximately 0.17-2% of all cases and the most often reported malignancy is squamous cell carcinoma. Other malignancies include basal cell carcinoma, melanoma, adenocarcinoma, sarcoma and thyroid cancer.…”