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Grisales-Gallo JE, Salinas-Castro KJ, Nasner D, Toro-Gutiérrez JS. Mature cystic teratoma overlapping with giant serous cystadenoma of the ovary: A case report. Radiol Case Rep 2024; 19:218-222. [PMID: 38028279 PMCID: PMC10651425 DOI: 10.1016/j.radcr.2023.10.030] [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: 07/13/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Ovarian lesions represent a diagnostic challenge for the radiologist and should be approached according to the patient's age, menstrual cycle, and imaging characteristics. These lesions can be cystic, mixed, or solid-predominant structures. Generally, the occurrence of benign lesions surpasses that of malignant ones at a ratio of 3:1. However, within infantile and juvenile age groups, this becomes an infrequent occurrence, making up only about 5% of ovarian tumor cases. This case report sheds light on a unique scenario involving a pediatric patient who harbored 2 benign tumors simultaneously: a mature cystic teratoma and a serous cystadenoma.
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Affiliation(s)
| | | | - Daniela Nasner
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
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Pio L, Abu-Zaid A, Zaghloul T, Halepota HF, Davidoff AM, Losty PD, Abdelhafeez HH. Ovarian-sparing surgery for ovarian tumors in children: A systematic review and meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106923. [PMID: 37211469 DOI: 10.1016/j.ejso.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION An increased number of children and adolescents with ovarian tumors have been managed with ovarian-sparing surgery in the last few years. However, comprehensive data on fertility outcomes and local relapse are scarce. In this study, we systematically describe the contemporary outcomes of ovarian-sparing surgery, as reported in the literature. MATERIALS AND METHODS Using PRISMA guidelines, we analyzed studies reporting ovarian-sparing techniques for ovarian tumors in children and adolescents. from 1980 to 2022. Reports with fewer than three patients, narrative reviews, and opinion articles were excluded. Statistical analysis was performed for dichotomous and continuous variables. RESULTS Of 283 articles screened, 16 papers (3057 patients) met inclusion criteria (15 retrospective/1 prospective) and were analyzed. The vast majority of studies had no long-term fertility follow-up data and direct comparison between ovarian-sparing surgery vs oophorectomy was reported in only a few studies. Ovarian sparing surgery was not associated with worse oncologic outcomes in terms of (i) tumour spillage or (ii) recurrence rates, and of key importance allowed a higher ovarian reserve at long term follow-up. CONCLUSIONS Ovarian-sparing surgery is a safe and feasible technique for benign tumors. Long-term outcome studies are needed to show efficacy and fertility preservation.
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Affiliation(s)
- Luca Pio
- Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
| | - Ahmed Abu-Zaid
- Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Tarek Zaghloul
- Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA; Department of Surgery, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Huma F Halepota
- Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Andrew M Davidoff
- Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA; Department of Surgery, University of Tennessee Health Science Center, 800 Madison Ave, Memphis, TN, 38163, USA
| | - Paul D Losty
- University of Liverpool, Institute of Life Course and Medical Sciences, Liverpool, L69 3BX, UK; Department of Paediatric Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Hafeez H Abdelhafeez
- Department of Surgery, MS 133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA; Department of Surgery, University of Tennessee Health Science Center, 800 Madison Ave, Memphis, TN, 38163, USA
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Cong L, Wang S, Yeung SY, Lee JHS, Chung JPW, Chan DYL. Mature Cystic Teratoma: An Integrated Review. Int J Mol Sci 2023; 24:ijms24076141. [PMID: 37047114 PMCID: PMC10093990 DOI: 10.3390/ijms24076141] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/19/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Ovarian dermoid cysts, also called mature cystic teratomas (MCTs), account for 69% of ovarian germ cell tumors in young women. The tumors are formed by tissues derived from three germ layers, and sebaceous materials are most commonly seen. The origin of MCTs is widely considered to be the germ cell origin, which completes meiosis I. The clinical symptoms vary widely, but 20% of tumors could be asymptomatic. The diagnosis of MCTs is usually made without difficulty by ultrasound and confirmed by histopathology post-operatively. The imaging findings have a high diagnostic value. The typical characteristics present in the sonographic images, including a dermoid plug or Rokitansky nodule, are considered strong evidence for a teratoma. Although the malignant transformation of MCTs is rare, it can occur in some cases, especially in women of advanced age. The treatment of MCTs depends on the risk of malignancy, the age of the patient, and the patient's fertility reserve requirement. In this article, we review the epidemiology, clinical symptoms, diagnosis criteria, cellular origin, and treatment of mature cystic teratomas.
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Affiliation(s)
- Luping Cong
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR 999077, China
| | - Sijia Wang
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR 999077, China
| | - Suet Ying Yeung
- Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR 999077, China
| | - Jacqueline Ho Sze Lee
- Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR 999077, China
| | - Jacqueline Pui Wah Chung
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR 999077, China
| | - David Yiu Leung Chan
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR 999077, China
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Gkrozou F, Tsonis O, Vatopoulou A, Galaziou G, Paschopoulos M. Ovarian Teratomas in Children and Adolescents: Our Own Experience and Review of Literature. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101571. [PMID: 36291507 PMCID: PMC9599961 DOI: 10.3390/children9101571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/17/2022]
Abstract
Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours and the indications for operating on them, and to put subjective criteria for the management in elective or emergency presentations. Methods: Medical records of patients between the age of 12 and 20 years old that underwent surgery for ovarian teratomas at the Department of Obstetrics and Gynaecology in University Hospital of Ioannina, between January 2000 and August 2022, were reviewed. A medical database was searched between January 2000 and August 2022 with the following keywords: ovarian teratoma, paediatrics and adolescents. Results: We present the results of forty patients, with a mean age of 11.8 years of age. All patients had surgery, where three out of four underwent oophorectomy and only one out of four underwent ovary-sparing operation; similar results were found in the literature. Conclusion: Ovary-sparing treatment is more common recently compared with the past, such as MIS compared with laparotomy. Better-organised and -planned prospective multi-centre studies are necessary to gain a deeper knowledge of the physiology and prognostic factors of teratomas in children.
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Affiliation(s)
- Fani Gkrozou
- Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Orestis Tsonis
- Assisted Conception Unit, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Anastasia Vatopoulou
- Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Georgia Galaziou
- Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Minas Paschopoulos
- Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, 45500 Ioannina, Greece
- Correspondence: ; Tel.: +30-6985726869
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Delehaye F, Sarnacki S, Orbach D, Cheikhelard A, Rouger J, Parienti JJ, Faure-Conter C, Hameury F, Dijoud F, Aubry E, Wacrenier A, Habonimana E, Duchesne C, Joseph S, Alliot H, Scalabre A, Chaussy Y, Podevin G, Croue A, Haraux E, Guibal MP, Pommepuy I, Ballouhey Q, Lavrand F, Peycelon M, Irtan S, Guerin F, Dariel A, Borionne C, Galmiche L, Rod J. Lessons from a large nationwide cohort of 350 children with ovarian mature teratoma: A study in favor of ovarian-sparing surgery. Pediatr Blood Cancer 2022; 69:e29421. [PMID: 34842332 DOI: 10.1002/pbc.29421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ovarian mature teratoma (OMT) is a common ovarian tumor found in the pediatric population. In 10%-20% of cases, OMT occurs as multiple synchronous or metachronous lesions on ipsi- or contralateral ovaries. Ovarian-sparing surgery (OSS) is recommended to preserve fertility, but total oophorectomy (TO) is still performed. DESIGN This study reviews the clinical data of patients with OMT, and analyzes risk factors for second events. A national retrospective review of girls under 18 years of age with OMTs was performed. Data on clinical features, imaging, laboratory studies, surgical reports, second events and their management were retrieved. RESULTS Overall, 350 children were included. Eighteen patients (5%) presented with a synchronous bilateral form at diagnosis. Surgery was performed by laparotomy (85%) and laparoscopy (15%). OSS and TO were performed in 59% and 41% of cases, respectively. Perioperative tumor rupture occurred in 23 cases, independently of the surgical approach. Twenty-nine second events occurred (8.3%) in a median time of 30.5 months from diagnosis (ipsilateral: eight cases including one malignant tumor; contralateral: 18 cases; both ovaries: three cases). A large palpable mass, bilateral forms, at diagnosis and perioperative rupture had a statistical impact on the risk of second event, whereas the type of surgery or approach did not. CONCLUSION This study is a plea in favor of OSS as the first-choice treatment of OMT when possible. Close follow-up during the first 5 years is mandatory considering the risk of 8.3% of second events, especially in cases with risk factors.
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Affiliation(s)
- Fanny Delehaye
- Department of Pediatric Haematology and Oncology, University Hospital of Caen, 14000, Caen, France
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Université de Paris, Hôpital Necker Enfants-Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Alaa Cheikhelard
- Department of Pediatric Surgery, Université de Paris, Hôpital Necker Enfants-Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.,National Reference Centre for Rare Gynecological Diseases (PGR), Paris, France
| | - Jérémie Rouger
- Department of Pediatric Haematology and Oncology, University Hospital of Caen, 14000, Caen, France
| | - Jean-Jacques Parienti
- Department of Biostatistics and Clinical Research, University Hospital of Caen Normandy, Caen, France
| | - Cécile Faure-Conter
- Centre Leon Bernard, Pediatric Hemato-Oncology Institute (IHOPe), Lyon, France
| | - Frédéric Hameury
- Pediatric Surgery Department, Femme-Mère-Enfant University Hospital, 59, boulevard Pinel, 69677, Bron, France
| | - Frédérique Dijoud
- Anatomy-Cytology-Pathology Department, Women-Mother and Child Hospital, Hospices Civils de Lyon, Lyon, France
| | - Estelle Aubry
- CHU Lille, Centre de Référence du Développement Génital DEV GEN, Service de Chirurgie Pédiatrique, Hôpital Jeanne de Flandres, 59000, Lille, France
| | - Agnès Wacrenier
- Anatomy-Cytology-Pathology Department, CHU Lille, Lille, France
| | - Edouard Habonimana
- Department of Pediatric Surgery, Rennes University Hospital, Rennes, France
| | - Camille Duchesne
- Department of Pediatric Surgery, Rennes University Hospital, Rennes, France
| | - Solène Joseph
- Department of Pediatric Surgery, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44000, Nantes, France
| | - Hortense Alliot
- Department of Pediatric Surgery, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44000, Nantes, France
| | - Aurélien Scalabre
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint-Etienne Cedex 2, France
| | - Yann Chaussy
- Paediatric Surgery Department, University Hospital of Besancon, Besancon, France
| | - Guillaume Podevin
- Paediatric Surgery Department, Angers University Hospital, Angers, France
| | - Anne Croue
- Anatomy-Cytology-Pathology Department, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Elodie Haraux
- Paediatric Surgery Department, Amiens University Hospital, Amiens, France
| | - Marie Pierre Guibal
- Department of Pediatric Surgery, University Hospital of Montpellier, Montpellier, France
| | - Isabelle Pommepuy
- Service d'anatomie Pathologique, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87042, Limoges Cedex, France
| | - Quentin Ballouhey
- Department of Pediatric Surgery, Hôpital des Enfants, 8 Avenue Dominique Larrey, 87042, Limoges Cedex, France
| | - Frédéric Lavrand
- Department of Pediatric Surgery, Groupe Hospitalier Pellegrin, Hôpital d'enfants, Bordeaux, France
| | - Matthieu Peycelon
- AP-HP, Hôpital Universitaire Robert-Debré, Pediatric Urology Department, Reference Center for Rare Diseases (CRMR), Malformations Rares des Voies Urinaires (MARVU), Université de Paris, Paris, France
| | - Sabine Irtan
- Paediatric Surgery Department, Trousseau Hospital - Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Florent Guerin
- Paediatric Surgery Department, Groupement Hospitalier Paris Sud (GHUPS), Hôpital Bicêtre, Le Kremlin-Bicetre, France
| | - Anne Dariel
- Pediatric Surgery Department, Hôpital d'enfants de la Timone, Marseille, France
| | - Claude Borionne
- Pediatric Surgery Department, Hôpital d'enfants de la Timone, Marseille, France
| | - Louise Galmiche
- Pathology Department, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44000, Nantes, France
| | - Julien Rod
- Department of Pediatric Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14000, Caen, France.,Laboratory INSERM U1086, ANTICIPE, Centre François Baclesse, Caen, France
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