Surgical treatment of mature cystic teratomas: A comparison of emergent and elective surgeries

Xia

Intl J Gynecology & Obste

et al. 2017

Section: Introductionmentioning

confidence: 99%

Use of cancer antigen 125, cancer antigen 19‐9, and the neutrophil‐to‐lymphocyte ratio to diagnose mature cystic teratoma with torsion

Xia

Intl J Gynecology & Obste

et al. 2017

“…Torsion of mature cystic ovarian teratoma usually concerns patients of reproductive age who wish to preserve fertility and more frequently occurs in premenopausal women, but it can also happen to women of postmenopausal age. This makes the minimally invasive approach the optimal treatment option for these patients [ 19 ]. Early diagnosis and treatment are vital for good clinical outcomes and preservation of the ovary and/or fallopian tube [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Adnexal Torsion of a Mature Cystic Ovarian Teratoma With Hemorrhagic Infarction Misdiagnosed As Pelvic Inflammatory Disease in a Perimenopausal Patient: A Case Report

Thanasa¹,

Thanasa²,

Xydias³

et al. 2023

Cureus

Mature cystic teratomas are common benign ovarian tumors. They usually occur in young women, less than 40 years old. Our case report concerns a patient of perimenopausal age who came to the hospital complaining about mild abdominal pain, fever below 37.8°C, and diarrhea. The patient had an intrauterine contraceptive device inserted. Based on the clinical findings and imaging, a possible diagnosis of pelvic inflammatory disease was set, and intravenous administration of broad-spectrum antibiotics started immediately. The decision for performing laparotomy was taken after the fact that the clinical condition and blood tests of the patient had shown no improvement. Intraoperatively, the presence of a large twisted ovarian mass with signs of total necrosis due to adnexal torsion was detected. A histological examination of the surgical specimen confirmed the diagnosis of mature cystic teratoma in the right ovary. The postoperative course was uneventful. The presentation of the case follows a brief literature review of this rare medical condition regarding the diagnostic and therapeutic approach of these patients.

“…We cannot precisely know how much before the CMTO was present but the patient referred an increase in the abdomen circumference during the previous 2 months suggesting a rapid growth rate. Conversely, MCTO are frequently benign with a growth rate lower than 2 cm/year [ 15 , 16 ]. In addition, a malignant transformation in squamous cell carcinoma was detected at the histopathologic examination.…”

Section: Discussionmentioning

confidence: 99%

Stage Ia squamous cell carcinoma as the malignant transformation of giant and unusual mature teratoma of the ovary in an elderly patient

Palomba

Russo²,

Albonico³

et al. 2022

J Ovarian Res

Background Mature cystic teratomas of the ovary (MCTO) are a type of germ cell tumor that may contain well-differentiated tissues developed from three germ cell layers and constitute about 20% of ovarian germ cell tumors. They are rare ovarian tumors with an annual incidence variable from 1.2 to 14.2 cases per 100,000 that occur mainly in women of reproductive age. They are frequently benign with a slow growth rate, even if they can undergo a malignant transformation in about 1–2% of cases. Case presentation Here, we present the case of an elderly woman referred to gynecological first aid for acute abdominal pain and showing a giant and unusual MCTO at rapid growth with malignant transformation in squamous cell carcinoma (FIGO stage Ia). The patient underwent pelvic mass removal trough emergency longitudinal midline laparotomic incision with intraoperative frozen pathologic examination. A complete surgical staging during the first surgery was performed. After about 9 years of follow-up, she died of non-oncological reasons without recurrence. Conclusions Present case highlights that CMTO with malignant transformation should always be suspected in elderly women in presence of pelvic mass at rapid growth, even if in absence of other clinical and ultrasonographic signs of malignancy. An intraoperative frozen pathologic examination may drive the best treatment.