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Gagnon MH, Derenoncourt PR, Rayamahi S, Taylor S, Parikh AK, Ponisio MR, Khanna G. Unusual imaging findings associated with abdominal pediatric germ cell tumors. Pediatr Radiol 2024; 54:1093-1104. [PMID: 38462578 DOI: 10.1007/s00247-024-05894-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
Germ cell tumors of childhood are tumors arising from germline cells in gonadal or extragonadal locations. Extragonadal germ cell tumors are characteristically located in the midline, arising intracranially or in the mediastinum, retroperitoneum, or pelvis. These tumors are generally easily diagnosed due to typical sites of origin, characteristic imaging findings, and laboratory markers. However, germ cell tumors can be associated with unusual clinical syndromes or imaging features that can perplex the radiologist. This review will illustrate atypical imaging/clinical manifestations and complications of abdominal germ cell tumors in childhood. These features include unusual primary tumors such as multifocal primaries; local complications such as ovarian torsion or ruptured dermoid; atypical presentations of metastatic disease associated with burned-out primary tumor, growing teratoma syndrome, and gliomatosis peritonei; endocrine manifestations such as precocious puberty and hyperthyroidism; and antibody mediated paraneoplastic syndrome such as anti-N-methyl-D-aspartate-receptor antibody-mediated encephalitis. This review aims to illustrate unusual imaging features associated with the primary tumor, metastatic disease, or distant complications of abdominal germ cell tumors of childhood.
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Affiliation(s)
- Marie-Helene Gagnon
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Paul-Robert Derenoncourt
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Sampanna Rayamahi
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Susan Taylor
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Ashishkumar K Parikh
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Maria R Ponisio
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Geetika Khanna
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA
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2
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Ahmad Nasfy SN, Abdul Hamid H, Md Khairuddin A, Mohamad Fauzi MK. Fertility-sparing approach in concurrent gliomatosis peritonei and growing teratoma syndrome in a young woman. BMJ Case Rep 2024; 17:e257326. [PMID: 38627058 PMCID: PMC11029277 DOI: 10.1136/bcr-2023-257326] [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: 04/19/2024] Open
Abstract
Gliomatosis peritonei (GP) and Growing Teratoma Syndrome (GTS) are rare and clinically significant conditions often associated with ovarian teratomas. GP involves the development of benign glial implants on the peritoneal surface, while GTS is characterised by the growth of benign, yet enlarging peritoneal implants following chemotherapy for malignant germ cell tumours. These implants are typically histologically mature teratomas devoid of malignancy. Our report documents a unique case where both GP and GTS manifested in a patient undergoing treatment for an immature ovarian teratoma. This dual occurrence is scarcely reported in the existing literature. The patient, a nulliparous woman in her 20s, developed a tumour indicative of GTS immediately after completing three cycles of bleomycin, etoposide and cisplatin therapy. This chemotherapy regimen followed fertility-sparing surgery for a stage IIIb ovarian immature teratoma. Given that total tumour resection is pivotal in positively influencing the prognosis of GTS, early minimally invasive surgical intervention before significant tumour growth is essential. This approach is particularly crucial considering that ovarian germ cell tumours are commonly present in younger patients, necessitating a focus on fertility preservation in most cases.
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Affiliation(s)
| | - Habibah Abdul Hamid
- Obstetrics and Gynaecology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Azalea Md Khairuddin
- Hospital Sultan Abdul Aziz Shah Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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3
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Liu S, Gao Q, Hu Y. A unique case of gliomatosis peritonei after resection of a retroperitoneal immature teratoma in an infant. Quant Imaging Med Surg 2023; 13:8859-8863. [PMID: 38106278 PMCID: PMC10722056 DOI: 10.21037/qims-23-798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/11/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Shuyi Liu
- Department of Radiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Qiu Gao
- Department of Pathology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Yuelin Hu
- Department of Radiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
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4
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Alna'irat M, McCluggage WG, Al-Hussaini M. Ovarian Immature Teratoma With Nodal Gliomatosis: A Case Report and Literature Review. Int J Gynecol Pathol 2023; 42:627-631. [PMID: 36867505 DOI: 10.1097/pgp.0000000000000938] [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: 03/04/2023]
Abstract
Gliomatosis involving lymph nodes (nodal gliomatosis) is rarely encountered in association with an ovarian teratoma, with 12 cases previously reported. We report this rare occurrence in a 23-yr-old female with an ovarian immature teratoma. The ovary contained a grade 3 immature teratoma, with immature neuroepithelium. A subcapsular liver mass contained metastatic immature teratoma with neuroepithelium. The omentum and peritoneum contained mature glial tissue, consistent with gliomatosis peritonei with no evidence of immature elements. One pelvic lymph node contained multiple nodules of mature glial tissue, diffusely positive for glial fibrillary acidic protein, in keeping with nodal gliomatosis. In reporting this case, we review prior reports of nodal gliomatosis.
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Lee SM, Choi MC, Lee JW, Kim T, Jang SJ. Peritoneal and Nodal Gliomatosis Mimicking Metastasis on FDG PET/CT in a Patient With Ovarian Immature Teratoma. Clin Nucl Med 2023; Publish Ahead of Print:00003072-990000000-00567. [PMID: 37220221 DOI: 10.1097/rlu.0000000000004705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
ABSTRACT Peritoneal and nodal gliomatosis is a rare disease condition characterized by implants of mature glial tissue on the peritoneum and lymph nodes. It is typically associated with teratoma and has no adverse effect on prognosis. We present a case of 22-year-old woman who underwent FDG PET/CT for the staging of ovarian immature teratoma. PET/CT revealed mildly increased FDG uptake in the peritoneal cavity and increased FDG uptake in the internal mammary and cardiophrenic angle lymph nodes, which were histopathologically diagnosed as peritoneal and nodal gliomatosis. This case suggests that PET/CT findings of peritoneal and nodal gliomatosis could mimic metastasis.
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Affiliation(s)
- Sang Mi Lee
- From the Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan
| | - Min Chul Choi
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam
| | - Jeong Won Lee
- Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon
| | | | - Su Jin Jang
- Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
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Guo F, Liu Y, Lu J, Wu Z, Zhu X. Human chorionic gonadotropin elevation in gliomatosis peritonei complicated with immature teratoma: A case report and review of the literature. Medicine (Baltimore) 2022; 101:e31305. [PMID: 36316907 PMCID: PMC9622604 DOI: 10.1097/md.0000000000031305] [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] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Gliomatosis peritonei (GP) refers to the implantation of glial tissue on the visceral and parietal peritoneal surface, often associated with immature teratoma. It is a rare condition and the pathogenesis is not fully understood. In addition, the indistinguishable radiological appearance of immature and mature teratomas, and limited pathology samples make an accurate diagnosis difficult in most cases. More importantly, patients are also at risk of recurrence after surgery. This report aims to describe the process of diagnosis and treatment of GP with immature teratoma. PATIENT CONCERNS The patient, a 38-year-old woman presented with GP complicated with immature teratoma after laparoscopic ovarian cyst excision. DIAGNOSES On physical examination, a 15 cm-pelvic mass, with poor mobility, was palpated. And tumor marker demonstrated a moderate increase in α-fetoprotein and carbohydrate antigen 125. We suspected malignancy according to the comprehensive preoperative evaluation, the postoperative pathology revealed an immature teratoma of the left ovary and complicated with gliomatosis peritonei. Three months after the second surgery, possible recurrence of immature teratoma was considered and the patient underwent the third laparotomy. But the postoperative pathology indicated mature teratoma and mature glial components in the pelvic lesions. INTERVENTIONS AND OUTCOME The patient underwent 2 more surgical resections after the initial resection and 3 cycles of bleomycin, etoposide, and cisplatin regimen chemotherapy. She was regularly followed up in the outpatient after surgery, and no recurrence has been reported in the pelvic cavity till date. LESSON The case illuminated that the primary diagnosis of GP complicated with immature teratoma is critical but highly challenging for both gynecologists and pathologists and more attention should be paid to "GP complicated with immature cystic teratoma" patients to avoid inappropriate treatment.
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Affiliation(s)
- Fei Guo
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yukai Liu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jiaqi Lu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zhiyong Wu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaoyong Zhu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- * Correspondence: Xiaoyong Zhu, Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China (e-mail: )
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Liu C, Yan B, Wang Y, Di W, Lou W. Aggressive Gliomatosis Peritonei Arising from Ovarian Mature Teratoma with NF1 Mutation: A Case Report and Literature Review. Cancer Manag Res 2022; 14:2979-2986. [PMID: 36247331 PMCID: PMC9554576 DOI: 10.2147/cmar.s374987] [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: 05/31/2022] [Accepted: 09/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background GP arising from ovarian mature teratoma is a rare disease, and no confirmed pathogenesis signature genes are reported. The progress of GP is seen as relatively slow. Rare aggressive GP cases with poor prognosis were reported and no guidelines to follow for treatment. Case Presentation Herein, we report a 17-year-old girl with a 3-year-history of GP arising from ovarian mature teratoma. Surgeries and drug therapy were used to treat the aggressively growing tumour. Genetic profiling revealed the pathogenic mutation with potential therapeutic approaches. We firstly reported the NF1 mutations in GP secondary to teratomas and may cause bad prognosis. Conclusion GP arising from ovarian mature teratoma is rare; we found NF1 mutation could be the trigger of GP. The study may provide new insights into a better understanding of this rare disease.
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Affiliation(s)
- Chang Liu
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Bin Yan
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - You Wang
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wen Di
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Correspondence: Wen Di; Weihua Lou, Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai, 200127, People’s Republic of China, Email ;
| | - Weihua Lou
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review. Curr Oncol 2022; 29:6364-6372. [PMID: 36135070 PMCID: PMC9497723 DOI: 10.3390/curroncol29090501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Coexistent growing teratoma syndrome (GTS) and gliomatosis peritonei (GP) arising during chemotherapy of ovarian immature teratoma (IMT) is extremely rare and can be misdiagnosed as recurrent or progressive disease. We present a 33-year-old woman diagnosed with GTS with synchronous GP during chemotherapy of IMT. She underwent ovarian cystectomy due to ovarian immature teratoma and chemotherapy were administered. The α-fetoprotein (AFP) concentration decreased from 28.7 ng/mL to normal after the second cycle. Four days after the third cycle of chemotherapy, ultrasound and CT revealed an 8-cm mass with negative tumor markers in the pouch of Douglas. An exploratory laparotomy was conducted, and a smooth round cystic-solid 8-cm mass was noted in the pouch of Douglas. Extensive peritoneal seeding glial nodules were also observed on the surface of the uterus, peritoneum, and omentum. The patient underwent a partial omentectomy, intact resection of the tumor, and resection of most of the glial nodules. Postoperative pathology demonstrated a pure mature cystic teratoma component in the mass, as well as diffuse GP involving the uterine serosa, peritoneum, and omentum; this diagnosis of GTS with synchorous GP should be considered in IMT patients with mass newly identified during chemotherapy while tumor markers are normal after treatment.
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Gică N, Peltecu G, Chirculescu R, Gică C, Stoicea MC, Serbanica AN, Panaitescu AM. Ovarian Germ Cell Tumors: Pictorial Essay. Diagnostics (Basel) 2022; 12:diagnostics12092050. [PMID: 36140449 PMCID: PMC9498179 DOI: 10.3390/diagnostics12092050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Ovarian germ cell tumors of the ovary represent a histologically heterogenous group of tumors with a high incidence at reproductive age. Patients with this pathology are very often young women with amenorrhea. The aim of this article is to present a pictorial essay of this rare pathology and to promote a national tumor registry and protocol. The treatment is individualized according to age, and fertility-sparing surgery is the actual standard of surgical treatment for young patients in early stage of the disease.
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Affiliation(s)
- Nicolae Gică
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Gheorghe Peltecu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Filantropia Clinical Hospital, 011132 Bucharest, Romania
- Correspondence:
| | - Raluca Chirculescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Corina Gică
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | | | - Andreea Nicoleta Serbanica
- Department of Pediatrics, Fundeni Clinical Institute, Department of Pediatrics Hematology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Anca Maria Panaitescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Filantropia Clinical Hospital, 011132 Bucharest, Romania
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Abstract
Background Gliomatosis peritonei (GP) is characterized by widespread implants of mature glial tissue in the peritoneum. It is most often associated with immature or mature ovarian teratomas. Case Report: A 6-month old infant developed isolated gliomatosis involving the tunica vaginalis following excision of an immature sacrococcygeal teratoma in the neonatal period. Conclusion: Tunica vaginalis gliomatosis can occur in the setting of a retroperitoneal extragonadal congenital immature teratoma.
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Affiliation(s)
- Sabita Patra
- Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Subhankar Chakravorty
- Department of Pediatric Surgery, Nilratan Sircar Medical College and Hospital, Kolkata, India
| | - Uttara Chatterjee
- Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Koushik Saha
- Department of Pediatric Surgery, Nilratan Sircar Medical College and Hospital, Kolkata, India
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Małgorzata SŻ, Anna KG, Reszeć J, Krawczuk-Rybak M. Growing Teratoma Syndrome and Gliomatosis Peritonei in a 15-Year-Old Girl With Immature Ovarian Teratoma: Case Report and Review of the Literature. J Pediatr Adolesc Gynecol 2021; 34:885-889. [PMID: 34314853 DOI: 10.1016/j.jpag.2021.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/25/2021] [Accepted: 07/10/2021] [Indexed: 11/19/2022]
Abstract
Gliomatosis peritonei (GP) is a rare clinical condition characterized by presence of mature glial cells in the peritoneum. Growing teratoma syndrome (GTS) is described as an uncommon phenomenon that could be related to the incidence of non-seminomatous germ cell tumors. We report a case of a patient treated for immature ovarian teratoma, in whom both GP and GTS were observed, an association to date scarcely described in literature. A 15-year-old girl presented to the emergency department with severe pain in her lower abdomen and right lumbar region. Upon admission, concentration of α-fetoprotein (AFP) was 1500 ng/mL and β-human chorionic gonadotropin (β-hCG) less than 2 ng/mL. A computed tomography (CT) scan of the abdominal cavity and pelvis confirmed the presence of an anomalous mass in the abdominal cavity and pelvis. Initial surgery was performed. Histopathology revealed the presence of immature teratoma with epithelial elements. Normalization of AFP was achieved within 8 weeks. Five months after surgery, a progressive increase in AFP was noted. Magnetic resonance imaging (MRI) and CT scans of the pelvis minor showed local relapse. Evaluation of the remission after 2 blocks of preoperative chemotherapy revealed the presence of a large tumor mass in the pelvis minor, despite normalization of the AFP concentration. After opening the abdominal walls, numerous abnormal white nodules were observed in the peritoneum. Histopathology revealed the presence of mature glial tissue (gliomatosis peritonei). The remaining tumor mass was removed, and histopathology confirmed existence of mature teratoma (growing teratoma syndrome). Postoperative chemotherapy was continued. To date, the patient remains under clinical and laboratory remission. Concomitant incidence of GP and GTS, although rare, should always be taken into consideration in pediatric patients with diagnosis of either condition.
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Affiliation(s)
| | - Krętowska-Grunwald Anna
- Department of Pediatrics, Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland.
| | - Joanna Reszeć
- Department of Medical Pathomorphology, Medical University of Bialystok, Bialystok, Poland.
| | - Maryna Krawczuk-Rybak
- Department of Pediatrics, Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland.
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Li J, Li S, Xiao D, Song J, Mao J, Yin J. Extratesticular gliomatosis peritonei after mesenteric teratoma: a case report and literature review. J Int Med Res 2021; 49:3000605211047076. [PMID: 34586943 PMCID: PMC8485300 DOI: 10.1177/03000605211047076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Mesenteric teratoma is a rare extragonadal teratoma. Gliomatosis peritonei (GP) is mature glial tissue implanted into the peritoneum's surface and is mainly accompanied by ovarian teratoma. Only a few cases of gliomatosis have occurred in the extraperitoneum. We present a rare case of a 3-year-old boy who presented with extratesticular GP after excision of an immature mesenteric teratoma at 2 months old. After the extratesticular mass was excised, we found ductile tissue on the surface of the terminal spermatic cord and epididymis. Some ductile tissue of the epididymis was removed and sent to a laboratory for a pathological examination. The mass and the ductile tissue of the epididymis had a hard consistency. The pathological diagnosis was extratesticular gliomatosis. Complete surgical resection of the teratoma and GP is helpful for identifying the presence of malignant lesions and for preventing malignant transformation. However, characteristics of GP lesions are extensive and they are difficult to completely remove. Moreover, GP is usually benign. Therefore, the residual GP tissue was not completely removed in our case. The child is still in good health, but requires lifelong follow-up. In conclusion, we report our experience of a rare case of extraperitoneal GP from an extragonadal teratoma.
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Affiliation(s)
- Jiaqiang Li
- Department of Pediatric Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
| | - Shoulin Li
- Department of Pediatric Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
| | - Dong Xiao
- Department of Pediatric General Surgery, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
| | - Jiaming Song
- Department of Pathology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
| | - Jianxiong Mao
- Department of Pediatric General Surgery, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
| | - Jianchun Yin
- Department of Pediatric Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
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13
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Veena K, Jayasree M, Karthik B, Preethi N. Mature Teratoma with Gliomatosis Peritonei with Abdominal Tuberculosis: A Diagnostic Dilemma. J Gynecol Surg 2021. [DOI: 10.1089/gyn.2020.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K.S. Veena
- Department of Obstetrics and Gynecology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Manivasakan Jayasree
- Department of Obstetrics and Gynecology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Bhandary Karthik
- Department of Pediatric Surgery, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Natarajan Preethi
- Department of Obstetrics and Gynecology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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Łuczak J, Bagłaj M, Dryjański P. What recent primary studies tell us about ovarian teratomas in children: a scoping review. Cancer Metastasis Rev 2020; 39:321-329. [PMID: 32006216 PMCID: PMC7098956 DOI: 10.1007/s10555-020-09844-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our knowledge of ovarian teratomas in children is still far from complete, and much remains to be discovered. Here, we conduct a scoping review of the primary research related to ovarian teratomas in pediatric age. To our knowledge, there is no published synthesis of the literature surrounding ovarian teratomas in children using scoping review methodology. We identified 24 studies from 11 countries; 18 studies were retrospective, 3 were prospective, and 3 were experimental. There were 6 studies concerning mature teratomas, 5 concerning immature teratomas, and 13 that included both tumor types. Overall, 9 out of all the studies concerned more than 50 patients. We revealed 7 major branches of research within the topic of ovarian teratoma in pediatric population: recurrence rate/relapse and follow-up strategy, malignant potential, prognostic factors, use of sparing surgery, differences between the use of laparoscopy and laparotomy, use of chemotherapy, and additional examinations to test the character of the lesion (immature vs. mature). This scoping review has revealed a number of knowledge gaps in the evidence base for pediatric ovarian teratomas. Overall, this topic has not been extensively explored, and more research dedicated exclusively to this tumor and patient population is required.
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Affiliation(s)
- Justyna Łuczak
- Pediatric Surgery and Urology Department, Wroclaw Medical University, Wroclaw, Poland.
| | - Maciej Bagłaj
- Pediatric Surgery and Urology Department, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Dryjański
- Pediatric Surgery and Urology Department, Wroclaw Medical University, Wroclaw, Poland
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15
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Hanafy AK, Mujtaba B, Yedururi S, Jensen CT, Sanchez R, Austin MT, Morani AC. Imaging in pediatric ovarian tumors. Abdom Radiol (NY) 2020; 45:520-536. [PMID: 31745573 DOI: 10.1007/s00261-019-02316-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The spectrum of ovarian tumors in the pediatric population differs significantly from that in adults. Germ cell tumors are the predominant class of ovarian tumors in children, whereas epithelial tumors are the most common in adults. Ultrasonography is the modality of choice for the initial evaluation of pediatric ovarian tumors. Determining the diagnosis based on imaging may prove difficult, and combining the imaging findings with the clinical scenario is very helpful in reaching a differential diagnosis during clinical practice. We will discuss the spectrum of ovarian neoplasms in the pediatric population and describe their clinical, pathologic, and imaging characteristics. A few unique entities related to ovarian tumors, such as growing teratoma syndrome, anti-N-methyl-D-aspartate receptor encephalitis, and hereditary ovarian tumor syndromes, are also discussed. In addition, we will review several entities that may mimic ovarian neoplasms as well as their distinct imaging features.
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Affiliation(s)
- Abdelrahman K Hanafy
- Diagnostic Radiology, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, 78229, USA
| | - Bilal Mujtaba
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Sireesha Yedururi
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Corey T Jensen
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Ramon Sanchez
- Radiology, Children's National Health System, 111 Michigan Avenue NW, Washington, DC, 20010, USA
| | - Mary T Austin
- Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Ajaykumar C Morani
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA.
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16
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Berney DM, Stoneham S, Arora R, Shamash J, Lockley M. Ovarian germ cell tumour classification: views from the testis. Histopathology 2020; 76:25-36. [PMID: 31846529 DOI: 10.1111/his.14016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/06/2019] [Indexed: 12/14/2022]
Abstract
The classification of ovarian germ cell tumours has remained unchanged for many years, while there have been considerable changes in the testicular classification. In recent years there has been concern about the overtreatment of clinical stage 1 testicular germ cell tumours with increasing use of surveillance for low-risk disease. We outline here the current classification of germ cell tumours of the ovary with particular regard to treatment and outcome and highlight some areas which may cause confusion, particularly pertaining to immature teratomas and mixed germ cell tumours. We suggest that some minor changes to the classification, evidenced by a recent retrospective series by some of the authors, may lead to less adjuvant chemotherapy for immature teratomas and may obviate the need for the grading of immature teratomas, by aligning with testicular experience in pure post-pubertal teratomas. Adoption of this will require retrospective and prospective re-evaluation, but may avoid long-term patient morbidity.
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Affiliation(s)
- Daniel M Berney
- Centre for Molecular Oncology, Barts Cancer Institute, Charterhouse Square, Queen Mary University of London, London, UK
| | - Sara Stoneham
- Department of Paediatric and Adolescent Haematology and Oncology, University College Hospitals London, London, UK
| | - Rupali Arora
- Department of Histopathology, University College Hospitals London, London, UK
| | - Jonathan Shamash
- Department of Medical Oncology, Bartshealth NHS Trust, St Bartholomew's Hospital, London, UK
| | - Michelle Lockley
- Centre for Molecular Oncology, Barts Cancer Institute, Charterhouse Square, Queen Mary University of London, London, UK
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17
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Kapatia G, Byreddy P, Gupta P, Rajwanshi A. Adnexal Mass with Multiple Peritoneal Nodules in a Young Girl: Report on a Rare Case. J Gynecol Surg 2019. [DOI: 10.1089/gyn.2019.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gargi Kapatia
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Poojitha Byreddy
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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18
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Baek S, Hecht S, Germeyer A. Teratom am Omentum – ein Zufallsbefund. GYNAKOLOGISCHE ENDOKRINOLOGIE 2019. [DOI: 10.1007/s10304-019-00286-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Abstract
Ovarian neoplasms are rare in children. Although usually asymptomatic, they sometimes present with abdominal pain, abdominal distension or palpable mass. The distribution of neoplasms in the pediatric population is different from in adults; benign mature cystic teratoma is the most common ovarian tumor in children. Radiologists should be familiar with the variable sonographic, CT and MRI findings of ovarian neoplasms. Although the less frequently encountered ovarian malignancies cannot be reliably distinguished by imaging alone, it does play an important role in workup. This review discusses the imaging and relevant clinical manifestations of the more commonly encountered pediatric ovarian neoplasms.
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20
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18F FDG positron-emission tomography findings of gliomatosis peritonei: A case report and review of the literature. Gynecol Oncol Rep 2017; 20:105-107. [PMID: 28393096 PMCID: PMC5377915 DOI: 10.1016/j.gore.2017.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/10/2017] [Accepted: 03/23/2017] [Indexed: 11/21/2022] Open
Abstract
Gliomatosis peritonei (GP) is a rare benign complication of ovarian teratomas that does not impact overall survival. GP exhibits high 18-F FDG uptake unlike other non-malignant forms of mature teratoma. The specific characteristics of GP on functional imaging may be used to follow it with active surveillance in select cases.
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