Mucinous Adenocarcinoma Transformation in Ovarian Mature Cystic Teratoma Complicating Pregnancy: A Case Report
Abstract
Most adnexal masses found in pregnancy are simple benign cysts less than 5 cm in diameter. On the other hand, the majority of persistent adnexal masses 5 cm or greater in diameter are mature teratomas. Malignant transformation occurs in 0.2 to 2 percent of mature teratomas, and squamous cell carcinoma arising from ectoderm is the most common secondary neoplasm. The mucinous cystadenocarcinoma transformation is very rare. We presented a 38-year-old G2Ab1 woman at 32 weeks of gestation with a huge, rapid growth adnexal mass who came to our emergency department due to severe preeclampsia, stage 1 of IUGR, and borderline AFI. After 48 hours of expectant management, a cesarean section associated with unilateral salpingo-oophorectomy was done, and the histopathology of the cyst revealed mature teratoma that was focally involved with mucinous cystadenocarcinoma. The complete surgical staging was done, and due to the stage of disease (1C1), she received adjuvant chemotherapy, and she has remained disease-free in her last follow up after one year.
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6. Hackethal A, Brueggmann D, Bohlmann MK, Franke FE, Tinneberg HR, Münstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. Lancet Oncol 2008;9:1173-80.
7. 7. Westhoff C, Pike M, Vessey M. Benign ovarian teratomas: a population-based case-control study. Br J Cancer 1988;58:93-8.
8. Comerci JT, Jr., Licciardi F, Bergh PA, Gregori C, Breen JL. Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol 1994;84:22-8.
9. Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A. Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary. Singapore Med J 1988;29:30-4.
10. 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;105:321-4.
11. Palmer J, Vatish M, Tidy J. Epithelial ovarian cancer in pregnancy: a review of the literature. BJOG 2009;116:480-91.
12. Giuntoli RL, 2nd, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol 2006;49:492-505.
13. Machado F, Vegas C, Leon J, Perez A, Sanchez R, Parrilla JJ, et al. Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol 2007;105:446-50.
14. Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, et al. Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature. Int J Gynecol Cancer 2006;16:379-84.
15. Mayer C, Miller DM, Ehlen TG. Peritoneal implantation of squamous cell carcinoma following rupture of a dermoid cyst during laparoscopic removal. Gynecol Oncol 2002;84:180-3.
16. Sarandakou A, Protonotariou E, Rizos D. Tumor markers in biological fluids associated with pregnancy. Crit Rev Clin Lab Sci 2007;44:151-78.
17. Elit L, Bocking A, Kenyon C, Natale R. An endodermal sinus tumor diagnosed in pregnancy: case report and review of the literature. Gynecol Oncol1999;72:123-7.
18. Sainz de la Cuesta R, Goff BA, Fuller AF, Jr., Nikrui N, Eichhorn JH, Rice LW. Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms. Obstet Gynecol 1994;84:897.
19. Bakkum-Gamez JN, Richardson DL, Seamon LG, Aletti GD, Powless CA, Keeney GL, et al. Influence of intraoperative capsule rupture on outcomes in stage I epithelial ovarian cancer. Obstet Gynecol 2009;113:11-7.
20. Kim HS, Ahn JH, Chung HH, Kim JW, Park NH, Song YS, et al. Impact of intraoperative rupture of the ovarian capsule on prognosis in patients with early-stage epithelial ovarian cancer: a meta-analysis. Eur J Surg Oncol 2013;39:279-89.
2. Webb KE, Sakhel K, Chauhan SP, Abuhamad AZ. Adnexal mass during pregnancy: a review. Am J Perinatol 2015;32:1010-6.
3. Aggarwal P, Kehoe S. Ovarian tumours in pregnancy: a literature review. Eur J Obstet Gynecol Reprod Biol 2011;155:119-24.
4. Smith LH, Dalrymple JL, Leiserowitz GS, Danielsen B, Gilbert WM. Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997. Am J Obstet Gynecol 2001;184:1504-12.
5. Ulker V, Gedikbasi A, Numanoglu C, Ozluk Y, Saygi S, Gulkilik A, et al. Mucinous adenocarcinoma arising in ovarian mature cystic teratoma in pregnancy. Arch Gynecol Obstet 2009;280:287-91.
6. Hackethal A, Brueggmann D, Bohlmann MK, Franke FE, Tinneberg HR, Münstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. Lancet Oncol 2008;9:1173-80.
7. 7. Westhoff C, Pike M, Vessey M. Benign ovarian teratomas: a population-based case-control study. Br J Cancer 1988;58:93-8.
8. Comerci JT, Jr., Licciardi F, Bergh PA, Gregori C, Breen JL. Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol 1994;84:22-8.
9. Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A. Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary. Singapore Med J 1988;29:30-4.
10. 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;105:321-4.
11. Palmer J, Vatish M, Tidy J. Epithelial ovarian cancer in pregnancy: a review of the literature. BJOG 2009;116:480-91.
12. Giuntoli RL, 2nd, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol 2006;49:492-505.
13. Machado F, Vegas C, Leon J, Perez A, Sanchez R, Parrilla JJ, et al. Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol 2007;105:446-50.
14. Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, et al. Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature. Int J Gynecol Cancer 2006;16:379-84.
15. Mayer C, Miller DM, Ehlen TG. Peritoneal implantation of squamous cell carcinoma following rupture of a dermoid cyst during laparoscopic removal. Gynecol Oncol 2002;84:180-3.
16. Sarandakou A, Protonotariou E, Rizos D. Tumor markers in biological fluids associated with pregnancy. Crit Rev Clin Lab Sci 2007;44:151-78.
17. Elit L, Bocking A, Kenyon C, Natale R. An endodermal sinus tumor diagnosed in pregnancy: case report and review of the literature. Gynecol Oncol1999;72:123-7.
18. Sainz de la Cuesta R, Goff BA, Fuller AF, Jr., Nikrui N, Eichhorn JH, Rice LW. Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms. Obstet Gynecol 1994;84:897.
19. Bakkum-Gamez JN, Richardson DL, Seamon LG, Aletti GD, Powless CA, Keeney GL, et al. Influence of intraoperative capsule rupture on outcomes in stage I epithelial ovarian cancer. Obstet Gynecol 2009;113:11-7.
20. Kim HS, Ahn JH, Chung HH, Kim JW, Park NH, Song YS, et al. Impact of intraoperative rupture of the ovarian capsule on prognosis in patients with early-stage epithelial ovarian cancer: a meta-analysis. Eur J Surg Oncol 2013;39:279-89.
| Files | ||
| Issue | Vol 59, No 2 (2021) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/acta.v59i2.5579 | |
| Keywords | ||
| Mature teratoma Adnexal mass in pregnancy Ovarian tumor Mucinous cystadenocarcinoma Malignant transformation Dermoid cyst | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Abbasi H, Mohammadi S, Moridi A, Behforouz A. Mucinous Adenocarcinoma Transformation in Ovarian Mature Cystic Teratoma Complicating Pregnancy: A Case Report. Acta Med Iran. 2021;59(2):118-121.
