J Gynecol Oncol.  2012 Apr;23(2):125-128. 10.3802/jgo.2012.23.2.125.

Early diagnosis of malignant-transformed ovarian mature cystic teratoma: fat-suppressed MRI findings

• Takagi H
• Ichigo S
• Murase T
• Ikeda T
• Imai A

• KMID: 2177587
• DOI: http://doi.org/10.3802/jgo.2012.23.2.125

Abstract

The most common form of malignant transformation developing from a mature cystic teratoma is squamous cell carcinoma, representing 80% of malignant transformations, while adenocarcinoma accounts for approximately 5%. Because of this rarity, few reports exist of preoperative diagnosis of this tumor by magnetic resonance imaging, in particular with fat suppression techniques. Here, we report magnetic resonance imaging findings and clinical features of a 79-year-old woman with mucinous adenocarcinoma arising from a mature cystic teratoma (measuring 5x6 cm), classified as surgical stage IA. Because of the poor prognosis of malignant transformation, when mature cystic teratomas are detected (even smaller than 5 cm tumor size) in postmenopausal women, serum tumor marker carcinoembryonic antigen levels and fat-suppressed magnetic resonance imaging may be potential indicators of malignant transformation.

Keyword

Adenocarcinoma; Fat-suppressed magnetic resonance imaging; Malignant transformation; Mature cystic teratoma

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Mucinous
Aged
Carcinoembryonic Antigen
Carcinoma, Squamous Cell
Early Diagnosis
Female
Humans
Magnetic Resonance Imaging
Prognosis
Teratoma
Carcinoembryonic Antigen

Figure

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  Fig. 1 Mucinous adenocarcinoma arising from a mature cystic teratoma. Magnetic resonance imaging of the pelvis (A-C): Transaxial T1-weighted (A) and T2-weighted images (B), and transaxial T1-weighted image with fat-suppression (C) show a 6×6 cm sized solid-cystic mass with fatty component (white arrows) in the left ovary. Underlying cyst wall is smooth, with no sign of transcapsular extension. Pathohistology (D): The cystic portion of the ovarian tumor consists of well differentiated mucinous adenocarcinoma, which is intimately associated with mature cystic teratoma (H&E, ×200).

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