J Gynecol Oncol.  2008 Sep;19(3):199-201. 10.3802/jgo.2008.19.3.199.

Adenocarcinoma arising in mature cystic teratoma: a case report

• Lee JM
• Kim JW
• Song JY
• Lee JK
• Lee NW
• Kim SH
• Lee KW

• KMID: 2173403
• DOI: http://doi.org/10.3802/jgo.2008.19.3.199

Abstract

Benign cystic teratoma is recognized as one of the most common tumors in women during the reproductive age and frequently is treated by pelviscopic operation. Malignant transformation of a benign cystic teratoma is a rare event, and adenocarcinoma is extremely rare, and distinguishing this malignant change from benign disease preoperatively is nearly impossible even by the use of radiological imaging or various tumor markers. Therefore, patients should be informed that if a laparoscopic cystectomy is undertaken, a prompt second staging operation should be performed if the definitive pathology reveals an unexpected malignancy. We present a case with thyroid papillary carcinoma of follicular variant arising from mature cystic teratoma removed by laparoscopic salpingo-oophorectomy followed by staging laparotomy. We briefly reviewed literatures with regard to malignant transformation of a benign cystic teratoma.

Keyword

Mature cystic teratoma; Malignant transformation; Adenocarcinoma; Tumor marker

MeSH Terms

Adenocarcinoma
Carcinoma, Papillary
Cystectomy
Female
Humans
Laparotomy
Teratoma
Thyroid Gland
Biomarkers, Tumor

Figure

• 

  Fig. 1 (A) Follicular variant papillary carcinoma, nuclear clearing, nuclear groove irregular nuclei (H&E; ×40). (B) In the ovarian tumor, there is a lesion of well formed follicles of thyroid gland (H&E; ×400).

Reference

1. Peterson WF. Malignant degeneration of benign cystic teratomas of the ovary: A collective review of the literature. Obstet Gynecol Surv. 1957. 12:793–830.

2. Chadha S, Schaberg A. Malignant transformation in benign cystic teratomas: Dermoids of the ovary. Eur J Obstet Gynecol Reprod Biol. 1988. 29:329–338.

3. Templeman CL, Fallat ME, Lam AM, Perlman SE, Hertweck SP, O'Connor DM. Managing mature cystic teratomas of the ovary. Obstet Gynecol Surv. 2000. 55:738–745.

4. Malik E, Bohm W, Stoz F, Nitsch CD, Rossmanith WG. Laparoscopic management of ovarian tumors. Surg Endosc. 1998. 12:1326–1333.

5. Mori Y, Nishii H, Takabe K, Shinozaki H, Matsumoto N, Suzuki K, et al. Preoperative diagnosis of malignant transformation arising from mature cystic teratoma of the ovary. Gynecol Oncol. 2003. 90:338–341.

6. Kawai M, Kano T, Kikkawa F, Morikawa Y, Oguchi H, Nakashima N, et al. Seven tumor markers in benign and malignant germ cell tumors of the ovary. Gynecol Oncol. 1992. 45:248–253.

7. Kikkawa F, Nawa A, Tamakoshi K, Ishikawa H, Kuzuya K, Suganuma N, et al. Diagnosis of squamous cell carcinoma arising from mature cystic teratoma of the ovary. Cancer. 1998. 82:2249–2255.

8. Kushima M. Adenocarcinoma arising from mature cystic teratoma of the ovary. Pathol Int. 2004. 54:139–143.

9. Min KJ, Jee BC, Lee HS, Kim YB. Intestinal adenocarcinoma arising in a mature cystic teratoma of the ovary: A case report. Pathol Res Pract. 2006. 202:531–535.

10. Rim SY, Kim SM, Choi HS. Malignant transformation of ovarian mature cystic teratoma. Int J Gynecol Cancer. 2006. 16:140–144.

11. Sumi T, Ishiko O, Maeda K, Haba T, Wakasa K, Ogita S. Adenocarcinoma arising from respiratory ciliated epithelium in mature ovarian cystic teratoma. Arch Gynecol Obstet. 2002. 267:107–109.

12. Saito N, Hatori T, Murata N, Shibuya K, Mitsuda A, Hasegawa C, et al. A case of concomitant occurrence of struma ovarii and malignant transformation of cystic teratoma. Int J Surg Pathol. 2007. 15:318–320.

13. Levine DA, Villella JA, Poynor EA, Soslow RA. Gastrointestinal adenocarcinoma arising in a mature cystic teratoma of the ovary. Gynecol Oncol. 2004. 94:597–599.

14. Morimitsu Y, Nakashima O, Nakashima Y, Kojiro M, Shimokobe T. Apocrine adenocarcinoma arising in cystic teratoma of the ovary. Arch Pathol Lab Med. 1993. 117:647–649.