Immature Ovarian Teratoma with Mature Peritoneal Metastatic Deposits Showing Glial, Epithelial, and Endometrioid Differentiation: A Case Report and Review of the Literature

Calder, Caroline; Light, A M; Rollason, T. P.

doi:10.1097/00004347-199407000-00013

Cited by 23 publications

(13 citation statements)

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“…3,7,8,21,22 Moreover, cystic peritoneal masses composed of tissue from all three germ layers (including immature neural elements) have been described in addition to small glial foci in some cases of GP, suggesting that the former are true metastases. 2,3,6,7 It remains unclear whether these metastases arise through the same or different mechanism as the foci of mature glial tissue observed in typical GP.…”

Section: Discussionmentioning

confidence: 99%

“…This hypothesis is based on the observation that many gynecological diseases seem to have a multifocal intraperitoneal origin and is further supported by reports of glial implants admixed with endometrial tissue. 2,3,4,23 Endometrial tissue is Mü llerian in origin and is uncommon in teratomas. Given that we analyzed only two cases of GP and a limited number of implants, it is possible that some glial foci result from true implantation, whereas others arise via metaplasia of normal stem cells within the peritoneum.…”

Section: Discussionmentioning

confidence: 99%

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Glial Implants in Gliomatosis Peritonei Arise from Normal Tissue, Not from the Associated Teratoma

Ferguson

Katabuchi

Ronnett

et al. 2001

The American Journal of Pathology

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Metaplasia of subcoelomic mesenchyme has been implicated, but not proven, in the pathogenesis of common gynecological diseases such as endometriosis and rarer entities such as leiomyomatosis peritonealis disseminata and gliomatosis peritonei (GP). GP is associated with ovarian teratomas and is characterized by numerous peritoneal and omental implants composed of glial tissue. Two theories to explain the origin of GP have been proposed. In one, glial implants arise from the teratoma, whereas in the other, pluripotent Müllerian stem cells in the peritoneum or subjacent mesenchyme undergo glial metaplasia. To address the origin of GP, we exploited a unique characteristic of many ovarian teratomas: they often contain a duplicated set of maternal chromosomes and are thus homozygous at polymorphic microsatellite (MS) loci. In contrast, DNA from matched normal or metaplastic tissue (containing genetic material of both maternal and paternal origin) is expected to show heterozygosity at many of these same MS loci. DNA samples extracted from paraffin-embedded normal tissue, ovarian teratoma and three individual laser-dissected glial implants were studied in two cases of GP. In one case, all three implants and normal tissue showed heterozygosity at each of three MS loci on different chromosomes, whereas the teratoma showed homozygosity at the same MS loci. Similar results were observed in the second case.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glial Implants in Gliomatosis Peritonei Arise from Normal Tissue, Not from the Associated Teratoma

Ferguson

Katabuchi

Ronnett

et al. 2001

The American Journal of Pathology

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“…Strong expression of GFAP suggests that tumor cells are mature and often well-differentiated. 11 The mature nature of implants generally implies a favorable prognosis, even in patients with IMT. The presence of GP does not modify the prognosis, and treatment of the patient is warranted per grade and stage of IMT.…”

Section: Discussionmentioning

confidence: 99%

Giant Immature Teratoma of the Ovary with Gliomatosis Peritonei in a 15-Year-Old Girl: A Case Report and Literature Review

KumarAwanindra

GoyalPrashant

SehgalShelly

et al. 2014

Journal of Gynecologic Surgery

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Background: Ovarian immature teratoma (IMT) with gliomatosis peritonei (GP) is a rare condition. IMT of the ovary represents 1% of all ovarian cancers. The majority of these are 5-31 cm in diameter. This article describes a case of a giant IMT (22.8 kg) in a girl with GP, which is an extremely rare presentation. Case: A 15-year-old girl presented with abdominal distension and pain of insidious onset. On clinical examination, a huge abdominal mass was found. Contrast-enhanced computed tomography (CECT) showed a large solid cystic abdominopelvic mass with multiple areas of calcified foci and fat density, likely to be malignant, and of ovarian origin. Serum alpha-fetoprotein (AFP), CA-125, and CA-15.3 were 1805 international units (IU)/mL, 1475 IU/mL, and 69.6 IU/mL, respectively. Left salpingo-oophorectomy with omentectomy was performed and samples were sent for histopathologic examination. Results: Microscopically, the ovary revealed IMT grade I, and the omentum showed an implant of mature glial tissue (GP). The patient had no complications at her 6-month follow-up. Conclusions: This is the first reported case of IMT of such massive size, with GP. This case demonstrates that IMT can grow to an enormous size (weighing >20 kg) and should be considered whenever gross abdominal distension is seen in young women. With peritoneal implants suspected to be of a teratomatous nature, thorough and extensive sampling is essential to exclude the presence of immature elements that may imply a poor prognosis and require aggressive therapy. ( J GYNECOL SURG 30:222)

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“…The pathogenesis of endometriosis and GP may be shared. Originally, the presence of GP indicated that these lesions were shared by implantation metastases of an ovarian teratomatous tumor with varying maturation 7,10-12. Metaplasia of pluripotent coelomic or Mullerian stem cells has also been suggested, but the most scientifically supported and widely accepted mechanism of endometriosis is retrograde effluent flow through the lumen of the fallopian tubes into the pelvic-peritoneal cavities during menstruation 9.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review

et al. 2013

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Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

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Immature Ovarian Teratoma with Mature Peritoneal Metastatic Deposits Showing Glial, Epithelial, and Endometrioid Differentiation: A Case Report and Review of the Literature

Cited by 23 publications

References 0 publications

Glial Implants in Gliomatosis Peritonei Arise from Normal Tissue, Not from the Associated Teratoma

Glial Implants in Gliomatosis Peritonei Arise from Normal Tissue, Not from the Associated Teratoma

Giant Immature Teratoma of the Ovary with Gliomatosis Peritonei in a 15-Year-Old Girl: A Case Report and Literature Review

Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review

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