Huge ovarian mature cystic teratoma with gliomatosis peritonei and massive ascites in a postmenopausal woman

Abstract

Teratoma of the ovary is the most frequently encountered germ cell tumor. It usually occurs in young women. Gliomatosis peritonei (GP) is mature neural glial tissue implanted onto the peritoneal surface. We present a case of a mature teratoma accompanied by GP and massive ascites in postmenopausal women. A 54-year-old, G0P0, woman presented in the gynecology outpatient department with abdominal distension for 6 months. Computed tomography scan of the abdomen and pelvis displayed an ovarian mass about 20 cm × 18 cm with peritoneal seeding, ascites, and enlarged paraaortic lymph nodes. A total hysterectomy and bilateral adnexectomy were performed. The pathology showed the left ovary contained a dermoid cyst. The biopsy of the peritoneal nodule displayed glial tissue confirming the diagnosis of GP. The patient remained in good condition 6 months postoperatively. We suggest GP be considered in patients presenting with teratomas and massive ascites. The radiological diagnosis is challenging due to the rarity of GP. Continued follow-up of patients with teratomas and GP is mandatory due to the potential of malignant transformation.

Large ovarian mature teratoma with gliomatosis peritonei in a young female: A case report

“…GP appears as multiple enhancing nodules in the peritoneum and omentum. The size of the nodules ranges from 0.3 to 1.2 cm in diameter [13 , 14] . Surgery is the usual modality of treatment for large teratomas with gliomatosis peritonei [15 , 16] .…”

“…Few similar cases are reported in the literature. Lin et al described a 54-year-old female with a large ovarian mass, peritoneal seeding, ascites, and enlarged para-aortic lymph nodes [13] . Similarly, Bajracharya et al reported a 21-year-old female with a large abdominopelvic heterogeneous complex cystic solid mass and nodular omental thickening [18] .…”