A case of mature cystic teratoma with intestinal structures harboring intestinal-type low-grade mucinous neoplasm

Abstract

The formation of gastrointestinal-type epithelium is found in 7-13% of mature cystic teratomas, which are the most common germ cell tumors of the ovary. Few cases harboring organized gastrointestinal tract formation have been reported, and a mucinous neoplasm arising in them is further rare. Here, we report a case of an ovarian mature cystic teratoma with intestinal structures harboring intestinal-type mucinous neoplasm, mimicking low-grade appendiceal mucinous cystadenoma. A 66-year-old female, with remarkably increased serum carcinoembryonic antigen (CEA) level, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy due to the ovarian tumor. The immunoprofile of the tumor showed CK7−/ CK20+. We review the past literatures, and then consider that the existence of mucinous neoplasm should be kept in mind if we find elevated level of serum CEA and the organized gastrointestinal development in an ovary. The immunoprofile of CK7/CK20 is useful to determine the origin of mucinous tumors associated with mature cystic teratomas.

Ovarian Mature Cystic Teratoma Combined with Mucinous Boderline Tumor-A Case Report with Literature Review

“…In our case, the mucous epithelium was benign, and the junction and canceration were visible. Additionally, CK20 was strongly positive, whereas CK7 was focally positive immunohistochemically, which was consistent with the findings of Takao M et al 7 The vast majority of primary ovarian mucinous tumors originate from surface epithelial-mesenchymal sources, whereas mature ovarian cystic teratomas derive from primordial germ cells. However, the relationship between the two types is still unclear.…”

A Case of Mature Ovarian Teratoma harbouring Intestine

“…In most of them the tumor size was less than 10 cm which in our case was also 10 cm. CEA can be an important marker for predicting presence of intestinal epithelium and to be vigilant for malignant intestinal cancers which was also raised in our case [12,13]. Well differentiated mature neuronal component showed FDG activity misleading the diagnosis as also found in our case [14].…”

Mature cystic teratoma of the ovary with a grossly visible, completely developed intestinal loop: A case report and review of the literature

“…[3] Gastrointestinal adenocarcinomas secondary to MCTO most often exhibit diffuse expression of CK20 as well as negative expression of CK7. [14] It has also been documented that CDX-2, choriocapillaris and CK-20 were strongly positive and CK-7 was negative as its characteristic. [15]…”