Benign cystic teratomas of the ovary: a review of seventy-two cases

Seventy-two cases of benign cystic teratoma of the ovary were diagnosed and treated at Northwick Park Hospital between 1970 and 1982. The presentation, clinical features and complications of these tumours presenting at a district general hospital during a period of over 11 years are reviewed. 66% were asymptomatic at presentation, 12.5% presented with the signs and symptoms of acute abdomen. The mean age at presentation was 37 years. Twenty-two patients had pelvic ultrasound which correctly diagnosed ovarian cyst in 9 cases. Eight had previously undergone laparotomy at which the ovaries were apparently normal.     

Managing mature cystic teratomas of the ovary

Mature cystic teratomas (MCT), commonly called dermoid cysts, are the most common benign germ cell tumors of the ovary in women of reproductive age. Future fertility is of major concern among these women; therefore, the surgical management must focus on preserving ovarian tissue and minimizing adhesion formation. Patients requiring surgery should be appropriately counseled about the risks and benefits of laparoscopy and laparotomy, the risks of intraoperative MCT spillage and adhesion formation. In addition, the risks of recurrence and malignant transformation should be discussed. The parents of children with MCTs have the same concerns as older women and a similar discussion should take place. The goal of this article is to review these issues and provide the physician with the information to counsel their patients preoperatively.     

Mature cystic teratomas in our series with review of the literature and retrospective analysis

Purpose  

Mature cystic teratomas are the most common benign ovarian neoplasms. Our aim is to analyse these cases by pathologic and clinical findings in our centre with the view of updated knowledge.     

Familial cystic teratomas: four case reports and review of the literature

Mature cystic teratomas (MCTs) are some of the most common ovarian neoplasms in women of reproductive age. However, familial teratomas are exceedingly rare. We present 4 cases of dermoid cysts seen in a mother and her 3 daughters with left MCTs. None of the patients had symptoms at the time of diagnosis, but all of them were diagnosed in their twenties during an annual gynecologic examination. In this report, we elaborate on MCTs familial incidence, genetic linkage, theories of pathogenesis, diagnosis, complications, and surgical management. To our knowledge, after extensive review of the literature, there have been only 2 cases, in addition to the present case, of unilateral MCTs across generations reported.     

Tumor markers in mature cystic teratomas of the ovary

Objective  The objective of this study was to evaluate the serum levels of tumor markers in patients with ovarian mature cystic teratomas. Method  Retrospective study of 215 patients operated at Zekai Tahir Burak Women Health Education and Research Hospital between January 2001 and October 2006 was performed. Results  The median age was 36 years (range 13–80). The mean tumor diameter was 7.7 ± 4.6 cm (range 2–25). The mean serum CA 125 level was 26.2 ± 29.9 U/mL (range 1.4–225, normal value <35), and the mean serum CA 19-9 level was 83.5 ± 179.2 IU/mL (range 0.6–1,000; normal value <37). The elevated rate of CA 19-9, CA 125 was 39.6% (74/187) and 23.3% (50/215), respectively. The mean age of patients and the rate of bilaterality of tumors were similar in both patients with elevated CA19-9 and with normal CA 19-9 level (P > 0.05). The mean tumor size of patients with elevated CA 19-9 was greater than those with normal CA19-9 level (P = 0.01). Conclusion  Serum CA 19-9 has the highest positivity rate among other tumor markers in ovarian mature cystic teratomas. Elevated serum CA 19-9 levels are correlated with larger tumor size. But the diagnostic value of elevated CA 19-9 in patients with MCT would be poor if the test was used alone.     

Benign clear cell adenofibroma of the ovary. A case report with literature review

Most clear cell neoplasms of the ovaries are carcinomas; benign and borderline clear cell tumors are uncommon. To date, only 12 cases of benign clear cell adenofibroma have been reported in the literature. Here we report a case of benign clear cell adenofibroma of the left ovary in a 51-year-old postmenopausal woman. Histological examination revealed widely spaced simple glands embedded in a dense fibrous stroma. The glands were lined by one to two layers of cells with abundant clear cytoplasm. The nuclei were bland and uniform in size and shape. There was minimal cytologic atypia in some areas. In this article we discussed the criteria for the diagnosis of benign and borderline clear cell adenofibromas and reviewed the literature.     

Malignant transformation in benign cystic teratomas: dermoids of the ovary

Twenty-four cases with a malignant change involving one of the elements of a benign ovarian dermoid cyst are reported. Squamous cell carcinoma was most frequent. Eighteen patients (75%) were over 50 years of age. The prognosis is rather good if the tumor has not extended beyond the capsule, 85% surviving without detectable disease after 4 months to 9 years. The prognosis is very poor if the tumor has extended beyond the capsule, over 80% dying within 2 years. Hysterectomy with bilateral salpingo-oophorectomy is the treatment of choice, certainly in older patients. Additional treatment with cytostatics or radiation seems to have little influence on the prognosis.     

Malignant transformation in mature cystic teratoma of the ovary: report of five cases and review of the literature

The incidence of malignant transformation in mature cystic teratoma (MCT) of the ovary is less than 2% as reported in gynaecological and pathological literature. Here we present a series of five patients, who developed malignant transformation in MCT of the ovary, over a 6-year period (1999–2004). The morphological and clinico-pathological features of malignant transformation in MCT of the ovary are discussed.     

Monodermal teratomas (struma ovarii). Clinicopathological characteristics of 11 cases and literature review

During the last 15 years in the Pathology Laboratory of Aretaieion University Hospital, 256 cases of teratomas were examined and 11 cases (4.3%) presented characteristics of struma ovarii. Eight patients aged 19-34 years and four 41-74 years (median 41 years). One 74-year-old patient presented with virilization signs but pain and a pelvic mass were the most frequent symptoms. The tumors were unilateral in 9/11 cases, the size ranged from 5-17 cm, and they were compact or microcystic in 10/11 cases and cystic in one case. Histological pattern was microfollicular in 5/11 cases, solid in 3/11 cases, pseudoglandular in 2/11 cases, with focal clear and oxyphil cell changes, and infiltration of the fibrous wall in one case. Tumorectomy was performed in 9/11 cases and total hysterectomy with adnexa in two cases with large tumors (16-17 cm in diameter). Immunohistochemistry is useful in the recognition of struma in atypical cases. No malignant struma ovarii was observed in our cases. Tumorectomy is the appropriate therapeutic approach because of the benign nature of these tumors despite atypical histological features and the young age of the patients.     

Malignant mixed Mullerian tumor of the ovary with two cases and review of the literature

Introduction  

Malignant mixed Müllerian tumor (MMMT) of the ovary is a rare and highly aggressive tumor. It accounts <1% of all ovarian carcinomas. It is characterized by the presence of both carcinomatous and sarcomatous components and tends to occur in low parity postmenopausal woman. These are mixed, mostly monoclonal tumors, and the predominance of the stromal component aggravates the prognosis. The staging system for ovarian and primary peritoneal cancer is also used for MMMT. After complete surgical staging, patient with stage II–IV at the time of surgery should have postoperative chemotherapy. Chemotherapy can be considered for stage I MMMT. Its optimal treatment is debatable. Taxane and platinum combination is standard for the epithelial ovarian carcinoma. There is very limited literature reporting this combination therapy in ovarian MMMTs.