Mature cystic teratomas of the ovary: case series from one institution over 34 years

Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues

“…This applies to those dermoid cysts that develop malignant somatic neoplasms, most commonly squamous cell carcinoma 41,42 but rarely other types such as malignant melanoma, 43 adenocarcinoma 24,44 and various forms of sarcoma, 42 a phenomenon seen in 0.2-1.4% of mature ovarian teratomas. 39,40 The homozygous nature of the malignant elements in these cases, which is similar to the benign elements, supports derivation of the former from the latter, 17 as do similar cytogenetic changes in the two components. 45 Additionally, immaturity in ovarian teratomas can be seen in a similar light as representing clones of malignant neuroepithelium that develop within a pre-existing teratoma.…”

“…In this model ( Figure 5), therefore, malignant transformation in the example of postpubertal testicular teratomas occurs prior to teratomatous differentiation ('preteratomatous' malignant transformation). On the other hand, for those rare ovarian teratomas with malignant elements, 39,40 malignant transformation occurs after the development of the teratoma ('post-teratomatous' malignant transformation). This applies to those dermoid cysts that develop malignant somatic neoplasms, most commonly squamous cell carcinoma 41,42 but rarely other types such as malignant melanoma, 43 adenocarcinoma 24,44 and various forms of sarcoma, 42 a phenomenon seen in 0.2-1.4% of mature ovarian teratomas.…”

Quiz Case: A Right Adnexal Mass in a Postmenopausal Patient

“…Malignancy potential is more common in patients over 40 years of age. Dermoid cysts are bilateral in 12-13% of cases and they are rarely symptomatic (1). In the diagnosis of dermoid cyst ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT), respectively can be used.…”

Sonographic diagnosis of multiple unilateral ovarian teratomas.

“…5,6 A summation of 4 separate pathologic reviews comprising a total of 957 benign cystic teratomas yielded 9 instances of multiple ipsilateral ovarian teratomas, or 0.9% . 5,7 The most likely cause of confusion at imaging is the presence of multiple dermoid plugs within a single teratoma. Buy et al 3 reported multiple plugs in 7 (16%) of 43 teratomas using computed tomography for diagnosis.…”

“…7,11 The recognition of multiple smaller teratomas rather than a single large teratoma would aid in planning surgical treatment, because the smaller tumors would be more amenable to laparoscopic excision.…”