Korean J Obstet Gynecol.  2012 Aug;55(8):590-595. 10.5468/KJOG.2012.55.8.590.

A case of pathologic fracture of the proximal femur resulting from metastatic bone tumor of ovarian immature teratoma

• Kim TH
• Choi SY
• Sung JH
• Choi CH
• Seo SW
• Bae DS

• KMID: 2078111
• DOI: http://doi.org/10.5468/KJOG.2012.55.8.590

Abstract

Composing of less than 1% of all ovarian cancers, immature teratoma is a malignancy that mainly affects the young. In this report, we present the first case of pathologic fracture of the proximal femur resulting from metastatic bone tumor of ovarian immature teratoma. A 33-year-old Korean female was diagnosed as immature teratoma of stage Ia and grade 3. Eleven months following initial surgery, she had developed right thigh pain and palpable mass, which was confirmed metastasis of immature teratoma. She had her right leg broken during concurrent chemoradiation. She took mass excision, closed reduction with internal fixation and allo-bone graft followed by 6 cycles of chemotherapy and 10 times of radiotherapy. Now she is on regular follow-up and remained disease-free for 14 months.

Keyword

Bone neoplasm; Teratoma; Fractures; Spontaneous; Ovary

MeSH Terms

Adult
Bone Neoplasms
Female
Femur
Follow-Up Studies
Fractures, Spontaneous
Humans
Leg
Neoplasm Metastasis
Ovarian Neoplasms
Ovary
Teratoma
Thigh
Transplants

Figure

• 

  Fig. 1 Initial imaging studies. (A) Plain radiography of the thigh. No pathologic fracture. (B) Magnetic resonance imaging finding. 20×5×4 cm sized solid mass in proximal to mid portion of right femur involving soft-tissue mass and vastus intermedius muscle.

• 

  Fig. 2 The pathologic finding of immature teratoma, incisonal biopsy at right thigh palpable mass. (A) Gandular, stromal and muscular differentiations was noted (H&E, ×40). (B) Multifocal malignant transforming area (H&E, ×100). (C, D) Mesenchymal and epithelial cell shows polymorphic and hyperchromatic change with prominent nucleoli. Malignant transformation was detected (H&E, ×200).

• 

  Fig. 3 Plain radiography findings. (A) Fracture of right femur mid-shaft. (B) Postoperation findings.

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