Development of immature ovarian teratoma after mature teratoma in a girl with familial ovarian teratoma:A case report

BACKGROUND Immature ovarian teratoma is a rare and aggressive neoplasm that affects young women.This report is the first to describe the development of immature teratoma after ovarian cystectomy for mature teratoma of the ovary in an adolescent female with a family history of ovarian teratoma.CASE SUMMARY A 16-year-old girl who had undergone bilateral ovarian cystectomy for mature teratomas 3 years ago showed bilateral adnexal tumors during her regular ultrasonography follow-up every 6 months.She received laparoscopic bilateral ovarian cystectomy,and final histopathology showed grade-1 immature teratoma of the left ovary and mature teratoma of the right ovary.Laparoscopic left salpingo-oophorectomy and staging procedures were performed again.Her mother,maternal aunt,and maternal grandmother had also received surgeries for mature ovarian teratomas.CONCLUSION It is important to have guidance on management of patient and family members with familial ovarian teratomas.

Ovarian teratoma related anti-N-methyl-D-aspartate receptor encephalitis:A case series and review of the literature

BACKGROUND Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis is a rare but important complication of ovarian teratoma.Between July 2012 and December 2019,six patients with ovarian teratoma-associated anti-NMDAR encephalitis were enrolled in our hospital and their clinical characteristics,treatment,and follow-up were reviewed.We also conducted a systematic literature review of ovarian teratoma related anti-NMDAR encephalitis reports between January 2014 and December 2019.AIM To better understand anti-NMDAR encephalitis through literature review and patients enrolled in our hospital.METHODS The six patients enrolled in the study were those diagnosed with anti-NMDAR encephalitis.Their history,clinical manifestations,and medications were recorded and optimum treatment provided in addition to maintaining a record of the follow-ups.In addition,we also extensively surveyed the literature and provide summarized data from 155 published cases of anti-NMDAR encephalitis from 130 case reports.PubMed and Scopus were the sources of these publications and the time period covered was 6 years ranging from January 2014 through December 2019.RESULTS The six patients enrolled for this study presented with typical symptoms resulting in a diagnosis of ovarian teratoma induced anti-NMDAR encephalitis.Appropriate interventions led to a positive outcome in all the patients,with five of six patients reporting full recovery and the sixth patient recovering with a few deficits.No death was recorded.The literature survey comprising of 155 patients cases across 130 case reports of anti-NMDAR encephalitis clearly indicated an upward trend in the reports/diagnosis in China,particularly in the surveyed time from 2014 through 2019.The majority of patients(150/155)underwent surgical intervention resulting in positive outcome.No treatment intervention was mentioned for one case while the four patients who were not surgically operated succumbed to the disease.CONCLUSION Suspected anti-NMDAR encephalitis should be quickly evaluated for anti-NMDAR antibodies since early diagnosis is important.In case of a tumor,its earliest and complete removal is recommended.Finally,early use of corticosteroids and IgG-depleting strategies(intravenous immunoglobulin or plasma exchange)may improve outcome.

Four-year-old anti-N-methyl-D-aspartate receptor encephalitis patient with ovarian teratoma: A case report

BACKGROUND A population-based comparative study in United States shows that the prevalence and incidence of autoimmune encephalitis are comparable to those of infectious encephalitis and its detection is increasing over time.Some patients are complicated with ovarian teratoma.The younger the patient is,the less likely a tumor will be present.CASE SUMMARY This case report describes the successful treatment of anti-N-methyl-D-aspartatereceptor(NMDAR)encephalitis by early laparoscopic ovarian cystectomy and immunotherapy in a 4-year-old female child.And to the best of our knowledge,this detailed case report describes the youngest patient to date with anti-NMDAR encephalitis who underwent laparoscopic ovarian cystectomy.CONCLUSION Although the younger the patient is,the less likely a tumor will be detected,we still emphasize that all patients with suspected or confirmed anti-NMDAR encephalitis should be screened for ovarian tumors if possible.Prompt initiation of immunotherapy and tumor removal are crucial for good outcomes.

Metaplastic carcinoma of the right breast and simultaneous giant ovarian teratoma:a case report

We describe here a female patient who presented with a breast mass and giant abdominal mass.Fine needle aspiration cytology of the breast mass and histological examination after modified radical mastectomy confirmed metaplastic carcinoma of the breast.The epithelial components were formed by infiltrating ductal carcinoma with poor differentiation,and the sarcomatous components were formed by fibrosarcoma and osteosarcoma.Histological examination of the abdominal mass confirmed ovarian teratoma.The patient underwent modified radical mastectomy of the right breast and laparoscopic excision of the abdominal mass in the lower right quadrant.Having underwent six courses of chemotherapy,the patient is now in her tenth month after surgery and under follow-up,and she has no relapsed disease.These two diseases have never seen in one patient before.The case we report here provides some new data for research and clinical experience and it may also provide a new insight into the relationship between metaplastic breast carcinoma and ovarian teratoma.

Adenocarcinoma of sigmoid colon with metastasis to an ovarian mature teratoma: A case report

BACKGROUND Colorectal cancer ranks third in global cancer-related mortality,often due to metastases to liver and lungs.Ovarian metastases are less common,accounting for 3.6%to 7.4%of cases.In contrast,mature ovarian teratomas are frequently benign.Tumor-to-tumor metastasis is a rare phenomenon,with a limited number of documented cases.Three cases of mature ovarian teratomas metastasizing from different cancers have been reported.This report focuses on a case of tumor-totumor metastasis from sigmoid colon adenocarcinoma to a mature ovarian teratoma.CASE SUMMARY A 41-year-old Taiwan residents woman with no known systemic diseases presented with lower back pain,which led to imaging revealing malignant lesions in the spine,pelvis,liver,and multiple lung metastases.She was diagnosed with sigmoid colon adenocarcinoma with metastases to the liver,lung,bone,and a left ovarian teratoma.Treatment involved radiotherapy and chemotherapy,resulting in regression of the primary tumor and stable lung and liver lesions.Due to abdominal symptoms,she underwent exploratory surgery,unveiling a mature teratoma in the left ovary with signs of metastatic adenocarcinoma.CONCLUSION Consider resecting mature ovarian teratomas with concurrent colorectal adenocarcinoma to prevent tumor-to-tumor metastasis.

Characteristics, diagnosis and treatment of hepatic metastasis of pure immature ovarian teratoma

Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and treatment.Methods Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively,Results All of the hepatic metastatic tumors were located on the surface of the liver. 61.1％ (11/18) of them were clinical stage Ⅲ and 44.4％ (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7％ (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2％ (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4％ (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8％ (14/ 18), and mortality rate was 22.2％. The 5- and 10-year-survival rate was 55.6％ (10/18) and 38.9％ (7/18), respectively. The rate of loss in follow-up was 22.2％ (4/18) and 38.9％ (7/18), respectively, and one patient has survived for more than 17 years.Conclusions The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients.

Ovarian growing teratoma syndrome with multiple metastases in the abdominal cavity and liver:A case report

BACKGROUND Growing teratoma syndrome(GTS)is an unusual presentation of an amazing transformation of teratoma from malignant to benign on pathology during or after systemic or intraperitoneal chemotherapy.The definitive pathogenesis is still not fully understood due to the lack of large-sample studies.CASE SUMMARY A 53-year-old woman underwent radical surgery and postoperative intraperitoneal chemotherapy due to immature teratoma of the right ovary at the age of 28.She remained well during a 25-year follow-up period after surgery.Multiple asymptomatic solid masses were found in the liver on ultrasonography a month ago.Enhanced computed tomography(CT)of the abdomen revealed multiple masses in the abdominal cavity.The largest one was located in the posterior peritoneum next to the sixth segment of the right liver,about 7.9 cm×7.5 cm in size.Three masses were present inside the liver,and one mass was in the right pelvic floor.Multiple lumps in the abdominal cavity were completely removed by surgery.During the operation,multiple space-occupying lesions were seen,ranging in size from 0.5 to 3 cm,and grayish white in color and hard in texture.Ovarian GTS was finally diagnosed based on postoperative pathology.After surgery,she recovered uneventfully.During a 3-year follow-up,the patient remained free of the disease without any recurrence on CT scan.CONCLUSION GTS is a rare phenomenon characterized by conversion of immature teratoma to mature one during or after chemotherapy and presents as growing and metastasizing masses.The pathogenesis of GTS is unclear,and the prognosis is good after surgical resection.

Papillary Carcinoma Derived from Ovarian Mature Cystic Teratoma: A New Case Report and Literature Review

Introduction: Papillary carcinoma arising from thyroid tissue in mature cysticteratoma (MCT) of the ovary is extremely rare, and it is not easy to diagnose preoperatively. No clinical, no radiological, no biological signs are specific to malignant transformation. Case presentation: A 51-year-old woman had a left ovarian tumor measuring approximately 18 cm diameter with malignant transformation of a mature cysticteratoma, who was diagnosed postoperatively with follicular variant of papillary thyroid carcinoma. A laparoscopic hysterectomy and left salpingo-oophorectomy were performed. During surgery, there were no signs of invasion or metastasis. Conclusion: Consideration should be given to thyroidectomy followed by total-body scanning and serum studies for foci of thyroid carcinoma and adjuvant therapy with thyroidectomy and radio ablation if residual disease is identified.

Granulocyte-colony stimulating factor-producing squamous cell carcinoma arising in ovarian mature cystic teratoma: A case report

Granulocyte-colony stimulating factor (G-CSF)-producing cancer has been reported to occur in various organs. It has an aggressive nature and shows resistance to conventional treatments, however, its clinical features are not well known because of the small number or reported cases. We report G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma. An 80-year-old woman underwent suboptimal surgical excision of stage IIIC ovarian cancer. Prior to the treatment, the patient presented severe granulocytosis and elevated serum G-CSF concentration. With the help of histopathological and immunohistochemical studies, we diagnosed this case to be a poorly differentiated squamous cell carcinoma developed in ovarian mature cystic teratoma, which highly expressed G-CSF. During radiation therapy, the patient died from rapid growth of residual tumor and peritoneal dissemination 2 months after surgery. This is the first case of G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma, and its prognosis was very poor.

Psammoma Bodies in Two Types of Human Ovarian Tumours: A Mineralogical Study

Mineralization in tumours is a complex dynamic process regulated by cancerization process, organic matter, mineral crystal growth mechanism, external environment, human body environment and other aspects. Differences between mineral crystals may imply different cancerization process and tumorous types. Therefore, the study on mineralization progress in human tumours can help to provide some important information on the occurrence and development of the diseases.

Ovarian torsion—A course for severe abdominal pain in children

Ovarian torsion is a rare, albeit important cause of abdominal pain as it may lead to ovarian necrosis if not resolved. Although it has been described in all ages, it is very rare in young children. The primary symptom is abdominal pain, and due to the abundance hereof in a pediatric setting and the significant overlap in the clinical manifestations between ovarian torsion and more common entities such as appendicitis, a high level of suspicion needs to be maintained. We report the case of a young girl with a history of severe abdominal pain. A primary hospitalization at the age of 1? years resolved quickly and spontaneously without any imaging. At the age of 2 years and 10 months, she was once again hospitalized for severe abdominal pain. A CT scan shoved a large dermoid cyst and possible torsion of the ovary. An exploratory laparotomy confirmed the diagnosis and oophorectomy was performed. Histopathological examination of the cyst demonstrated a 5 × 5 × 6 cm mature cystic teratoma without malignancy. This case illustrates how a high level of suspicion for ovarian torsion needs to be maintained, even in otherwise healthy children.

Anti-N-methyl-D-aspartate receptor-associated encephalitis: A review of clinicopathologic hallmarks and multimodal imaging manifestations

Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mechanism of pathogenesis remains incompletely understood,but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways.Young adults are most frequently affected;the median age at diagnosis is 21 years.There is a strong female predilection with a female sex predominance of 4:1.NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma.However,NMDARE has also been described in patients with small cell lung cancer,clear cell renal carcinoma,and other benign and malignant neoplasms.Diagnosis is based on correlation of the clinical presentation,electro-encephalography,laboratory studies,and imaging.Computed tomography,positron emission tomography,and magnetic resonance imaging are essential to identify an underlying tumor,exclude clinicopathologic mimics,and predict the likelihood of long-term functional impairment.Nuclear imaging may be of value for prognostication and to assess the response to therapy.Treatment may involve high-dose corticosteroids,intravenous immunoglobulin,and plasma exchange.Herein,we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria,treatment regimens,and proposed pathogenetic mechanisms.

儿童卵巢未成熟畸胎瘤临床诊治分析

目的 探讨儿童卵巢未成熟畸胎瘤的临床特点和治疗效果。方法 回顾性分析2015年6月—2020年6月我院收治6例儿童卵巢未成熟畸胎瘤的临床资料。中位年龄3.5岁。肿瘤位于左侧卵巢5例,右侧1例。3例表现为腹部肿物,2例为腹痛,1例为腹胀。术前检查所有患儿甲胎蛋白均增高,超声提示囊实性肿物伴钙化,腹部CT均为囊实性占位,含脂肪及钙化。结果 4例患儿行保留卵巢的肿瘤剜除术,2例行卵巢肿瘤切除术。病理结果回报均为未成熟畸胎瘤,1级2例,2级3例,3级1例。术后均未予化疗。随访23~67个月,均无瘤存活。结论 儿童卵巢未成熟畸胎瘤可行保留卵巢的肿瘤剜除术,术后需密切随访。

Bilateral Mixed Germ Cell Tumour in an Adolescent Girl with Premature Ovarian Failure

Germ cell tumours (GCTs) of the ovary are rare, comprising approximately 20% of all ovarian tumors with the malignant variant accounting for less than 5% of all ovarian neoplasms. Malignant mixed germ cell tumours are rarer still with dysgerminoma & yolk sac tumour being the most common components with three component variants being categorised in the rarest of rare varieties. Bilateral dysgerminomas occur in 15% of germ cell neoplasms but rarely present with premature ovarian failure. We present the case of an adolescent girl with a short history of abdominal pain and distension with amenorrhoea for a year. Clinical and radio ogical examination revealed a pelvic/adnexal mass with elevation of tumour markers and she had to undergo a staging laparotomy with bilateral salpingo-oophorectomy. Histopatholgy examination was reported as malignant mixed germ cell tumour of left ovary, predominantly with immature teratoma and minor components of yolk-sac tumour and dysgerminoma and right ovary with dysgerminoma. In view of mixed germ cell disease, she was planned for adjuvant chemotherapy.

卵巢成熟性囊性畸胎瘤恶性转化一例

卵巢成熟性囊性畸胎瘤(mature cystic teratoma of ovary,MCTO)是最常见的卵巢生殖细胞肿瘤,通常为良性,然而在极少数情况下,其可能发生恶性转化(malignant transformation,MT)。MT-MCTO多见于绝经后期女性,由于其罕见性,目前尚缺乏标准的诊治方案。报告1例77岁MT-MCTO为鳞状细胞癌ⅡB期患者的诊治过程,该患者在经肿瘤细胞减灭术后接受1个疗程博来霉素+依托泊苷+顺铂方案化疗。然而,由于患者身体情况无法耐受进一步治疗,随访术后半年死亡。

卵巢畸胎瘤相关抗N-甲基-D-天冬氨酸受体脑炎的临床分析

目的分析卵巢成熟畸胎瘤相关抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的临床特征、治疗及预后。方法回顾性分析2014年5月至2022年10月期间11例抗NMDAR脑炎合并卵巢畸胎瘤患者的临床数据。结果患者年龄14~34岁,平均(22.40±2.89)岁。6例患者先有发热症状,8例临床表现为精神异常,9例四肢抽搐,伴有不同程度的不自主运动。头颅MRI和脑电图缺乏特异性,脑脊液和血清NMDAR抗体检测是诊断的关键。所有患者行免疫疗法联合卵巢肿瘤切除术后预后良好。所有患者术后1~7个月改良Rankin量表(mRS)评分明显下降,1例对侧卵巢肿瘤复发,1例术后11个月脑炎复发。结论卵巢畸胎瘤引起的抗NMDA脑炎多为神经、精神异常的非特异性临床表现,易误诊、延误。临床应充分认识该病,早期诊断,及时手术干预,提高预后。

标准化腹腔镜手术治疗卵巢畸胎瘤的临床效果研究

目的:探析在卵巢畸胎瘤治疗中选择标准化腹腔镜手术的应用效果。方法:选取2020年1月至2023年12月蚌埠医科大学第一附属医院收治的卵巢畸胎瘤患者100例,以选择随机数表法,将入选患者划分为对照组(多孔腹腔镜手术)与观察组(单孔标准化腹腔镜手术),观察其效果。结果:观察组较对照组于手术时长、术中出血量、排气时间、禁食时间和住院时间上,有统计学意义(P﹤0.05)。术前两组患者卵巢功能有关激素差异性小(P﹤0.05),经手术后,孕激素、血清雌二醇以及促卵泡生成素等指标均有所改善,但两组差异性不大,对比不存在统计学差异(P﹥0.05)。观察组较对照组于术后3日雌激素水平低,而于术后1个月和3个月两组的雌激素水平差异小,对比无统计学差异(P﹥0.05),观察组较对照组满意度高,差异明显(P﹤0.05)。结论:在卵巢畸胎瘤治疗中选择标准化腹腔镜手术具有良好优势,可有效改善围手术期指标,提升满意度和预后,具有推广意义。

1例犬卵巢成熟性囊性畸胎瘤的病例报告

1只4岁雌性德国牧羊犬,发情周期正常,偶尔出现爬跨行为,就诊前3个月左右开始出现腹围增大的情况,就诊前几日出现排尿困难、精神萎靡、食欲下降等症状。腹部触诊患犬表现疼痛感,腹部内容物坚硬且活动范围较大。剖腹探查后发现左侧卵巢可见囊性团块肿物,遂进行绝育手术及肿物切除手术,并对其病变卵巢进行组织病理学检查。组织病理学诊断结果为卵巢成熟型囊性畸胎瘤。

血清CA125、HE4联合CDU指标对卵巢成熟性畸胎瘤的诊断价值

目的分析血清糖类抗原125(CA125)、人附睾分泌蛋白4(HE4)联合彩色多普勒超声(CDU)指标对卵巢成熟性畸胎瘤的诊断价值。方法将2021年6月至2023年6月我院收治的82例卵巢成熟性畸胎瘤患者纳入研究组,另选取同期健康体检人群90例为对照组。分析两组的血清CA125、HE4水平及CDU指标,绘制ROC曲线分析血清CA125、HE4水平及CDU指标单独及联合检测对卵巢成熟性畸胎瘤的诊断价值。结果与对照组比较,研究组血清CA125、HE4水平较高,子宫动脉RI、PI水平较低(P<0.05)。ROC曲线分析显示CA125、HE4、子宫动脉RI、PI联合检测对卵巢成熟性畸胎瘤的诊断价值最高(AUC=0.906,P<0.01)。结论血清CA125、HE4联合CDU指标对卵巢成熟性畸胎瘤具有较高的诊断价值。

卵巢成熟畸胎瘤695例临床分析

目的分析695例卵巢成熟畸胎瘤病例的临床特点。方法选取北京协和医院1990年1月～2000年12月间住院的行开腹或腹腔镜手术治疗的卵巢成熟畸胎瘤患者695例,建立数据库后对其临床特点进行分析。结果腹腔镜手术在平均住院日、术中出血量、手术时间上均较开腹手术缩短或减少(P<0.001)。肿瘤以单侧多见,占85.8%,右侧略高于左侧(45.2%和40.6%)。手术中对另一侧卵巢的情况进行分析,结果显示在459例肉眼未发现异常表现者行剖探术,仅有1例(0.22%)有阳性发现。并发症以扭转最为常见(占7.5%),发生扭转的肿瘤平均直径(10.2±4.5)cm较未发生扭转者(6.9±3.2)cm大(P<0.001)。扭转的概率随肿瘤的增大而增加,当肿瘤最大径在6cm以下时,发生扭转的机率小于4.4%,而在8cm以上时,扭转发生的机率在10%以上(P<0.001)。破裂、感染、恶性变均为罕见的并发症。结论在卵巢成熟畸胎瘤的处理上腹腔镜手术优于开腹手术;如术中肉眼见对侧卵巢无异常时,可以考虑不行剖探术;肿瘤最大径大于8cm时,发生扭转的机率将大为增加。