A Case Report of Endometrial Polyp with Bilateral Cystic Teratoma Ovary
Life Sciences-Gynaecology
DOI:
https://doi.org/10.22376/ijlpr.2023.13.2.L146-L152Keywords:
Dermoid cyst, ovarian teratoma, benign ovarian tumours, teratoma, recurrent endometriosisAbstract
Benign ovarian teratomas or dermoid cysts are the commonest germ cell tumour of ovaries, accounting for 10 to 15% of all ovarian tumours. The common age of presentation includes women's reproductive age group and post-menopausal age. These lesions can be benign, like mature teratoma or malignant, like immature teratoma, yolk sac tumour, and mixed germ cell neoplasm. These lesions are usually asymptomatic, or they can present with varying symptoms and signs. Diagnosis includes imaging and measurement of levels of tumour markers. Here we report a case of a 48-year-old woman who presented with menorrhagia for four years. The patient initially underwent dilation and curettage for similar complaints in the past, following which her cycles regularized. Later the patient was started on medications for the recurrence of symptoms. Examination revealed no abnormalities. The patient was further investigated with ultrasound and MRI pelvis and proceeded with bilateral salpingo-oopherectomy. Biopsy revealed features suggestive of benign ovarian teratoma. The patient has managed accordingly and is in regular follow-up. Benign ovarian tumours are mostly asymptomatic or present with nonspecific symptoms, of which abdominal pain and mass are seen in many cases. The commonest of these tumours is a benign mature cystic teratoma or dermoid cyst, which is bilateral. Though only one per cent contain a secondary malignancy arising from one of their components, early recognition and timely intervention are necessary to avoid untoward complications. Therefore, we recommend follow-up of such cases with radiological and blood investigations.
References
Papadia A, Rutigliani M, Gerbaldo D, Fulcheri E, Ragni N. Mature cystic teratoma of the uterus presenting as an endometrial polyp. Ultrasound Obstet Gynecol. 2007 Apr;29(4):477-8. doi: 10.1002/uog.3969, PMID 17330830.
Sengar K, Trisal M, Deb S, Dawar R. Mature cystic teratoma of the uterine surface and ovary with adenocarcinoma of the endometrium: an unusual case scenario and literature review. Middle East J Cancer. 2016 Oct 1;7(4):229-33.
Utsunomiya D, Shiraishi S, Kawanaka K, Lwakatare F, Tomiguchi S, Kido R et al. Struma ovarii coexisting with mucinous cystadenoma detected by radioactive iodine. Clin Nucl Med. 2003 Sep 1;28(9):725-7. doi: 10.1097/01.rlu.0000082657.06194.b3, PMID 12972992.
Mui MP, Tam KF, Tam FK, Ngan HY. Coexistence of struma ovarii with marked ascites and elevated CA-125 levels: case report and literature review. Arch Gynecol Obstet. 2009 May;279(5):753-7. doi: 10.1007/s00404-008-0794-1, PMID 18807056.
Iwanaga S, SHIMADA A, HASUO Y, YOH S, MIYAJIMA S, NISHIMURA H et al. Immature teratoma of the uterine fundus. Kurume Med J. 1993 Dec 10;40(3):153-8. doi: 10.2739/kurumemedj.40.153, PMID 8139215.
Palombini L, Vecchione R, De Rosa G, Cortese F. Benign solid teratoma of the sigmoid colon: report of a case. Dis Colon Rectum. 1976 Jul 1;19(5):441-4. doi: 10.1007/BF02590830, PMID 939159.
Wang WC, Lee MS, Ko JL, Lai YC. Origin of uterine teratoma differs from that of ovarian teratoma: a case of uterine mature cystic teratoma. Int J Gynecol Pathol. 2011 Nov 1;30(6):544-8. doi: 10.1097/PGP.0b013e31821c3205, PMID 21979590.
Caruso PA, Marsh MR, Minkowitz S, Karten G. An intense clinicopathologic study of 305 teratomas of the ovary. Cancer. 1971 Feb;27(2):343-8. doi: 10.1002/1097-0142(197102)27:2<343::aid-cncr2820270215>3.0.co;2-b, PMID 5100397.
Saba L, Guerriero S, Sulcis R, Virgilio B, Melis G, Mallarini G. Mature and immature ovarian teratomas: CT, US and MR imaging characteristics. Eur J Radiol. 2009 Dec 1;72(3):454-63. doi: 10.1016/j.ejrad.2008.07.044, PMID 18804932.
Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A. Mature cystic teratomas of the ovary: case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol. 2000 Feb 1;88(2):153-7. doi: 10.1016/s0301-2115(99)00141-4, PMID 10690674.
Goudeli C, Varytimiadi A, Koufopoulos N, Syrios J, Terzakis E. An ovarian mature cystic teratoma evolving in squamous cell carcinoma: A case report and review of the literature. Gynecol Oncol Rep. 2017 Feb 1;19:27-30. doi: 10.1016/j.gore.2016.12.005, PMID 28050596.
Gadducci A, Giuliani D, Cosio S, Lissoni A, Ferrero AM, Landoni F. Clinical outcome of patients with malignant tumors associated with mature cystic teratomas of the ovary: a retrospective multicenter Italian study. Anticancer Res. 2019 May 1;39(5):2513-7. doi: 10.21873/anticanres.13372, PMID 31092447.
Rathore R, Sharma S, Arora D. Clinicopathological evaluation of 223 cases of mature cystic teratoma, ovary: 25-year experience in a single tertiary care centre in India. J Clin Diagn Res. 2017 Apr;11(4):EC11-4. doi: 10.7860/JCDR/2017/23909.9612, PMID 28571142.
Anteby EY, Ron M, Revel A, Shimonovitz S, Ariel I, Hurwitz A. Germ cell tumors of the ovary arising after dermoid cyst resection: a long-term follow-up study. Obstet Gynecol. 1994 Apr 1;83(4):605-8. doi: 10.1097/00006250-199404000-00021, PMID 8134074.
Sinha A, Ewies AA. Ovarian mature cystic teratoma: challenges of surgical management. Obstet Gynecol Int. 2016 Mar 24;2016:2390178. doi: 10.1155/2016/2390178, PMID 27110246.
Ganer Herman H, Sagiv R, Raphaeli H, Kerner R, Keidar R, Bar J et al. Surgical treatment of mature cystic teratomas: A comparison of emergent and elective surgeries. J Obstet Gynaecol Res. 2017 Jan;43(1):190-5. doi: 10.1111/jog.13190, PMID 27935160.
Ahmed A, Lotfollahzadeh S. Cystic teratoma. InStatPearls. 2022 Jun 3. StatPearlsPublishing.
Dos Santos L, Mok E, Iasonos A, Park K, Soslow RA, Aghajanian C et al. Squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case series and review of the literature. Gynecol Oncol. 2007 May 1;105(2):321-4. doi: 10.1016/j.ygyno.2006.12.008, PMID 17240432.
Templeman CL, Fallat ME, Lam AM, Perlman SE, Hertweck SP, O’Connor DM. Managing mature cystic teratomas of the ovary. Obstet Gynecol Surv. 2000 Dec 1;55(12):738-45. doi: 10.1097/00006254-200012000-00004, PMID 11128910.
Tehranian A, Ghahghaei-Nezamabadi A, Seifollahi A, Kasraei S, Dehghani-Nejad H, Maleki-Hajiagha A. Ovarian mature cystic teratoma with malignant transformation: two case reports. J Med Case Rep. 2021 Dec;15(1):23. doi: 10.1186/s13256-020-02594-4, PMID 33499917.
Rathore R, Sharma S, Agarwal S. Malignant transformation in mature cystic teratoma of the ovary: a retrospective study of eight cases and review of literature. Prz Menopauzalny. 2018 Jun 30;17(2):63-8. doi: 10.5114/pm.2018.77304, PMID 30150913.
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