Korean J Radiol.  2008 Oct;9(5):458-461. 10.3348/kjr.2008.9.5.458.

CT Images of a Malignant-Transformed Ovarian Mature Cystic Teratoma with Rupture: a Case Report

• Wang PC
• Yang TL
• Pan HB

• KMID: 1385405
• DOI: http://doi.org/10.3348/kjr.2008.9.5.458

Abstract

A malignant transformation or a tumor rupture is a rare complication of ovarian mature cystic teratoma (MCT). A tumor rupture in a malignant-transformed MCT has never been reported in the literature. We present the CT images of a 39-year-old woman showing a large, predominantly cystic mass in the lower abdomen, with fat-fluid-level ascites. A contrast-enhanced solid component, with regional discontinuity within the cystic lesion, is also demonstrated. The pathologic diagnosis of the ruptured MCT unveils the malignant transformation (squamous cell carcinoma) and mesenteric carcinomatosis.

Keyword

Ovarian cystic teratoma; Malignant transformation; Tumor rupture; Computed tomography (CT)

MeSH Terms

Adult
Cell Transformation, Neoplastic/pathology
Diagnosis, Differential
Female
Humans
Ovarian Neoplasms/*pathology/*radiography/surgery
Teratoma/*pathology/*radiography/surgery
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Malignant transformation of mature cystic teratoma. A. Contrast-enhanced CT scan shows predominantly cystic mass (arrowheads) in lower abdomen with irregular, enhanced solid components (thick arrow; before contrast [not shown], 30-35 HU; after contrast, 75-80 HU), and calcified entity (thin arrow, more than 1000 HU) with scanty fat contents (curved arrows, -120 HU). B. Contrast-enhanced CT image caudal to A shows disruptive tumor margin (thick arrow) at enhanced solid components (thin arrows) of lesion. C. Contrast-enhanced CT scan shows thickened, contrast-enhanced peritoneum (thin arrows) and omentum (thick arrow). D. Contrast-enhanced CT scan shows moderate ascites with multiple scattered fat-fluid levels (thin arrows; fat: less than -130 HU) in bilateral subphrenic regions. E. Cystic tumor consists of three germ cell components: squamous cell epithelium (ectoderm: curved black arrow), adipose tissue (mesoderm: thick black arrow), sebaceous gland (mesoderm: black arrowhead) and pseudostratified columnar epithelium (endoderm: thin black arrow) (Hematoxylin & Eosin staining, ×40). F, G. Cystic tumor contains squamous cell epithelium with indistinct basement (thin black arrow), diffuse submucosal infiltration of differentiated neoplastic squamous cells with hyperchromatic and pleomorphic nuclei (thick black arrows) and keratin pearl formation (arrowheads) (F: Hematoxylin & Eosin staining, ×40; G: Hematoxylin & Eosin staining, ×400).

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