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

Abstract

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.

Mature cystic teratoma of the uterus presenting as an endometrial polyp in a patient with a history of ovarian mature cystic teratoma with gliomatosis peritonei and ovarian endometriosis: a case report

“…To date, eight case reports describe the association be-tween GP and endometriosis [16,18,[25][26][27][28][29][30]. Six cases were associated with immature teratoma, while the remaining cases involved a mature teratoma as in the present case.…”

Peritoneal gliomatosis: a case report

“…3 The spread of GP to lymph nodes has been documented as well as the coexistence with endometriosis. 4 In the CT are observed as multiple peritoneal nodules of variable size or omental cake. During surgery, the macroscopic appearance is similarly to carcinomatosis, peritoneal tuberculosis, endometriosis, ectopic decidua, peritoneal leiomyomatosis.…”

Gliomatosis peritonei: a series of eight cases and review of the literature

“…In some reports, GP was only found in the second surgery (as in case 4 in the present study). Kim et al reviewed about 100 cases in the literature and found 9 cases of nodal gliomatosis in the pelvic or para-aortic lymph nodes with or without the presence of GP [ 6 ]. However, in their literature review, there were three cases of nodal gliomatosis presented as grades 1 to 3.…”

“…Presence of glial tissue in lymph nodes is rare. Thus far, 14 cases have been reported in nine articles [ 6 , 8 , 13 – 18 ] (Table 2 ). Based on previous reports, adjuvant chemotherapy is unnecessary for patients with retroperitoneal lymph node metastasis of mature glial tissue.…”