1
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Vo J, Hayler R, Tyler A, Verschuer K. Chronic constipation and abdominal distension in a patient with adult Hirschprung's disease and bilateral ovarian teratomas. J Surg Case Rep 2024; 2024:rjae227. [PMID: 38638925 PMCID: PMC11026061 DOI: 10.1093/jscr/rjae227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Hirschprung's disease is a congenital disorder characterized by aganglionic bowel, usually diagnosed in infancy. Here, we present a unique case of Hirschprung's disease diagnosed in a 29-year-old female with acute on chronic constipation. As part of her work up, a computerized tomography of her abdomen and pelvis revealed large, bilateral dermoid cysts. A diagnostic and therapeutic colonoscopy allowed manual disimpaction and decompression of her bowel, as well as biopsy attainment. Histopathology revealed absence of ganglionic cells on haematoxylin and eosin stain and calretinin immunostaining. This case underscores the diagnostic challenges of Adult Hirschprung's disease and how this impacts patient quality of life, as well as the work up and management of concurrent causes abdominopelvic conditions.
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Affiliation(s)
- Jessica Vo
- Department of Obstetrics and Gynaecology, St George Hospital, Gray St George Hospital, Kogarah, Sydney, NSW, Australia
- Faculty of Women’s Health, St George and Sutherland Clinical School (University of New South Wales), St George Hospital, Gray St, Kogarah, Sydney, NSW, Australia
| | - Raymond Hayler
- Department of Surgery, St George Hospital, Gray St, Kogarah, Sydney, NSW, Australia
- Faculty of Medicine & Health, St George and Sutherland Clinical School (University of New South Wales), St George Hospital, Gray St, Kogarah, Sydney, NSW, Australia
- Faculty of Medicine and Health, Macquarie University, Technology Pl, Macquarie Park, Sydney, NSW, Australia
| | - Alex Tyler
- Department of Surgery, Shoalhaven District Memorial Hospital, Scenic Dr, Nowra, NSW, Australia
| | - Kurt Verschuer
- Department of Surgery, Shoalhaven District Memorial Hospital, Scenic Dr, Nowra, NSW, Australia
- Department of Surgery, Goulburn Base Hospital, 130 Goldsmith St, Goulburn, NSW, Australia
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2
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Li M, Zheng W. Mature solid teratoma of the uterine cervix: A rare case report and review of the literature. Medicine (Baltimore) 2024; 103:e37451. [PMID: 38552061 PMCID: PMC10977552 DOI: 10.1097/md.0000000000037451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/09/2024] [Indexed: 04/02/2024] Open
Abstract
RATIONALE Most of the mature teratomas are found in the ovaries. Extragonadal teratomas are extremely rare. To date, there are only a handful of reports of uterine cervical teratomas documented in the English literature. PATIENT CONCERNS Herein we describe a rare case of a 40-year-old patient who was presented to our hospital for a cervical polypoid mass, which was finally confirmed to be mature solid teratoma in uterine cervix. DIAGNOSES Histological examination of the polypoid mass was found to consist of ciliated pseudostratified columnar respiratory epithelium, intestinal epithelium and smooth muscle tissue, adipose tissue and mature glial component, epidermis, and skin adnexa. Meanwhile, no history of abortion, dilatation, and curettage was present in this patient, so implantation of fetal tissue was excluded. Therefore, we make a diagnosis of uterine cervical mature teratoma. INTERVENTIONS Tumorectomy was performed after discovering the cervical polypoid mass. OUTCOMES The patient had been followed-up for next 3 months after surgery and no recurrence was documented until now. LESSONS Though teratomas of the uterine cervix are extremely rare, more attention should be paid on this rare but possible tumor for appropriate treatment in these patients.
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Affiliation(s)
- Minhua Li
- Department of Pathology, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
| | - Weiping Zheng
- Department of Gynecology, Shaoxing People’s Hospital, Shaoxing, Zhejiang, China
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3
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Naito M, Terasaki M, Ouchi N, Toyoshima M. Uterine carcinosarcoma showing immature teratoid-like differentiation. BMJ Case Rep 2023; 16:e257228. [PMID: 38154864 PMCID: PMC10759010 DOI: 10.1136/bcr-2023-257228] [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] [Indexed: 12/30/2023] Open
Abstract
A carcinosarcoma is a rare form of cancer characterised by the presence of both carcinomatous and sarcomatous components. Here, we present our experience with an extremely rare case of an uterine carcinosarcoma with immature teratoid-like differentiation. The patient was a woman in her 60s. She was referred for the evaluation of a uterine tumour. She underwent total abdominal hysterectomy with bilateral adnexectomy and received postoperative treatment with paclitaxel and carboplatin. On microscopic examination, the tumour had a heterogeneous appearance with a combination of carcinomatous and sarcomatous elements, and teratoid features. The tumour included immature squamous epithelial cells and immature epithelial glands, and focal atypical fused glands, which are consistent with endometrioid carcinoma, were identified in the endometrium. Pathological differentiation from extrarenal Wilms' tumour and teratocarcinosarcoma was challenging. The final pathological diagnosis was uterine carcinosarcoma with immature teratoid-like differentiation. At 14 months after the surgery, the patient has not experienced recurrence.
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Affiliation(s)
- Mio Naito
- Obstetrics and Gynecology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Mika Terasaki
- Analytic Human Pathology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Nozomi Ouchi
- Obstetrics and Gynecology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Masafumi Toyoshima
- Obstetrics and Gynecology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
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Moraru L, Mitranovici MI, Chiorean DM, Coroș M, Moraru R, Oală IE, Turdean SG. Immature Teratoma: Diagnosis and Management-A Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13091516. [PMID: 37174909 PMCID: PMC10177811 DOI: 10.3390/diagnostics13091516] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/05/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
An immature teratoma is a germinal malignant tumor composed of three germ cell layers, occurring more frequently in young women. It is the second most frequent among the malignant germinal tumors after dysgerminoma, and it is the only neoplasm with germ cells that are histologically graded. Even if we do not have a consensus regarding its therapeutical management, it has a good prognosis, with an excellent overall survival rate and good fertility preservation. More studies are needed regarding the necessity of adjuvant chemotherapy in pediatric oncology, and because of chemotherapy's long-term adverse effects, surveillance or a targeted treatment is preferred, but the main therapy is fertility-sparing surgery. Special attention should be given to the genetic mapping of the histological pieces for patient risk stratification due to its value in prognosis and future treatment.
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Affiliation(s)
- Liviu Moraru
- Department of Anatomy, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
| | | | - Diana Maria Chiorean
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania
| | - Marius Coroș
- Department of Surgery, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
| | - Raluca Moraru
- Faculty of Medicine, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
| | - Ioan Emilian Oală
- Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 331057 Hunedoara, Romania
| | - Sabin Gligore Turdean
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania
- Department of Pathology, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
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5
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Paredes de la Fuente R, Anderson ME, Peters MLB. Primary Undifferentiated Neoplasm of the Left Arm with Characteristics of Extragonadal Germ Cell Tumor and High-Grade Sarcoma. CLINICAL ONCOLOGY, CASE REPORTS 2023; 6:276. [PMID: 38239822 PMCID: PMC10795492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
A previously healthy man in his late 20s was diagnosed with a primary undifferentiated non- metastatic tumor of the left arm. After a biopsy, a clear pathological diagnosis could not be established. The tumor had positive immunohistological markers for both an extragonadal germ cell tumor and a high-grade sarcoma. Given the presumed germ cell etiology, he was started on empiric chemotherapy with etoposide and cisplatin. After a few cycles, the tumor showed dramatic response. However, due to poor patient follow- up, it progressed to massive size with severe compromise of the joint and critical neurovascular structures, which led to the decision for limb amputation. Post-surgical checkups showed no recurrence of the primary tumor or metastasis. This is the first report in the literature showing a tumor with these histological characteristics that responded to platinum-based therapy. It provides evidence for the need of more specific markers for the pathological evaluation of undifferentiated neoplasms.
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Affiliation(s)
| | - Megan E Anderson
- Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston MA 02215, United States
| | - Mary Linton B Peters
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States
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Buhas CL, Pascalau A, Judea-Pusta CT, Pop OL, Judea AS, Negrutiu BM, Marcut L, Buhas BA, Gheorghita D, Bodog AD. Epidermoid Cyst of the Uterine Cervix, an Unusual Location: Literature Review and Case Report. Healthcare (Basel) 2023; 11:healthcare11020257. [PMID: 36673625 PMCID: PMC9858676 DOI: 10.3390/healthcare11020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
Epidermoid cysts are most often benign cystic lesions, with uterine cervical localisation being very unusual. We present the case of a 52-year-old female patient diagnosed with an epidermoid cyst at the level of the uterine cervix. A bioptic and haemostatic uterine curettage was performed, followed by total hysterectomy with bilateral adnexectomy. The histopathologic analysis and immunohistochemical essay of the resection specimens confirmed the cervical epidermoid cyst. The presence of high-risk HPV (human papillomavirus) was only seen in the cervical mucosa. The exact etiopathogenesis is unknown, but postpartum cell implantation of reminiscent embryonic tissue can be involved in the development of these lesions.
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Affiliation(s)
- Camelia Liana Buhas
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Andrei Pascalau
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Claudia Teodora Judea-Pusta
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
- Correspondence: (C.T.J.-P.); (D.G.)
| | - Ovidiu Laurean Pop
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Adrian Sorin Judea
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Bianca-Maria Negrutiu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Lavinia Marcut
- Department of Surgical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | | | - Daniela Gheorghita
- Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 060042 Bucharest, Romania
- Correspondence: (C.T.J.-P.); (D.G.)
| | - Alin Danut Bodog
- Department of Surgical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Felicelli C, Gulliver J, Gray C, Khramtsov A, Blanco LZ, Wadhwani NR. Neuroblastoma Arising in an Immature Teratoma of the Ovary in a 13-Year-Old. Pediatr Dev Pathol 2023; 26:72-76. [PMID: 36448449 DOI: 10.1177/10935266221129087] [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] [Indexed: 12/02/2022]
Abstract
Somatic malignancies arising in mature teratomas are exceedingly rare entities and even more so are those arising in immature teratomas. Here, we present a unique case of a 13-year-old who initially underwent ovarian sparing cystectomy for a 7.7 cm left ovarian mass with a pre-operative diagnosis of mature cystic teratoma. Histologically, all 3 germ cell layers were present and immature neuroepithelial tubules were also identified. Subsequent sections revealed a nodular lesion composed of neuropil, neuroblasts with a spectrum of maturation, and Schwannian-type stroma. The neuroblasts were diffusely positive for PHOX2B. Neuroblastoma arising in an immature teratoma has only been described in the literature once previously in an adult patient.
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Affiliation(s)
- Christopher Felicelli
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jessica Gulliver
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Corey Gray
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL, USA
| | - Andrey Khramtsov
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Luis Z Blanco
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Nitin R Wadhwani
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
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8
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Xiu W, Pang J, Hu Y, Shi H. Immune-related mechanisms and immunotherapy in extragonadal germ cell tumors. Front Immunol 2023; 14:1145788. [PMID: 37138865 PMCID: PMC10149945 DOI: 10.3389/fimmu.2023.1145788] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
Purpose of review Extragonadal germ cell tumors (EGCTs) are relatively rare tumors, accounting for 1%-5% of all GCTs. In this review, we summarize the current research progress regarding the pathogenesis, diagnosis, and treatment of EGCTs from an immunology perspective. Recent findings The histological origin of EGCTs is related to a gonadal origin, but they are located outside the gonad. They show great variation in morphology and can occur in the cranium, mediastinum, sacrococcygeal bone, and other areas. The pathogenesis of EGCTs is poorly understood, and their differential diagnosis is extensive and challenging. EGCT behavior varies greatly according to patient age, histological subtype, and clinical stage. Summary This review provides ideas for the future application of immunology in the fight against such diseases, which is a hot topic currently.
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Affiliation(s)
- Weigang Xiu
- 1Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiyun Pang
- 1Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yang Hu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Yang Hu, ; Huashan Shi,
| | - Huashan Shi
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Yang Hu, ; Huashan Shi,
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9
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Mitranovici MI, Chiorean DM, Mureșan MC, Buicu CF, Moraru R, Moraru L, Cotoi TC, Cotoi OS, Toru HS, Apostol A, Turdean SG, Mărginean C, Petre I, Oală IE, Simon-Szabo Z, Ivan V, Pușcașiu L. Diagnosis and Management of Dysgerminomas with a Brief Summary of Primitive Germ Cell Tumors. Diagnostics (Basel) 2022; 12:diagnostics12123105. [PMID: 36553112 PMCID: PMC9776801 DOI: 10.3390/diagnostics12123105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Dysgerminoma represents a rare malignant tumor composed of germ cells, originally from the embryonic gonads. Regarding its incidence, we do not have precise data due to its rarity. Dysgerminoma occurs at a fertile age. The preferred treatment is the surgical removal of the tumor succeeded by the preservation of fertility. Even if a multidisciplinary team, founded in 2009 by a gynecologist, an oncologist, a pediatric oncologist and a pediatric surgeon, under the guidance of the Malignant Germ Cell International Consortium (MaGIC), studies this type of tumor, issues still remain related to the lack of a randomized study and to both the management and understanding of the concept of OMGCTs (ovarian malignant germ cell tumors). The aim of this review is to present from the literature the various approaches for this type of tumor, and, regarding innovative therapies or possible prevention, which can be applied in clinical practice. Multidisciplinarity and treatment in reference centers have proven their usefulness as well.
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Affiliation(s)
- Melinda-Ildiko Mitranovici
- Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania
- Correspondence: (M.-I.M.); (D.M.C.)
| | - Diana Maria Chiorean
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania
- Correspondence: (M.-I.M.); (D.M.C.)
| | - Maria Cezara Mureșan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Corneliu-Florin Buicu
- Public Health and Management Department, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - Raluca Moraru
- Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
| | - Liviu Moraru
- Department of Anatomy, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
| | - Titiana Cornelia Cotoi
- Department of Pharmaceutical Technology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
- Close Circuit Pharmacy of County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania
| | - Ovidiu Simion Cotoi
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania
- Department of Pathophysiology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania
| | - Havva Serap Toru
- Department of Pathology, Akdeniz University School of Medicine, Antalya Pınarbaşı, Konyaaltı, 07070 Antalya, Turkey
| | - Adrian Apostol
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Sabin Gligore Turdean
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania
| | - Claudiu Mărginean
- Department of Obstetrics and Gynecology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
| | - Ion Petre
- Department of Medical Informatics and Biostatistics, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Ioan Emilian Oală
- Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania
| | - Zsuzsanna Simon-Szabo
- Department of Pathophysiology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania
| | - Viviana Ivan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Lucian Pușcașiu
- Department of Obstetrics and Gynecology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania
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10
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Fadare O. Mucinous Proliferations of the Uterine Corpus: Comprehensive Appraisal of an Evolving Spectrum of Neoplasms. Adv Anat Pathol 2022; 29:275-296. [PMID: 35499137 DOI: 10.1097/pap.0000000000000348] [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: 11/26/2022]
Abstract
A variety of endometrial lesions may contain mucinous cells. Herein, the author reviews the literature on the classification and clinicopathologic significance of uterine corpus proliferations with a significant mucinous component, assesses the 2020 World Health Organization classification of such lesions, and presents a diagnostic framework. The key epithelial mucinous lesions include mucinous metaplasia, atypical mucinous glandular proliferation and mucinous carcinoma. Each of these categories are classifiable into "usual" and gastrointestinal subtypes, the latter being indicative of intestinal (presence of goblet cells) and/or gastric-type (abundant, pale eosinophilic or clear cytoplasm and well-defined cell borders) morphology. It has been proposed that at least focal expression of gastrointestinal immunohistochemical markers be required for all gastrointestinal type lesions, and for gastrointestinal type atypical mucinous glandular proliferation and carcinoma, minimality or absence of estrogen receptor expression, and the absence of an endometrioid component. Mucinous carcinomas of the usual type, in which >50% of the tumor is comprised of a mucinous component, are the most common. Morphologic subtypes include mucinous carcinoma with microglandular features and mucinous carcinoma with signet rings (signet ring carcinoma). Endometrioid carcinomas with a less than a 50% mucinous component are classified as endometrioid carcinoma with mucinous differentiation. Several studies have directly compared endometrioid and mucinous carcinomas, the latter presumably of the usual type, with respect to patient outcomes after treatment. All have found no difference in overall and disease free survival between these groups. However, three major studies have found mucinous carcinomas to be associated with a higher risk of lymph node metastases. Nineteen cases of mucinous carcinoma of the gastrointestinal type have been reported, and the limited data on their follow-up after primary treatment suggests that this subtype is more clinically aggressive and should accordingly be classified separately from mucinous carcinomas of the usual type. The morphologic spectrum of mucinous carcinoma of the gastrointestinal type is unclear and continues to evolve. Mucinous change, which may sometimes be extensive, may also be associated with papillary proliferation of the endometrium, adenomyoma of the endocervical type, atypical, and typical adenomyomas. In a curettage or biopsy, intestinal type mucinous epithelium may be indicative of any of the gastrointestinal lesions mentioned above, but may also represent samplings of uterine teratomas, yolk sac tumors, genital and extragenital adenocarcinomas with intestinal differentiation, or low-grade appendiceal mucinous neoplasms that secondarily involve the endometrium.
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Affiliation(s)
- Oluwole Fadare
- Department of Pathology, University of California San Diego, San Diego, CA
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Xie S, Jia X, Li T, Xu Y, Wu W, Qiu Y, Yuan S, Peng X, Wang H. Pelvic masses after surgery for immature ovarian teratoma: A 10-year experience of Western China. Medicine (Baltimore) 2022; 101:e29727. [PMID: 35945757 PMCID: PMC9351857 DOI: 10.1097/md.0000000000029727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
There are debates on the management of immature ovarian teratoma and its recurrence. This study aimed to report the incidence of pelvic masses after surgery for immature ovarian teratoma and to identify prognostic factors of disease-free survival after surgery, discussing aspects of primary treatment and postoperative management. Data on the diagnosis and treatment of patients with immature teratomas were collected. Follow-up data were acquired from clinic visits and telephone interviews. Disease-free survival was defined as the time interval between the initial surgery for immature ovarian teratoma and the diagnosis of a new pelvic mass. Survival curves were drawn using the Kaplan-Meire method, and multivariate analysis was performed using the Cox proportional hazard regression model using PASW statistics software. The estimated 5-year disease-free survival and overall survival were 74.3% (95%CI 63.9%-84.7%) and 96.5% (95%CI 91.6%-100.0%), respectively. The incidence of growing teratoma syndrome and immature teratoma relapse at a median follow-up of 46 months were 20.0% and 7.7%, respectively. Two patients died of repeated relapses or repeated growing teratoma syndrome. Rupture of initial lesions (RR 4.010, 95%CI 1.035-5.531), lymph node dissection (RR 0.212, 95%CI 0.051-0.887) and adjuvant chemotherapy (RR 0.143, 95%CI 0.024-0.845) were independent prognostic factors for disease-free survival. The development of growing teratoma syndrome is more prevalent than relapse after treatment of immature ovarian teratomas. Lymph node dissection and chemotherapy are recommended to reduce recurrence. Close surveillance and active surgical intervention are important for the diagnosis and appropriate management of new pelvic masses.
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Affiliation(s)
- Sixia Xie
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xibiao Jia
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
| | - Tingting Li
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yuanyuan Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Weiwei Wu
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yichao Qiu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Shuang Yuan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xue Peng
- Department of Obstetrics and Gynecology, People’s Hospital of Deyang City, Deyang, People’s Republic of China
| | - Hongjing Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People’s Republic of China
- *Correspondence: Hongjing Wang, West China Second University Hospital, No. 20, Section 3, South Renmin Road, Chengdu, Sichuan Province, People’s Republic of China (e-mail: )
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12
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Guido LP, Camacho F, Freire R, Pinto A. Unusual Variants of Teratoma Involving the Gynecologic Tract. Int J Gynecol Pathol 2022; 41:320-326. [PMID: 34320530 DOI: 10.1097/pgp.0000000000000813] [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: 11/26/2022]
Abstract
Teratomas are tumors of germ cell origin, and in the female genital tract are subclassified as immature or mature based on the presence or absence, respectively, of immature elements. Somatic tumors may also develop in association with teratomas, and most commonly include thyroid tumors, carcinoids and carcinomas. We report herein 2 rare forms of gynecologic teratomas: 1 case of immature teratoma of the uterus and 1 case of a benign follicular hamartoma arising in association with mature cystic teratoma of the ovary.
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Affiliation(s)
- Luiz P Guido
- Department of Pathology, University of Miami/Jackson Health System, Miami, Florida
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Sayyah-Melli M, Shokohi B, Yagoobi S, Adili A, Hosseini SS. Immature teratoma of the uterine cervix. J OBSTET GYNAECOL 2022; 42:1600-1601. [PMID: 35148248 DOI: 10.1080/01443615.2022.2026901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Manizheh Sayyah-Melli
- Department of Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrouz Shokohi
- Department of Pathology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shabnam Yagoobi
- Department of Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Adili
- Department of Radio-Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyyedeh Sanaz Hosseini
- Department of Obstetrics and Gynecology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Lin TC, Chen TH, Huang RH, Tsai HD, Chen M. Pre-operative diagnosis of a primary uterine mature teratoma. Taiwan J Obstet Gynecol 2021; 59:586-589. [PMID: 32653134 DOI: 10.1016/j.tjog.2020.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Mature cystic teratoma is a common benign ovarian tumor. But extragonadal teratomas are very rare. They mainly occur in the midline structure of the body. Uterine teratomas are extremely rare with only few reports. The diagnosis was mainly based on the operative findings. We report a case of uterine mature teratoma in a 37 year-old woman who was diagnosed before the operation. We also review the literature about this exceptional presentation. CASE REPORT We report a case of uterine teratoma that was initially diagnosed as a uterine tumor under ultrasound examination. But teratoma was highly suspected preoperatively by the abdominal CT scan. She underwent tumor excision via laparotomy. The operative finding and the histological examination confirms the diagnosis of primary uterine teratoma. CONCLUSION Preoperatively diagnosis of uterine teratoma was difficult. Although there are no gold standard to treat the uterine teratoma, the majority of the treatment choice is surgery. The prognosis of this unusual disease is relatively good in benign lesions.
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Affiliation(s)
- Tzu-Chi Lin
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Tze-Ho Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ren-Hong Huang
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
| | - Horng-Der Tsai
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming Chen
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, 50046, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, 50046, Taiwan; Department of Medical Research, Changhua Christian Hospital, Changhua, 50006, Taiwan; Department of Molecular Biotechnology, Da-Yeh University, Changhua, 51591, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 10041, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, 10041, Taiwan; Department of Life Science, Tunghai University, Taichung, 40704, Taiwan.
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Zhao Y, Xu T, Bu X, Yuan D, Wu Y, Qian H. Immature teratoma arising from uterine corpus in an 11-year-old girl: Case report and review of the literature. J Obstet Gynaecol Res 2020; 47:452-455. [PMID: 33197962 PMCID: PMC7839763 DOI: 10.1111/jog.14547] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 09/20/2020] [Accepted: 10/16/2020] [Indexed: 12/22/2022]
Abstract
Teratomas are one of the most common germ cell tumors, and they usually occur in ovaries. Extragonadal teratomas are rare, especially immature ones. Only several cases of primary teratomas of the uterus have been reported since 1929. Here, the case of an 11-year-old patient who had a 6-month history of sustained abnormal vaginal discharge is presented. Transabdominal ultrasonography revealed a solid mass in her uterus, resulting in the patient undergoing surgery. Examination of PET-CT scans revealed a mass in the right ovary of the patient 20 days after surgery. The patient underwent a second surgery followed by chemotherapy. This is the youngest case among reported patients of primary immature uterine teratoma, and this patient showed no evidence of recurrence during 2 years of follow-up.
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Affiliation(s)
- Yinling Zhao
- Department of Obstetrics and Gynaecology, Hospital Affiliated 5 to Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Tianhui Xu
- Department of Obstetrics and Gynaecology, Hospital Affiliated 5 to Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Xinhua Bu
- Department of Obstetrics and Gynaecology, Hospital Affiliated 5 to Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Donglan Yuan
- Department of Obstetrics and Gynaecology, Hospital Affiliated 5 to Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Yiqun Wu
- Department of Obstetrics and Gynaecology, Hospital Affiliated 5 to Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Hua Qian
- Department of Obstetrics and Gynaecology, Hospital Affiliated 5 to Nantong University (Taizhou People's Hospital), Taizhou, China
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Collision Glial Neoplasms Arising in an Ovarian Mature Cystic Teratoma: A Rare Event. Case Rep Pathol 2020; 2020:7568671. [PMID: 32082676 PMCID: PMC7021464 DOI: 10.1155/2020/7568671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/27/2020] [Indexed: 12/29/2022] Open
Abstract
Germ cell neoplasms represent around 20% of all ovarian tumors. They most frequently affect children and young adults. Mature cystic teratoma is a common benign ovarian neoplasm comprising about 95% and is made up of all three germ cell embryonic layers. By definition, mature cystic teratoma may be derived from any of the three germ cell lines. On the other hand, immature teratomas contain primitive neuroepithelial elements. However, it is quite uncommon in the English literature to have a neuroepithelial glial neoplasm arising in a mature cystic teratoma of an adolescent. Interestingly enough, all published cases described a single type of glial neoplasm arising in mature ovarian teratoma. Herein, the authors discuss a unique case of concomitant occurrence of two different glial neoplasms, namely pilocytic astrocytoma and subependymoma arising in an ovarian mature cystic teratoma. To the best of our knowledge, this is the first reported case with such a distinctive histopathologic finding.
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Ronchi A, Cozzolino I, Montella M, Panarese I, Zito Marino F, Rossetti S, Chieffi P, Accardo M, Facchini G, Franco R. Extragonadal germ cell tumors: Not just a matter of location. A review about clinical, molecular and pathological features. Cancer Med 2019; 8:6832-6840. [PMID: 31568647 PMCID: PMC6853824 DOI: 10.1002/cam4.2195] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022] Open
Abstract
Extragonadal germ cell tumors (EGGCTs) are uncommon neoplasms, which arise in anatomical locations other than gonads. The pathogenesis of these neoplasms is still poorly understood and it is a matter of debate if they really represent extragondal primary neoplasms or rather extragondal metastasis from occult gonadal neoplasms. The actual observations suggest that EGGCTs represent a unique entity, so their biology and behavior are substantially different from gonadal counterparts. The diagnosis of EGGCTs is often challenging, and differential diagnosis is particularly wide. Nevertheless, a correct diagnosis is essential for the correct management of the patient. We summarize the state of art about EGGCTs, with particular emphasis on diagnosis and prognosis.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Iacopo Panarese
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Sabrina Rossetti
- Uro-Andrologic Oncology Unit, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Paolo Chieffi
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaetano Facchini
- Uro-Andrologic Oncology Unit, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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Central Nervous System-type Neuroepithelial Tumors and Tumor-like Proliferations Developing in the Gynecologic Tract and Pelvis. Am J Surg Pathol 2018; 42:1429-1444. [DOI: 10.1097/pas.0000000000001131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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