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Zhou G, Sun F, Yu X, Huang R, Liu X, Ouyang Y, Yang Z, Li S. Clinical characteristics and long-term management of prepubertal testicular teratomas: a retrospective, multicenter study. Eur J Pediatr 2023; 182:1823-1828. [PMID: 36795187 PMCID: PMC10167136 DOI: 10.1007/s00431-023-04859-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
Prepubertal testicular teratomas are rare tumors with limited practical guidance for their management. This study aimed to analyze a large multicenter database to establish the optimal management of testicular teratomas. We retrospectively collected data on testicular teratomas in children younger than 12 years who underwent surgery without postoperative chemotherapy in three large professional children's institutions in China between 2007 and 2021. The biological behavior and long-term outcomes of testicular teratomas were analyzed. In total, 487 children (with 393 mature teratomas and 94 immature teratomas) were included. Among mature teratomas, 375 cases were testis-sparing, 18 were orchiectomies, 346 were operated through the scrotal approach, and 47 underwent the inguinal approach. The median follow-up period was 70 months, and no recurrence or testicular atrophy was observed. Among the children with immature teratomas, 54 underwent testis-sparing surgery, 40 underwent orchiectomy, 43 were operated through the scrotal approach, and 51 were operated through the inguinal approach. Two cases of immature teratomas with cryptorchidism had local recurrence or metastasis within 1 year of the operation. The median follow-up duration was 76 months. No other patients had recurrence, metastasis, or testicular atrophy. Conclusion: Testicular-sparing surgery is the first treatment choice for prepubertal testicular teratomas, with the scrotal approach being a safe and well-tolerated strategy for these diseases. Additionally, patients with immature teratomas and cryptorchidism may have tumor recurrence or metastasis after surgery. Therefore, these patients should be closely followed up in the first year after surgery. What is Known: • There is a fundamental difference between testicular tumours in childhood and those in adulthood - not only in terms of the difference and incidence but also in terms of histology. • For surgical techniques, the inguinal approach is recommended for the treatment of testicular teratomas in children. What is New: • The scrotal approach being a safe and well-tolerated strategy for testicular teratomas in children. • Patients with immature teratomas and cryptorchidism may have tumor recurrence or metastasis after surgery. These patients should be closely followed up in the first year after surgery.
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Affiliation(s)
- Guanglun Zhou
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Fenglan Sun
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, China
| | - Xin Yu
- Department of Urology, Anhui Provincial Children's Hospital, Hefei, China
| | - Ruifeng Huang
- Department of Gastroenterology and Zhengzhou Key Laboratory of Children's Digestive Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Xiaodong Liu
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Yaoling Ouyang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, China
| | - Zhilin Yang
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Shoulin Li
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China.
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Sauer MA, Coy S, Quade BJ, Nucci MR. Well-developed Cerebellum in an Ovarian Mature Teratoma From a Pregnant Female. Int J Gynecol Pathol 2022; 41:615-621. [PMID: 34954707 DOI: 10.1097/pgp.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Teratomas are the most common neoplasm of the ovary, comprising over half of all diagnosed tumors in patients under 50. Most lesions are classified as benign mature teratomas and are histologically defined by the presence of mature tissues from one or more of the embryological germ layers: ectoderm, mesoderm, and endoderm. Neuroectodermal derivatives, including glia, neurons, ependymal cells, and meninges are present in a third to half of mature teratomas. Although teratomatous tissue elements are typically arranged in a haphazard fashion, well-developed and organized embryonic organ structures have been rarely reported and often with limited histologic, clinical, or gross characterization. In this report, we describe the case of an ovarian mature cystic teratoma identified in a pregnant female which exhibited remarkably well-developed posterior fossa structures including lobated and foliated cerebellum with appropriate anatomic organization and associated brainstem, ventricular, and meningeal structures.
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Affiliation(s)
- Madeline A Sauer
- University of Missouri School of Medicine (M.A.S); Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital (B.J.Q., M.R.N.); and Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital (S.C.)
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Assarrar I, Harhar M, Zerrouki D, Draoui N, Miry A, Bennani A, Rouf S, El Harroudi T, Latrech H. Primary adrenal mature teratoma: A rare case report and review of literature. Ann Med Surg (Lond) 2022; 75:103422. [PMID: 35386796 PMCID: PMC8977937 DOI: 10.1016/j.amsu.2022.103422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/21/2022] [Accepted: 02/27/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Teratoma is a germ cell tumor, deriving from totipotent cells. Teratomas usually occur in gonads and are rarely extra-gonadal. The adrenal location is exceptional. Only few cases of primary adrenal teratomas have been reported in literature, mainly in young patients. Case report We report the case of a 56-year-old female patient who presented with pyrosis, dyspepsia and abdominal pain that was evolving for 5 months. The abdominal computed tomography revealed a voluminous mass of the right adrenal gland and the hormonal evaluation was normal. The patient underwent an open transperitoneal adrenalectomy and the histopathological examination of the specimen confirmed the diagnosis of mature teratoma. Discussion Adrenal teratomas are commonly asymptomatic and their diagnosis depends mostly on radiologic findings. Malignant transformation is very rare. Surgical excision is the mainstay of treatment with a good prognosis. Conclusion Open surgery should always be considered in large and adhering teratoma tumors of the adrenal gland. Some pathologic features and tumorigenesis of adrenal teratomas are not entirely elucidated, thus the importance of larger studies in order to comprehend this pathological entity. The adrenal location of primary adrenal teratomas is exceptional. The preoperative diagnosis is challenging, based mainly on imaging findings. Open surgery should always be considered in large and adhering teratoma tumors of the adrenal gland.
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Affiliation(s)
- Imane Assarrar
- Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Marouane Harhar
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Department of Surgical Oncology, Regional Oncology Center, Mohammed VI University Hospital Center, Oujda, Morocco
| | - Dounia Zerrouki
- Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Najat Draoui
- Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Achraf Miry
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Laboratory of Anatomic Pathology, Mohammed VI University Hospital Center, Oujda, Morocco
| | - Amal Bennani
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Laboratory of Anatomic Pathology, Mohammed VI University Hospital Center, Oujda, Morocco
| | - Siham Rouf
- Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Tijani El Harroudi
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Department of Surgical Oncology, Regional Oncology Center, Mohammed VI University Hospital Center, Oujda, Morocco
| | - Hanane Latrech
- Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
- Corresponding author. Mohammed VI University Hospital Center, 4806, 60049, Oujda, Morocco.
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“Recurrence or Retro-conversion? A Diagnostic Dilemma”: Case Report and Review of Literature on Growing Teratoma Syndrome (GTS). INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2019. [DOI: 10.1007/s40944-018-0252-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ovarian Teratocarcinoma in an Emu (Dromaius novaehollandiae): Histopathological and Immunohistochemical Characterization. J Comp Pathol 2018; 159:31-35. [DOI: 10.1016/j.jcpa.2018.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 11/23/2022]
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Li S, Li H, Ji Z, Yan W, Zhang Y. Primary adrenal teratoma: Clinical characteristics and retroperitoneal laparoscopic resection in five adults. Oncol Lett 2015; 10:2865-2870. [PMID: 26722254 DOI: 10.3892/ol.2015.3701] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 08/17/2015] [Indexed: 12/17/2022] Open
Abstract
Primary adrenal teratoma is extremely rare. To investigate the clinical characteristics and further enrich the limited knowledge on its diagnosis and treatment, the present study retrospectively analyzed the detailed clinical data of five patients with primary adrenal teratomas treated in the Peking Union Medical College Hospital (Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China) between March 2009 and February 2014. The five patients were female, aged from 16 to 51 years (mean, 36.0±16.3 years), with solitary lesions that were incidentally found on routine physical examinations. The tumor size ranged from 2.4 to 9.0 cm (mean, 6.0±2.7 cm). Ultrasonography revealed a mixed echo in four patients, and computed tomography showed mixed density masses with fat components and calcification in three patients. Adrenal-related endocrine tests were normal in all five patients, and no abnormalities were found in the three patients who underwent somatostatin receptor scintigraphy examination. All patients were treated with retroperitoneal laparoscopic surgery, with no complications, and the resected tumors were identified as mature cystic teratomas pathologically. To date, the patients have been followed up for 4-60 months post-operatively, with no recurrence. In conclusion, this rare adrenal teratoma is an occult entity to which reproductive females are susceptible. The tumor exhibits no typical clinical manifestations or adrenal-related laboratory abnormalities, and the pre-operative diagnosis mainly relies on imaging characteristics of a heterogeneous lesion containing fat components with scattered and marginal calcifications. The preferred treatment is retroperitoneal laparoscopic surgery, and the prognosis is good.
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Affiliation(s)
- Shuqiang Li
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Hanzhong Li
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Zhigang Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Weigang Yan
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Yushi Zhang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
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Elkind L, Jalaguier-Coudray A, Lambaudie E, Villard-Mahjoub R, Delarbre B, Juhan V, Thomassin-Piana J, Houvenaeghel G. Tératome immature ovarien chez une patiente de 38ans : intérêt de l’IRM pelvienne préopératoire. IMAGERIE DE LA FEMME 2015. [DOI: 10.1016/j.femme.2014.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gheorghisan-Galateanu A, Terzea DC, Carsote M, Poiana C. Immature ovarian teratoma with unusual gliomatosis. J Ovarian Res 2013; 6:28. [PMID: 23590935 PMCID: PMC3637604 DOI: 10.1186/1757-2215-6-28] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 04/06/2013] [Indexed: 04/25/2023] Open
Abstract
This study aimed to investigate an unusual case of immature ovarian teratoma with onset of mature glial cells implanted on the contralateral ovary, a challenge in the diagnosis of the second ovarian tumor. We report the case of a 31- yr-old woman, who developed at the age of 16 an immature teratoma in the right ovary that was surgically removed. Six years later mature glial implants were present on the left ovary and six months later at the level of peritoneum that relapsed after other six months. The patient suffered three surgical resections after the initial one. Paraffin sections and immunohistochemical examinations using antibodies against glial and neuronal antigens were performed. In the teratoma, the neuroectodermal tissue expressed Glial fibrillary acidic protein (GFAP), S100 protein, Epithelial membrane antigen (EMA) and Cytokeratin 34 beta E12 (Ck34beta E12), wheares the implants expressed only GFAP and S100 protein. The immature teratoma is the rarest type of ovarian teratomas. Gliomatosis peritonei is an exceptional finding, expecially with onset on the contralaterally ovary. The implant of the mature glial cells has a high risk of relapse, as seen in our case, thus close follow-up of the patient is necessary.
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Harper J, Stewart AJ, Kuhnt L, Waguespack RW, Holland M, Downs C. Ultrasonographic appearance and abdominal haemorrhage associated with a juvenile granulosa cell tumour in a foal. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2009.00020.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Virant-Klun I, Rožman P, Cvjeticanin B, Vrtacnik-Bokal E, Novakovic S, Rülicke T, Dovc P, Meden-Vrtovec H. Parthenogenetic Embryo-Like Structures in the Human Ovarian Surface Epithelium Cell Culture in Postmenopausal Women with No Naturally Present Follicles and Oocytes. Stem Cells Dev 2009; 18:137-49. [DOI: 10.1089/scd.2007.0238] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Irma Virant-Klun
- Department of Obstetrics and Gynecology, University Medical Centre, Ljubljana, Slovenia
| | - Primož Rožman
- Blood Transfusion Centre of Slovenia, Immunohaematology, Ljubljana, Slovenia
| | - Branko Cvjeticanin
- Department of Obstetrics and Gynecology, University Medical Centre, Ljubljana, Slovenia
| | - Eda Vrtacnik-Bokal
- Department of Obstetrics and Gynecology, University Medical Centre, Ljubljana, Slovenia
| | | | | | - Peter Dovc
- Biotechnical Faculty Ljubljana, Animal Genetics and Biotechnology, Ljubljana, Slovenia
| | - Helena Meden-Vrtovec
- Department of Obstetrics and Gynecology, University Medical Centre, Ljubljana, Slovenia
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