Granular Cell Tumor Within an Ovarian Mature Cystic Teratoma: Report of a Unique Case and Review of the Literature

Abstract

Granular cell tumors involving the female reproductive tract are rare, with only a small number of cases described. Of the reported cases, none are documented within an ovarian mature cystic teratoma (MCT). This report documents a case of a granular cell tumor, incidentally discovered within an ovarian MCT in a 50-yr-old woman undergoing a supracervical hysterectomy and left salpingo-oophorectomy. Although malignant transformation and other secondary ovarian neoplasms in MCT have been well documented, synchronous nonovarian benign neoplasms are reported much less frequently. The histogenesis of secondary tumors arising in MCT is incompletely understood, and the current case provides additional insight, especially pertaining to schwannian and neuroectodermal tumors arising in this setting. The current case, to the best of our knowledge, represents the first report of a granular cell tumor involving a mature teratoma of any site, with the diagnosis being supported by morphologic and immunohistochemical staining characteristics.

Malignant transformation of mature cystic teratoma of the ovary

“…10, Carcinomas can arise from any mature epithelial tissue. Adenosquamous carcinoma 13,14 Anaplastic Carcinoma 15 Angiosarcoma 16,17 Atypical compound nevus 18 BRAF-wild type PTEN mutant uveal malignant melanoma 19 Carcinoid tumor [20][21][22] Carcinosarcoma 23 Chordoma 24 Dedifferentiated chondrosarcoma 25 Fibrosarcoma 26 Follicular lymphoma 27 Follicular variant of papillary thyroid carcinoma 28 Ganglioneuroblastoma 29 Glioblastoma multiforme 30 Granular cell tumor 31 High-grade B-cell non-Hodgkin lymphoma 32 Large cell neuroendocrine carcinoma 33 Leiomyosarcoma 34 Low-grade astrocytoma 35 Malignant melanoma 10,36 Mucoepidermoid carcinoma 37,38 Multifocal carcinoma arising in struma ovarii 21 Oligodendroglioma/oligodendroglial cell proliferation 20,39 Ovarian clear cell adenocarcinoma 40 Ovarian mucinous cystadenocarcinoma 41 Papillary thyroid carcinoma 20,42 Poorly differentiated adenocarcinoma 43 Primary apocrine adenocarcinoma 44 Primary primitive neuroectodermal tumor 45 Prostate-type adenocarcinoma 46 Rhabdomyosarcoma 47 Sarcomatoid squamous cell carcinoma 48 Sebaceous carcinoma 21,49,…”

“…Less frequent histologic types include adenocarcinoma, sarcomas, thyroid carcinoma, malignant melanoma, and neuroectodermal tumors, among others (Table 1). 10,13–56 Carcinomas can arise from any mature epithelial tissue. Squamous cell carcinoma in mature cystic teratoma arises from the epidermal component via a carcinoma in situ pathway, or from the respiratory epithelium via squamous metaplasia/dysplasia/carcinoma in situ pathway 2,7,11 .…”