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.

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.

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.

Monodermal teratoma:Three case reports and review of literature

BACKGROUND The incidence of monodermal teratomas of the reproductive system is low,and most doctors lack adequate understanding,which can easily lead to missed diagnoses and/or misdiagnosis.Therefore,it is important to fully understand the clinical characteristics,diagnosis,differential diagnosis,and treatment of monodermal teratomas of the reproductive system.CASE SUMMARY Case 1:A 14-year-old boy was admitted to the hospital with a right testicular mass for 1 wk and underwent surgical resection.He was finally diagnosed with right testicular monodermal teratoma with no special postoperative discomfort.Case 2:A 40-year-old woman was admitted to the hospital for uterine abnormalities indicated by ultrasound 20 d prior and underwent laparoscopic surgery.She was finally diagnosed with a left ovarian monodermal teratoma with a satisfactory postoperative quality of life.Case 3:A 49-year-old woman was admitted to the hospital with a pelvic mass that was discovered on B-ultrasound a week prior and underwent laparoscopic resection of the left adnexa.She was finally diagnosed with left ovarian monodermal teratoma,and her postoperative quality of life was satisfactory.CONCLUSION Monodermal teratoma is a rare tumor whose clinical manifestations are primarily benign.Simple surgical resection of the tumor is effective.

Stage IV malignant transformation of mature cystic teratoma palliatively treated with concurrent chemoradiotherapy:A case report

BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.

Prenatal ultrasound diagnosis of fetal maxillofacial teratoma:Two case reports

BACKGROUND Facial teratoma is a rare benign tumor that accounts for about 1.6%of all teratomas and can be diagnosed by prenatal ultrasound(US).The purpose of this report was to describe our experience with the diagnosis of fetal facial teratoma by prenatal US at second trimester to provide a reference for clinical diagnosis of fetal maxillofacial teratoma.CASE SUMMARY We present two cases of patients with abnormal fetal facial findings on US at second trimester of pregnancy in our department.Case 1 was a 31-year-old G3 P1+1 female,with US revealing a heterogeneous echogenicity of 32 mm×20 mm×31 mm on the fetal face,most of it located outside the oral cavity and filling the root of the oral cavity.Case 2 was a 29-year-old G1P0 female,with fetal head and neck US revealing a cystic-solid echo mass measuring 42 mm×33 mm×44 mm,the upper edge of the lesion reaching the palate and filling the oral cavity.The contours of the lesions were visualized using three-dimensional(3D)US imaging.Both patients decided to give up treatment.Biopsies of the lesions were performed after induction of labor,and diagnosed as maxillofacial teratoma.CONCLUSION Fetal maxillofacial teratomas can be diagnosed by US in early pregnancy,allowing parents to expedite treatment decisions.

鼻咽部及翼腭窝畸胎瘤1例

1临床资料患儿,男,13岁,因反复双侧鼻塞伴流脓涕4年,于2021-09-01就诊于川北医学院附属医院耳鼻咽喉科。患儿4年前无明显诱因出现双侧鼻塞,呈间歇性,伴流脓涕,量少,稍臭。无鼻腔疼痛、出血、回吸性血痰,无耳鸣、听力下降、头晕头痛。每次发作予以口服抗生素治疗后上述症状稍缓解,但反复发作。电子鼻咽喉镜检查见双侧鼻腔新生物,光滑质韧,肿物左侧为主,予以鼻腔新生物活组织检查,结果提示慢性炎症改变。鼻咽部CT示左侧翼腭窝区可见含脂性、骨性混杂团块影,邻近骨质受压吸收,部分脂肪团块影累及鼻腔、鼻咽腔及口咽腔,致相应腔隙狭窄,多考虑畸胎瘤可能或其他(图1A)。门诊以“鼻腔鼻窦新生物”收治入院,于2021-09-04全麻下通过鼻颅底影像导航系统辅助行手术切除瘤体。鼻内镜下予以低温等离子刀剥离切除左侧中鼻甲及左后半部分下鼻甲,开放左侧上颌窦及筛窦,清除窦腔内脓性分泌物。

宫颈原发性成熟性畸胎瘤2例临床病理分析并文献复习

畸胎瘤是妇科常见的生殖细胞肿瘤,好发于卵巢,其中95%为成熟性囊性畸胎瘤[1]。性腺外畸胎瘤占生殖细胞肿瘤的2%~5%,较常发生于近中线部位。发生于宫颈的畸胎瘤罕见,其发生机制并不清楚。本研究报道2例原发于宫颈的成熟性畸胎瘤,并结合近年来国内外相关文献对宫颈原发性畸胎瘤的临床病理特点进行讨论。1材料与方法1.1材料收集在解放军总医院第七医学中心会诊的2例原发于宫颈的成熟性畸胎瘤。

Ruptured teratoma mimicking a pelvic inflammatory disease and ovarian malignancy:A case report

BACKGROUND We report a case of ruptured ovarian teratoma mimicking pelvic inflammatory disease(PID)and ovarian malignancy.The case indicates the need for reviewing the information on ovarian teratomas,as the symptoms are vague,and,therefore,diagnosis and treatment had to be structured accordingly.CASE SUMMARY A 60-year-old woman was admitted to the emergency department with acute lower abdominal pain.She experienced weight loss and increased abdominal girth.Pelvic ultrasound and computed tomography revealed a 14-cm pelvic tumor.Laboratory examination revealed leukocytosis(white blood cell count:12620/μL,segment:87.7%)and high levels of C-reactive protein(18.2 mg/dL).Elevated levels of the tumor marker cancer antigen 19-9(367.8 U/mL,normal value<35 U/mL)were also noted.Due to the impression of a ruptured tuboovarian abscess or a tumor with malignancy,she immediately underwent an exploratory laparotomy.A ruptured ovarian tumor with fat balls,hair strands,cartilage,and yellowish fluid was observed on the right side.Right salpingooophorectomy was performed.A pathological examination revealed a mature cystic teratoma.The patient recovered after surgery and was discharged on postoperative day three.No antibiotics were administered.CONCLUSION This case illustrates the differential diagnosis of an ovarian tumor.Therefore,surgery is the mainstay for treating a ruptured teratoma.

Giant teratoma with isolated intestinal duplication in adult: A case report and review of literature

BACKGROUND A combination of diseases is a rare phenomenon.Their clinical manifestations can vary,and the diagnosis can be challenging.Intestinal duplication is a rare congenital malformation,whereas retroperitoneal teratoma is a tumor in the retroperitoneal space,derived from the remaining embryonic tissue.There are relatively few clinical findings on adult retroperitoneal benign tumors.It is hard to believe that these two rare diseases can happen to the same person.CASE SUMMARY A 19-year-old woman complaining of abdominal pain with nausea and vomiting was admitted.Abdominal computed tomography angiography was suggested for invasive teratoma.Intraoperative exploration revealed that the giant teratoma was connected to an isolated intestinal tract in the retroperitoneum.The postoperative pathological examination revealed that mature giant teratoma was present with intestinal duplication.This was a rare intraoperative finding that was successfully treated surgically.CONCLUSION The clinical manifestations of intestinal duplication malformation are various,and difficult to diagnose before the operation.The possibility of intestinal replication should be considered when intraperitoneal cystic lesions are present.

耳后畸胎瘤1例

畸胎瘤为来源于生殖细胞的由多胚层构成的肿瘤。多发于身体中线两旁,以盆腔、腹腔、胸腔常见,耳部畸胎瘤临床少见。

甲状腺畸胎瘤1例

1临床资料患者男,22岁,因左颈部无痛性肿块6年余就诊。患者6年前无意中发现左侧颈前部有一＂核桃＂样大小肿块,无疼痛、气短、声嘶及吞咽困难,近6年来肿块逐渐增大,右侧卧位时有呼吸困难等不适感。查体：颈软、气管右移,甲状腺左叶可触及一大小约8.0cm×5.0cm肿块,表面光滑、质中、压痛（-）,随吞咽动作上下移动度较差,甲状腺右叶未触及肿块,颈部淋巴结未触及肿大。实验室检查：甲状腺各项功能正常。B超结果示：左侧甲状腺增大至胸骨后,左侧甲状腺可见类椭圆形混合回声光团,

鼻腔鼻窦畸胎癌肉瘤1例

鼻腔鼻窦畸胎癌肉瘤（sinonsal teratocarcinosarcoma,SNTCS）是一种罕见的同时具有畸胎癌和肉瘤特征的高度恶性肿瘤。国外曾报道86例,国内报道更少。我科曾收治1例,现报道如下。

Derivation and transcriptional profiling analysis of pluripotent stem cell lines from rat blastocysts

Embryonic stem （ES） cells are derived from blastocyst-stage embryos. Their unique properties of self-renewal and pluripotency make them an attractive tool for basic research and a potential cell resource for therapy. ES cells of mouse and human have been successfully generated and applied in a wide range of research. However, no genuine ES cell lines have been obtained from rat to date. In this study, we identified pluripotent cells in early rat embryos using specific antibodies against markers of pluripotent stem ceils. Subsequently, by modifying the culture medium for rat blastocysts, we derived pluripotent rat ES-like cell lines, which expressed pluripotency markers and formed embryoid bodies （EBs） in vitro. Importantly, these rat ES-like cells were able to produce teratomas. Both EBs and teratomas contained tissues from all three embryonic germ layers. In addition, from the rat ES-like cells, we derived a rat primitive endoderm （PrE） cell line. Furthermore, we conducted transcriptional profiling of the rat ES-like cells and identified the unique molecular signature of the rat pluripotent stem cells. Our analysis demonstrates that multiple signaling pathways, including the BMP, Activin and mTOR pathways, may be involved in keeping the rat ES-like cells in an undifferentiated state. The cell lines and information obtained in this study will accelerate our understanding of the molecular regulation underlying pluripotency and guide us in the appropriate manipulation of ES cells from a particular species.

Retrorectal tumors:A challenge for the surgeons

Retrorectal or presacral tumors are rare lesions located in the presacral area and considered as being derived from multiple embryological remnants.These tumors are classified as congenital,neurogenic,osseous,inflammatory,or miscellaneous.The most common among these are congenital benign lesions that present with non-specific symptoms,such as lower back pain and change in bowel habit.Although congenital and developmental tumors occur in younger patients,the median age of presentation is reported to be 45 years.Magnetic resonance imaging plays a crucial role in treatment management through accurate diagnosis of the lesion,the evaluation of invasion to adjacent structures,and the decision of appropriate surgical approach.The usefulness of preoperative biopsy is still debated;currently,it is only indicated for solid or heterogeneous tumors if it will alter the treatment management.Surgical resection with clear margins is considered the optimal treatment;described approaches are transabdominal,perineal,combined abdominoperineal,and minimally invasive.Benign retrorectal tumors have favorable long-term outcomes with a low incidence of recurrence,whereas malignant tumors have a potential for distant organ metastasis in addition to local recurrence.

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.

Sacrococcygeal Teratoma

Key Facts Synonyms:Sacrococcygeal teratoma(SGT),germ cell tumor of coccyx Definition:Tumors containing hair,teeth,cartilage,and fat extending from the coccyx and potentially growing both internally and externally.

Serial imaging of human embryonic stem-cell engraftment and teratoma formation in live mouse models

Two new types of lentiviral vectors expressing a reporter transgene encoding either firefly luciferase （fLuc） for bioluminescence imaging or the HSV1 thymidine kinase （HSV1-TK） for radiopharmaceutical-based imaging were constructed to monitor human embryonic stem cell （hESC） engraftment and proliferation in live mice after trans- plantation. The constitutive expression of either transgene did not alter the properties of hESCs in the culture. We next monitored the formation of teratomas in SCID mice to test （1） whether the gene-modified hESCs maintain their developmental pluripotency, and （2） whether sustained reporter gene expression allows noninvasive, whole-body imaging of hESC derivatives in a live mouse model. We observed teratoma formation from both types of gene-modified cells as well as wild-type hESCs 2-4 months after inoculation. Using an optical imaging system, bioluminescence from the fLuc-transduced hESCs was easily detected in mice bearing teratomas long before palpable tumors could be detected. To develop a noninvasive imaging method more readily translatable to the clinic, we also utilized HSV1-TK and its specific substrate, 1-（2＇-deoxy-2＇-fluoro-β-D-arabinofuranosyl）-5-[^125I]iodouracil（[^125I]FIAU）, as a reporter/ probe pair. After systemic administration, [^125I]FIAU is phosphorylated only by the transgene-encoded HSV1-TK enzyme and retained within transduced （and transplanted） cells, allowing sensitive and quantitative imaging by single-photon emission computed tomography. Noninvasive imaging methods such as these may enable us to monitor the presence and distribution of transplanted human stem cells repetitively within live recipients over a long term through the expression of a reporter gene.

Short and long term fate of human AMSC subcutaneously injected in mice

AIM:To study the ability of human adipose-derived mesenchymal stem cells(AMSCs)to survive over the short and long term,their biodistribution and their biosafety in vivo in tumor-prone environments.METHODS:We subcutaneously injected human AMSCs from different human donors into immunodeficient SCID mice over both short-(2 and 4 mo)and long-(17 mo)term in young,and aged tumor-prone mice.Presence of human cells was studied by immunohistochemistry and polymerase chain reaction analysis in all organs of injected mice.RESULTS:Subcutaneously injected AMSCs did not form teratomas at any time point.They did not migrate but remained at the site of injection regardless of animal age,and did not fuse with host cells in any organ examined.AMSCs survived in vivo for at least 17 mo after injection,and differentiated into fibroblasts of the subdermic connective tissue and into mature adipocytes of fat tissue,exclusively at the site of injection.CONCLUSION:Our results support the assertion that AMSC may be safe candidates for therapy when injected subcutaneously because of their long term inability to form teratomas.

Human embryonic stem cell lines derived from the Chinese population

Six human embryonic stem cell lines were established from surplus blastocysts. The cell lines expressed alkaline phosphatase and molecules typical of primate embryonic stem cells, including Oct-4, Nanog, TDGF1, Sox2, EBAF, Thy-1, FGF4, Rex-1, SSEA-3, SSEA-4, TRA-1-60 and TRA-1-81. Five of the six lines formed embryoid bodies that expressed markers of a variety of cell types; four of them formed teratomas with tissue types representative of all three embryonic germ layers. These human embryonic stem cells are capable of producing clones of undifferentiated morphology, and one of them was propagated to become a subline. Human embryonic stem cell lines from the Chinese population should facilitate stem cell research and may be valuable in studies of population genetics and ecology.