Ovarian neuroblastoma due to malignant transformation of mature cystic teratoma: A clinicopathologic and immunohistologic analysis.

Abstract

Ovarian neuroblastoma due to malignant transformation of mature cystic teratoma: A clinicopathologic and immunohistologic analysis

Two cases of primary ovarian neuroblastoma arising from mature cystic teratomas

“…Only a few reports of primary ovarian neuroblastoma have been reported worldwide. Although it is commonly known that malignancy occurs in 0.3–4.8% of mature cystic teratomas of the ovary ( Mori et al, 2003 ), neurobalstomas arising from mature cystic teratomas are extremely rare, as we found only 4 cases published in the literature since 1982 ( Reid et al, 1983; Kleinman et al, 1993; Kiyozuka et al, 1994; Muhlstein et al, 2010 ). Almost all ovarian neuroblastomas have very poor prognoses; however, we performed intensive treatment with a combination of surgery and chemotherapy and found no occurrence of relapse in two cases.…”

“…These data suggest that malignant transformation may arise from mature cystic teratomas after an average of 10 years. On the other hand, Kiyozuka et al (1994) reported that the average age of patients with primary ovarian neuroblastomas was 23.4 years, which was younger than those with common malignant transformations. Interestingly, neuroblastomas are common in infants and children, as the mean age at diagnosis is 2 years, and 90% cases occur before the age of 5 years.…”

“…Neuroblastomas can arise anywhere throughout the sympathetic nervous system, although the adrenal glands are the most common primary site. There have been only 9 cases of primary ovarian neuroblastoma reported worldwide since 1982 ( Reid et al, 1983; Kleinman et al, 1993; Kiyozuka et al, 1994; Muhlstein et al, 2010; Aguirre and Scully, 1982; Block et al, 1984; Lawlor et al, 1997 ).…”

“…Thus, we suggest intensive treatment consisting of a combination of surgery and intravenous chemotherapy of cisplatin (20 mg/m 2 on days 1–5) and etoposide (100 mg/m 2 on days 1–5) once every 3 weeks for a total of 6 courses. As a treatment basis, Kiyozuka et al (1994) reported this same regimen and recommended these agents as key drugs against childhood neuroblastoma. Dose reduction was necessary to protect renal function in case 2, and there was no major side effects, except for grade 2 myelosuppression in both patients, who are alive and present no evidence of relapse.…”