Journal of Pathology and Translational Medicine

Original Article

Diagnostic Significance of Cellular Neuroglial Tissue in Ovarian Immature Teratoma: Yun Chai, Chang Gok Woo, Joo-Young Kim, Chong Jai Kim, Shin Kwang Khang, Jiyoon Kim, In Ah Park, Eun Na Kim, Kyu-Rae Kim; J Pathol Transl Med. 2017;51(1):49-55. Published online October 14, 2016; DOI: https://doi.org/10.4132/jptm.2016.09.19

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Background
Immature teratoma (IT) is a tumor containing immature neuroectodermal tissue, primarily in the form of neuroepithelial tubules. However, the diagnosis of tumors containing only cellular neuroglial tissue (CNT) without distinct neuroepithelial tubules is often difficult, since the histological characteristics of immature neuroectodermal tissues remain unclear. Here, we examined the significance of CNT and tried to define immature neuroectodermal tissues by comparing the histological features of neuroglial tissues between mature teratoma (MT) and IT.
Methods
The histological features of neuroglial tissue, including the cellularity, border between the neuroglial and adjacent tissues, cellular composition, mitotic index, Ki-67 proliferation rate, presence or absence of tissue necrosis, vascularity, and endothelial hyperplasia, were compared between 91 MT and 35 IT cases.
Results
CNTs with a cellularity grade of ≥ 2 were observed in 96% of IT cases and 4% of MT cases (p < .001); however, CNT with a cellularity grade of 3 in MT cases was confined to the histologically distinct granular layer of mature cerebellar tissue. Moreover, CNT in IT exhibited significantly higher rates of Ki-67 proliferation, mitoses, and necrosis than those in MT (p < .001). Furthermore, an infiltrative border of neuroglial tissue and glomeruloid endothelial hyperplasia were significantly more frequent in IT cases than in MT cases (p < .001).
Conclusions
Our results suggest that if CNT with a cellularity grade of ≥ 2 is not a component of cerebellar tissue, such cases should be diagnosed as IT containing immature neuroectodermal tissue, particularly if they exhibit an infiltrative border, mitoses, necrosis, and increased Ki-67 proliferation.

Citations

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An Atypical Presentation of a Pediatric Mature Teratoma: A Case Report and Review of the Literature
Ahmed M Othman, Abdulaziz A Abu Alnasr, Reem E Kordi, Shahad A Abu Alnasr
Cureus.2024;[Epub] CrossRef
Immature Teratoma: Diagnosis and Management—A Review of the Literature
Liviu Moraru, Melinda-Ildiko Mitranovici, Diana Maria Chiorean, Marius Coroș, Raluca Moraru, Ioan Emilian Oală, Sabin Gligore Turdean
Diagnostics.2023; 13(9): 1516. CrossRef
Congenital Immature Grade ΙΙΙ Teratoma of the Neck: A Case Report
Nazneen Liaqat, Israr Ud Din, Zeeshan Ali, Majid Rashid, Afsheen Liaqat
Cureus.2023;[Epub] CrossRef
Benign ovarian teratoma in the dog with predominantly nervous tissue: A case report
P Makovicky, AV Makarevich, P Makovicky, A Seidavi, L Vannucci, K Rimarova
Veterinární medicína.2022; 67(2): 99. CrossRef
Fascin as a Useful Marker for Identifying Neural Components in Immature Teratomas of Human Ovary and Those Derived From Murine Embryonic Stem Cells
Ryunosuke Umehara, Atsushi Kurata, Masakatsu Takanashi, Hirotsugu Hashimoto, Koji Fujita, Toshitaka Nagao, Masahiko Kuroda
International Journal of Gynecological Pathology.2019; 38(4): 377. CrossRef
Cerebellar Differentiation in Ovarian Teratoma: A Report of 6 Cases
Colin J.R. Stewart, Maxine L. Crook
International Journal of Gynecological Pathology.2018; 37(4): 316. CrossRef
Mitotic activity of epithelia of ectoand entodermal types in spontaneous and experimental teratomas of mice
Pavel A. Dyban
Medical academic journal.2018; 18(4): 42. CrossRef
Ovarian cystectomy in the treatment of apparent early-stage immature teratoma
Ting Zhao, Yan Liu, Xiao Wang, Hao Zhang, Yuan Lu
Journal of International Medical Research.2017; 45(2): 771. CrossRef

Case Studies

Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review: Na Rae Kim, Soyi Lim, Juhyeon Jeong, Hyun Yee Cho; Korean J Pathol. 2013;47(6):587-591. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.587

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Abstract PDF

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

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Mimics of primary ovarian cancer and primary peritoneal carcinomatosis – A pictorial review
B. Lawson, I. Rajendran, J. Smith, A. Shakur, V. Sadler, T.J. Sadler, H.C. Addley, S. Freeman
Clinical Radiology.2024; 79(10): 736. CrossRef
Ovarian Immature Teratoma With Nodal Gliomatosis: A Case Report and Literature Review
Marwa Alna’irat, W. Glenn McCluggage, Maysa Al-Hussaini
International Journal of Gynecological Pathology.2023; 42(6): 627. CrossRef
Germ Cell Tumors of the Ovary: A Review
Preetha Ramalingam
Seminars in Diagnostic Pathology.2023; 40(1): 22. CrossRef
Immature Teratoma with Gliomatosis Peritonei Arising in a Young Girl: Report of a Rare Case and Review of Literature
Isheeta Ahuja, Ruchi Rathore, Neerja Bhatla, Sandeep R. Mathur
Indian Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review
Sijian Li, Na Su, Congwei Jia, Xinyue Zhang, Min Yin, Jiaxin Yang
Current Oncology.2022; 29(9): 6364. CrossRef
Extratesticular gliomatosis peritonei after mesenteric teratoma: a case report and literature review
Jiaqiang Li, Shoulin Li, Dong Xiao, Jiaming Song, Jianxiong Mao, Jianchun Yin
Journal of International Medical Research.2021;[Epub] CrossRef
Germ Cell Tumors of the Female Genital Tract
Elizabeth D. Euscher
Surgical Pathology Clinics.2019; 12(2): 621. CrossRef
Gliomatosis peritonei: a series of eight cases and review of the literature
Dan Wang, Cong-wei Jia, Rui-e Feng, Hong-hui Shi, Juan Sun
Journal of Ovarian Research.2016;[Epub] CrossRef

Sebaceous Carcinoma Arising in Mature Cystic Teratoma of Ovary: Hyo Jeong An, Yong Han Jung, Hye Kyoung Yoon, Soo Jin Jung; Korean J Pathol. 2013;47(4):383-387. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.383

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Abstract PDF

Roughly 1% of mature cystic teratomas undergo malignant transformation. In particular, cutaneous-type adnexal neoplasms may occur in mature cystic teratomas. Sebaceous carcinomas, which arise from mature cystic teratomas, have rarely been observed, with only seven cases previously reported. Here, we present a case of a 69-year-old female who had pelvic pain for two weeks and who subsequently underwent bilateral salpingo-oophorectomy and hysterectomy. Her left ovary showed a unilocular cyst, measuring 22.0 cm in diameter, filled with sebaceous material and a few hairs. A luminally-protruding solid mass measuring 4.0 cm in diameter was also noted. Microscopic findings revealed lobular or diffusely arranged basophilic, atypical sebaceous cells connected to a typical mature cystic teratoma. Tumor cells demonstrated positive immunoreactivity for high molecular weight cytokeratin, cytokeratin 7, cytokeratin 19, epithelial membrane antigen, and carcinoembryonic antigen. Here, we present a case of sebaceous carcinoma arising from a mature cystic teratoma along with a review of previously published reports.

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How can we best manage ovarian sebaceous carcinomas arising from mature cystic teratomas?
Hong Min Shaye Peng, Sung Hock Chew, Yang Huang Grace Ng, Felicia Hui Xian Chin
BMJ Case Reports.2025; 18(2): e264651. CrossRef
Genetic Profiling of Sebaceous Carcinoma Arising from an Ovarian Mature Teratoma: A Case Report
Sumika Zaitsu, Yoko Aoyagi, Haruto Nishida, Kohei Nakamura, Mitsutake Yano, Eiji Kobayashi
International Journal of Molecular Sciences.2024; 25(12): 6351. CrossRef
Extraocular sebaceous carcinoma arising in a mature cystic teratoma of ovary: A case report and review of literature
Sara Pakbaz, Tanya Chawla, Marcus Q Bernardini, Liat Hogen, Marjan Rouzbahman
Human Pathology Reports.2022; 27: 300592. CrossRef
Sebaceous adenoma occurring within an intracranial dermoid cyst
Takashi Minamisaka, Johji Imura, Keitaro Shiraishi, Kohji Takagi, Takahiko Tomia, Sinichi Tanaka, Akira Noguchi, Takuya Akai, Kyo Noguchi, Satoshi Kuroda
Neuropathology.2022; 42(4): 289. CrossRef
Malignant transformation of mature cystic teratoma of the ovary
Doaa Atwi, Maria Kamal, Michael Quinton, Lewis A. Hassell
Journal of Obstetrics and Gynaecology Research.2022; 48(12): 3068. CrossRef
Sebaceous Carcinoma Arising in Ovarian Teratoma: First Report Associated With Germline Mismatch Repair Gene Mutation
Jacinta Murray, Patrick McIlwaine, Patrick J. Morrison, W. Glenn McCluggage
International Journal of Gynecological Pathology.2022; 41(6): 608. CrossRef
Impact of surgery and adjuvant treatment on the outcome of extraocular sebaceous carcinoma: a systematic review and individual patient's data analysis of 206 cases
Prashanth Giridhar, Lakhan Kashyap, Supriya Mallick, Ashish Dutt Upadhyay, Goura K. Rath
International Journal of Dermatology.2020; 59(4): 494. CrossRef
Mismatch repair deficiency is implicated in carcinoma arising from ovarian teratoma
Alvin Ho-Kwan Cheung, Chit Chow, Mei-Yung Yu, Wendy Wai-Tak Law, Peggy Pui-Ying Law, Paul Cheung-Lung Choi, Wei Kang, Ka-Fai To
Pathology.2019; 51(1): 67. CrossRef
Malignant transformation of an ovary mature cystic teratoma: case report and review of the literature
Elkin Fabián Dorado-Roncancio, Oscar Joel Carrillo-Garibaldi
Obstetrics & Gynecology International Journal.2019;[Epub] CrossRef
A case of ovarian clear cell carcinoma arising from ovarian mature cystic teratoma
Kazuya Maeda, Yoshito Terai, Shinichi Terada, Hiroshi Maruoka, Yuhei Kogata, Keisuke Ashihara, Yoshimichi Tanaka, Tomohito Tanaka, Hiroshi Sasaki, Satoshi Tsunetoh, Takashi Yamada, Masahide Ohmichi
Journal of Ovarian Research.2018;[Epub] CrossRef
Sebaceous carcinoma arising within an ovarian mature cystic teratoma: A case report with discussion of clinical management and genetic evaluation
Alyssa Wield, Melissa Hodeib, Mohammad Khan, Lindsay Gubernick, Andrew J. Li, Shivani Kandukuri
Gynecologic Oncology Reports.2018; 26: 37. CrossRef

Case Reports

Mature Teratoma in the Adrenal Gland.: Eun Jung Cha; Korean J Pathol. 2011;45:S98-S100.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S98

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Abstract PDF: A teratoma is a germ-cell tumor composed of tissue components representing derivatives of three germ layers. A teratoma in the region of adrenal gland is a rare retroperitoneal tumor. We now report a case of a primary adrenal teratoma. A 38-year-old woman presented with an incidentally detected adrenal mass. The computed tomography scan revealed a 9x8x7.5 cm fat density mass with calcification in the left adrenal gland. The surgically resected tumor was round and well circumscribed and the adrenal gland was present at the periphery of the tumor. The cut surface contained fat tissue and a hair containing cyst. Microscopically, the tumor consisted of adipose tissue, hair, skin appendage, nerve, muscle bundle and bone.

Primary Malignant Melanoma Arising in an Ovarian Mature Cystic Teratoma: A Case Report and Literature Review.: Sangho Lee, Ji Hoon Kim, Gyu Rak Chon, Aeree Kim, Baek Hui Kim; Korean J Pathol. 2011;45(6):659-664.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.659

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Abstract PDF

Ovarian primary malignant melanoma is very uncommon with only 44 reported cases in the literature. A 71-year-old woman with an ovarian mass and multiple nodules in the liver presented to our hospital. She was treated with bilateral salpingo-oophorectomy, and malignant melanoma was found in the mature cystic teratoma of the ovary. Malignant melanoma cells were also found in the ascitic fluid. She died 5 months later. Here we report a very uncommon case of malignant melanoma arising in an ovarian mature cystic teratoma with a review of the literature.

Citations

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Malignant Transformation of an Ovarian Mature Cystic Teratoma to a Malignant Melanoma
Rita Rathore, Sana Ahuja, Nuneno Nakhro, Pallavi Punhani, Sufian Zaheer
Indian Journal of Surgical Oncology.2024; 15(2): 380. CrossRef
Malignant melanoma arising in mature teratoma with pugnacious spread: A case report
Sumedha Gupta, Shalu Solanki, Saritha Shamsunder, Sana Ahuja, Vinayak Varma
Indian Journal of Obstetrics and Gynecology Research.2024; 11(1): 119. CrossRef
Therapeutic Management of Rare Primary Ovarian Neoplasms: Carcinosarcoma, Leiomyosarcoma, Melanoma and Carcinoid
Mateusz Kozłowski, Katarzyna Nowak, Agnieszka Kordek, Aneta Cymbaluk-Płoska
International Journal of Environmental Research and Public Health.2021; 18(15): 7819. CrossRef
Primary form of malignant melanoma in an ovarian mature cystic teratoma: case report and literature review
Fatemeh Samiee-rad, Amir Abdollah Zangivand, Kamran Soleimanitadi
Comparative Clinical Pathology.2017; 26(4): 989. CrossRef
Malignant melanoma arising in a mature teratoma: A case report with review of the recent literature
Lorna A. Brudie, Faizan Khan, Michael J. Radi, Melissa M. Yates, Sarfraz Ahmad
Gynecologic Oncology Reports.2016; 16: 47. CrossRef
Metastasizing Primary Malignant Melanoma of the Ovary: A Diagnostic Enigma
Narendra Hulikal, Manilal Banoth, Revanth Gangasani, Praveen C. Suresh, Radhika Kottu, Asha Thota
Journal of Gynecologic Surgery.2015; 31(3): 166. CrossRef

Mature Cystic Teratoma of the Fallopian Tube: A Brief Case Report.: Woo Jung Sung, Jun Mo Kim, Mi Jin Kim; Korean J Pathol. 2011;45(3):303-305.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.303

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Abstract PDF

Mature cystic teratomas of the fallopian tube are unusual, being almost incidentally identified. Here we describe a case of mature cystic teratoma arising in the fallopian tube, in a 44-year-old female. The mass was found during a regular checkup without complication. Microscopically, components from each germ layer were identified.

Citations

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Mature Cystic Teratoma of the Fallopian Tube in a Postmenopausal Woman: A Case Report and Review of the Literature
Mustafa Erkan Sari, Ozhan Ozdemir, Pinar Kadirogullari, Funda Arpaci Ertugrul, Cemal Resat Atalay
Case Reports in Obstetrics and Gynecology.2015; 2015: 1. CrossRef

Urothelial (Transitional Cell) Carcinoma Arising in Mature Cystic Teratoma: A Case Report.: Ok Jun Lee, Ho chang Lee; Korean J Pathol. 2010;44(6):666-669.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.666

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4 Crossref

Abstract PDF

Mature cystic teratoma (MCT) is one of the most common benign ovarian tumors, but 1-2% of MCTs are transformed to a malignant neoplasm. Urothelial carcinoma (UC) or transitional cell carcinoma is the most common cancer in the urinary tract. However, UC is a very rare component of transformed malignancy of MCT. Here we report a case of UC arising in an MCT in a 52-year-old woman. Grossly, the ovary was partly cystic and partly solid. Microscopically, the cyst revealed the classic features of MCT and the solid area was papillary UC. By immunohistochemistry using cytokeratins and thrombomodulin, the UC showed a similar expression to that of UC arising in the urinary tract, rather than resembling a primary transitional cell carcinoma of the ovary. When UC is found in a component of MCT, the origin of the carcinoma should be evaluated and urinary tract examinations are required to rule out metastasis.

Citations

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A Rare Urothelial Malignant Transformation in a Mature Cystic Teratoma of the Ovary
Moito Iijima, Iori Kisu, Tetsuro Shiraishi, Rie Irie, Nobumaru Hirao
Cureus.2021;[Epub] CrossRef
Transitional Cell Carcinoma arising in Ovarian Cystic Teratoma: A Rare Case Report
Abhay V. Deshmukh, Vitaladevuni B. Shivkumar, Neha V. Fulzele, Nitin M. Gangane
Indian Journal of Gynecologic Oncology.2020;[Epub] CrossRef
A Rare Malignant Transformation of an Ovarian Cystic Teratoma: A Case Report
Manju Rachel Mathew, Anita Ramdas, Susy S. Kurian, Linu Kuruvilla, Neelima Singh
Case Reports in Pathology.2018; 2018: 1. CrossRef
Urothelial carcinoma arising from an ovarian mature cystic teratoma
Hui-Yu Chuang, Yi-Ting Chen, Tak-Loi Mac, Yu-Chieh Chen, Hung-Sheng Chen, Wan-Shan Wang, Eing-Mei Tsai
Taiwanese Journal of Obstetrics and Gynecology.2015; 54(4): 442. CrossRef

Malignant Fibrous Histiocytoma Arising in a Mature Cystic Teratoma of the Ovary: A Case Report.: Soyoung Im, Sun Mi Lee, Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2010;44(3):322-325.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.322

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Abstract PDF: A 50-year-old female patient presented with anorexia and weight loss. Pelvic computed tomography revealed a 12.5 x 7.3 cm heterogeneous mass in the left ovary. About 30% of the tumor was occupied by a mature cystic teratoma. The remaining solid portion was composed of fibrous and histiocytic elements, arranged in storiform patterns admixed with bizarre giant cells. The mitotic index was 8 per 10 high power fields, including atypical mitoses. The only immunopositivity was for vimentin. The tumor was diagnosed as a malignant fibrous histiocytoma arising in a mature cystic teratoma. To the best of our knowledge, this is only the third such case in the English language literature.

Mature Cystic Teratoma of the Fallopian Tube: A case report.: Kye Weon Kwon, Jong Yup Bae, Hee Jung Ahn, Yoon Jung Ahn, Bok Soo Kim; Korean J Pathol. 1996;30(10):951-953.

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Abstract PDF: Teratomas of the fallopian tube are extremely rare, and only about 50 cases have reported in the world literature. Most cases of mature cystic tubal teratoma are asymptomatic and are discovered as an incidental finding on physical or radiologic examination, or at the time of laparatomy. We report a case of mature cystic teratoma of the right fallopian tube which was discovered during pelvic ultrasonogram for antenatal care in a 28 year old woman. Right salpingectomy was performed during cesarean section for cephalo-pelvic distortion at IUP 39 weeks. Gross examination of the right fallopian tube reveals a distended fallopian tube, measuring 8cm in length and 2cm in diameter. On section, it is filled with several small pedunculated nodules and cysts containing sebaceous materials. Microscopically the tumor was seen in continuity with the lining epithelium of mucosal folds. The majority of the tumor was composed of well differentiated mature elements of three germ layers with skin and skin appendages, mature brain tissue, bone, breast tissue, intestinal mucosa and bronchial epithelium.

Primitive Neuroectodermal Tumor Associated with Mature Cystic Teratoma of the Ovary: A case report.: Young Ju Kim, Mi Yeong Jeon, Mi Sun Kang, Chan Hwan Kim; Korean J Pathol. 1996;30(12):1150-1154.

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Abstract PDF: Malignant transformation of benign cystic teratomas of the ovary is rare, with an incidence rate of 1-3%. The most common malignancy associated with benign cystic teratoma of the ovary is squamous cell carcinoma, which represents 90% of malignant transformations, followed by adenocarcinoma and carcinoid. Primary malignant neuroectodermal tumor in a mature cystic teratoma is extremely rare and microscopically can be subclassified as differentiated, primitive, and anaplatic. We experienced a case of primitive neuroectodermal tumor (PNET) associated with mature cystic teratoma of the ovary in a 11-year-old girl. Grossly, the ovary was a unilocular cyst which contained sebum material and disclosed several large, yellow to gray-tan polypoid excresences attached to the inner cystic wall. Except a large, fish-flesh, soft mass, the other polypoid masses were covered with sebum and contained small pieces of cartilage and tooth, and microscopically represented as mature teratoma. The large, fish-flesh, soft mass disclosed sheets and lobules of closely packed small cells with thin fibrovascular septa, which frequently replacing and encroaching the mature cystic teratoma. The small tumor cells were uniform and made up of round to oval nuclei with coarse chromatin and prominent nucleoli, very similar to those of PNET of the central nervous system.

Cystic Struma Ovarii Mimicking Adenomatous Goiter of the Thyroid.: Kee Taek Jang, Je Geun Chi; Korean J Pathol. 1997;31(7):692-694.

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Abstract PDF: Struma ovarii, the most common monodennal teratoma of the ovary, causes diverse problems in differential diagnosis. The literature on the pathology of struma ovarii has focused principally on the problem of formulating criteria of malignancy. In contrast, unusual gross and microscopic features of struma ovarii and its resultant problems in differential diagnosis have received relatively little attention. We report an ovarian teratoma which was almost entirely cystic, causing the diagnosis of struma to be overlooked. The removed ovarian tumor showed all the features of adenomatous goiter of the thyroid gland. The lining epithelium of the cysts was frequently flattened, and the follicles in the cyst wall were few and atrophic. The patient was a 58-year-old woman who was found to have an ovarian tumor by routine monographic examination

Adenocarcinoma Arising in Sacrococcygeal Teratoma: A case report.: Hae Jeong Choi, Mi Jin Gu, Yeong Kyung Bae, Joon Hyuk Choi, Jae Hwan Kim; Korean J Pathol. 1998;32(4):315-317.

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Abstract PDF: We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.

Prostatic Tissue in Ovarian Mature Cystic Teratoma: A case report.: Seung Mo Hong, Mi Sun Choe, Eun Mee Han, Hun Kyung Lee, Jae Y Ro; Korean J Pathol. 1999;33(7):525-528.

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Abstract PDF: Ovarian mature cystic teratoma containing benign prostatic tissue is rare and only 11 cases have been reported in the literature to date. We report a case of mature cystic teratoma of the ovary containing prostatic tissue. A 23-year-old female patient came to our hospital complaining of irregular menstruation for 3 months. Her menarche had occurred when she was 13 years old. The patient showed no evidence of virilization nor of endocrinopathy. A goose-egg-sized mass was palpable in the left lower abdomen on physical examination. Ultrasonography revealed a cystic ovarian mass with internal echogenecity. Microscopic finding was consistent with that of usual mature cystic teratoma except for a 1.5 cm focus of prostatic and bladder tissues. Prostatic tissue demonstrated strong immunoreactivity for prostatic specific antigen (PSA), prostatic alkaline phosphatase (PAP) and cytokeratin 7. Basal cells of the prostate glands were positive for high molecular weight cytokeratin (34betaE12). Although ovarian mature cystic teratoma containing prostatic tissue has been reported as a rare occurrence, a careful examination with immunohistochemical staining may increase the detection of prostatic tissue in mature cystic teratoma of the ovary.

Squamous Cell Carcinoma Arising from Mature Cystic Teratoma of the Ovary: A report of three cases .: Mee Joo, Han Nae Min, Yun Kyung Kang, Hye Kyung Lee, Young Chae Cho, Eung Soo Lee; Korean J Pathol. 1999;33(12):1211-1215.

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Abstract PDF: Malignant transformation develops in a little less than 2% of mature cystic teratomas. A wide variety of malignant tumors may arise within benign mature cystic teratomas, and the most common of these is squamous cell carcinoma, which account for 75~85%. In general, the tumors are in an advanced stage and the prognosis is poor as most patients die within a year. However, when the tumor is confined to the ovary, they have a good prognosis and the 5-year survival rate is 63~83%. We experienced three cases of squamous cell carcinoma arising in mature cystic teratoma. Two of the carcinomas occurred in postmenopausal women: 58-(case 1) and 66-(case 2) year-old, and were confined to the ovaries. They were alive 37 months and 18 months after the operation, respectively. The third case was a 45-year-old premenopausal woman who had an extraovarian extension of the tumor and early recurrence within two months. Histologically, cases 1 and 3 were conventional well to moderately differentiated squamous cell carcinomas and case 2 showed a well-differentiated squamous cell carcinoma with exuberant proliferating trichilemmal tumor-like areas.

Mature Teratoma of the Rectum: A Case Report.: Kyung Sun Park, Mi Seon Kang, Young Ju Kim, Chan Hwan Kim, Hye Kyoung Yoon; Korean J Pathol. 2001;35(1):83-85.

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Abstract PDF: Teratoma commonly affects the gonads. Its occurrence in extragonadal sites has also been reported. However, teratoma affecting the gastrointestinal tract is extremely uncommon. Herein, we describe a rare case of rectal teratoma presenting a solid polypoid tumor. A 61-year-old woman with constipation is presented. She had a colonoscopic examination and was noted to have a pedunculated polyp at the rectum, located 15 cm from the anal verge. The 4.2x2.4x2.0 cm polyp arose at the rectal mucosa which had a long stalk and smooth surface. The cut surface showed a solid area with a central yellow area. Microscopically, the polyp was covered with keratinizing stratified squamous epithelium which was abruptly exchanged from the columnar rectal mucosa. Sebaceous glands, sweat glands and hair follicles were mixed in stroma under the surface of the polyp. The central portion of the polyp was composed of mature adipose tissue and collagen fibers. Mature neural elements were noted in the stalk.

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