Case Report
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Multiple ve Bilateral Matür Kistik Teratom: Nadir Bir Olgu Sunumu

Year 2023, Issue: 19, 327 - 333, 29.04.2023
https://doi.org/10.38079/igusabder.878988

Abstract

Genç ve orta yaşlı kadınlarda en sık görülen iyi huylu over tümörleri, matür teratomlardır (dermoid kistler). Matür teratomların bilateralizm oranı %10'dur. Matür teratomların sağ ve sol overlerde görülme sıklığı eşittir ve malign dönüşüm olguların %1-3'ünde gözlenir. Sonografik incelemede, matür kistik teratomlar yağ ve kalsifikasyon alanlarının görüldüğü kistik, katı veya heterojen kitle olarak görülür. Makroskopik olarak, olguların %90'ında yağ alanları ve %50'sinde kalsifikasyon alanları gözlenir. 28 yaşındaki bir bekâr kadın hastamız, her iki adneksal bölgede ağrı şikayeti ile başvurdu. Tümör belirteçleri normal olarak saptandı. Yan yana sağ over parankiminde 65x47 mm boyutunda kompleks bir kitle ve yan yana sol over parankiminde 44x41 mm boyutunda kompleks bir kitle görüldü. Ancak ameliyat sırasında palpasyon yapıldığında, bu kistin yanında iki tane daha teratom olduğu görüldü. Hem bilateral hem de çoklu matür teratomlar nadir görüldüğü için olgumuzu sunmaya karar verdik.

References

  • Damjanov I, Linder J, Anderson WAD. Anderson's Pathology. Vol. 2. Mosby, 1996.
  • Comerci JT, Licciardi F, Berghi PA, Gregori C, Breen JL. Mature cystic teratoma: A clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol. 1994;84:22–28.
  • Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A. Mature cystic teratomas of the ovary: Case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol. 2000;88:153-7.
  • Sakuma M, Otsuki T, Yoshinaga K, et al. Malignant transformation arising from mature cystic teratoma of the ovary: A retrospective study of 20 cases. Int J Gynecol Cancer. 2010;20:766-71.
  • Kim I, Lee JY, Kwon JH, et al. A case of autoimmune haemolytic anemia associated with an ovarian teratoma. J Korean Med Sci. 2006;21:365–367.
  • Bonilla-Musoles F, Cadete C, Raga F, Bonilla F Jr, Osborne NG, Caballero O. HDLive ultrasound images of ovarian dermoid cysts: diagnostic accuracy. Clin Exp Obstet Gynecol. 2016;43(1):16-24.
  • Ozgur T, Atik E, Silfeler DB, Toprak S. Mature cystic teratomas in our series with review of the literature and retrospective analysis. Arch Gynecol Obstet. 2012;285(4):1099-1101.
  • Shi X-X, Shen H, Chen T, et al. Mature cystic teratoma of the ovary with three kinds of entire gastrointestinal wall and complete bronchial structure in a pregnant woman. Int J Surg Pathol. 2016;24(5):428-430.
  • Vortmeyer AO, Devouassoux-Shisheboran M, Li G, Mohr V, Tavassoli F, Zhuang Z. Microdissection-based analysis of mature ovarian teratoma. Am J Pathol. 1999;154(4):987-991.
  • Al-Fozan H, Glassman J, Caspi B, Appelman Z, Tulandi T. Lateral distribution of ovarian dermoid cyst. J Am Assoc Gynecol Laparosc. 2003;10:489–90.
  • Sinha R, Sunduram M, Lakhotia S. Multiple intraabdominal parasitic cystic teratomas. J Minim Invasive Gynecol. 2009;16:789–791.
  • Tokunaga M, Seta M, Yamada M, Nishio M, Yamamoto K, Koyasu Y. Coexistent dermoid cysts of the pouch of the Douglas and ovary resected by laparoscopy. Asian J Endosc Surg. 2012;5:31–33.
  • Moawad NS, Starks D, Ashby K. Ectopic ovarian teratoma of the uterosacral ligament associated with a large ovarian dermoid. J Minim Invasive Gynecol. 2008;15:523–524.
  • Pepe F, Lo Monaco S, Rapisarda F, Raciti G, Genovese C, Pepe P. An unusual case of multiple and bilateral ovarian dermoid cysts. Case report. G Chir. 2014;35(3-4):75–77.
  • Sinha R, Sethi S, Mahajan C, Bindra V. Multiple and bilateral dermoids: A case report. J Minim Invasive Gynecol. 2010;17:235–38.
  • Bournas N, Varras M, Kassanos D, Chrelias Ch, Tzaida O, Salamalekis E. Multiple dermoid cysts within the same ovary: Our experience of a rare case with review of the literature. Clin Exp Obstet Gynecol. 2004;31:305–8.
  • Walid MS, Boddy MG. Bilateral dermoid cysts of the ovary in a pregnant woman: Case report and review of the literature. Arch Gynecol Obstet. 2009;279:105–8.
  • Chen JM, Gao HY, Wang Q, Li Q. Expression and clinical significance of tumor markers in ovarian mature cystic teratoma. Clin Exp Obstet Gynecol. 2016;43(3):397-400.
  • Seracchioli R, Venturoli S, Colombo FM, Govoni F, Missiroli S, Bagnoli A. Fertility and tumor recurrence rate after conservative laparoscopic management of young women with early-stage borderline ovarian tumors. Fertil Steril. 2001;76(5):999-1004.
  • Laberge PY, Levesque S. Short-term morbidity and long-term recurrence rate of ovarian dermoid cysts treated by laparoscopy versus laparotomy. J Obstet Gynaecol Can. 2006;28(9):789-793.
  • Harada M, Osuga Y, Fujimoto A, et al. Predictive factors for recurrence of ovarian mature cystic teratomas after surgical excision. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):325-328.
  • Song YN, Zhu L, Lang JH. Recurrent mature ovarian teratomas: retrospective analysis of 20 cases. Zhonghua Yi Xue Za Zhi. 2007;87:1184–1186.
  • El-Agwany AS, Moneim ASA. Multiple bilateral huge synchronous ovarian mature cystic teratomas: A rarely encountered condition in practice. The Egyptian Journal of Radiology and Nuclear Medicine. 2015;46(1):195-197.

Multiple and Bilateral Mature Cystic Teratoma: A Rare Case Report

Year 2023, Issue: 19, 327 - 333, 29.04.2023
https://doi.org/10.38079/igusabder.878988

Abstract

Mature teratomas, also known as dermoid cysts, are the most commonly occurring benign ovarian tumors in young and middle-aged women. Bilateral occurrence of mature teratomas is observed in 10% of cases. The incidence rate of mature teratomas is equal in both the right and left ovaries, and malignant transformation is observed in 1-3% of cases. At sonographic examination, mature cystic teratomas appear as cystic, solid, or heterogeneous masses containing areas of fat and calcification. Macroscopically, areas of fat are observed in 90% of cases, while areas of calcification are observed in 50% of them. In our presented case, a 28-year-old virgin female patient complained of pain in both adnexal regions, and tumor markers were found to be normal. During imaging, a complex mass measuring 65x47 mm was observed in the adjacent right ovarian parenchyma, and a complex mass measuring 44x41 mm was observed in the adjacent left ovarian parenchyma. However, during surgery, it was discovered that there were two additional teratomas adjacent to the cyst. Given that the presence of both bilateral and multiple mature teratomas is rare, decided to present this case.

References

  • Damjanov I, Linder J, Anderson WAD. Anderson's Pathology. Vol. 2. Mosby, 1996.
  • Comerci JT, Licciardi F, Berghi PA, Gregori C, Breen JL. Mature cystic teratoma: A clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol. 1994;84:22–28.
  • Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A. Mature cystic teratomas of the ovary: Case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol. 2000;88:153-7.
  • Sakuma M, Otsuki T, Yoshinaga K, et al. Malignant transformation arising from mature cystic teratoma of the ovary: A retrospective study of 20 cases. Int J Gynecol Cancer. 2010;20:766-71.
  • Kim I, Lee JY, Kwon JH, et al. A case of autoimmune haemolytic anemia associated with an ovarian teratoma. J Korean Med Sci. 2006;21:365–367.
  • Bonilla-Musoles F, Cadete C, Raga F, Bonilla F Jr, Osborne NG, Caballero O. HDLive ultrasound images of ovarian dermoid cysts: diagnostic accuracy. Clin Exp Obstet Gynecol. 2016;43(1):16-24.
  • Ozgur T, Atik E, Silfeler DB, Toprak S. Mature cystic teratomas in our series with review of the literature and retrospective analysis. Arch Gynecol Obstet. 2012;285(4):1099-1101.
  • Shi X-X, Shen H, Chen T, et al. Mature cystic teratoma of the ovary with three kinds of entire gastrointestinal wall and complete bronchial structure in a pregnant woman. Int J Surg Pathol. 2016;24(5):428-430.
  • Vortmeyer AO, Devouassoux-Shisheboran M, Li G, Mohr V, Tavassoli F, Zhuang Z. Microdissection-based analysis of mature ovarian teratoma. Am J Pathol. 1999;154(4):987-991.
  • Al-Fozan H, Glassman J, Caspi B, Appelman Z, Tulandi T. Lateral distribution of ovarian dermoid cyst. J Am Assoc Gynecol Laparosc. 2003;10:489–90.
  • Sinha R, Sunduram M, Lakhotia S. Multiple intraabdominal parasitic cystic teratomas. J Minim Invasive Gynecol. 2009;16:789–791.
  • Tokunaga M, Seta M, Yamada M, Nishio M, Yamamoto K, Koyasu Y. Coexistent dermoid cysts of the pouch of the Douglas and ovary resected by laparoscopy. Asian J Endosc Surg. 2012;5:31–33.
  • Moawad NS, Starks D, Ashby K. Ectopic ovarian teratoma of the uterosacral ligament associated with a large ovarian dermoid. J Minim Invasive Gynecol. 2008;15:523–524.
  • Pepe F, Lo Monaco S, Rapisarda F, Raciti G, Genovese C, Pepe P. An unusual case of multiple and bilateral ovarian dermoid cysts. Case report. G Chir. 2014;35(3-4):75–77.
  • Sinha R, Sethi S, Mahajan C, Bindra V. Multiple and bilateral dermoids: A case report. J Minim Invasive Gynecol. 2010;17:235–38.
  • Bournas N, Varras M, Kassanos D, Chrelias Ch, Tzaida O, Salamalekis E. Multiple dermoid cysts within the same ovary: Our experience of a rare case with review of the literature. Clin Exp Obstet Gynecol. 2004;31:305–8.
  • Walid MS, Boddy MG. Bilateral dermoid cysts of the ovary in a pregnant woman: Case report and review of the literature. Arch Gynecol Obstet. 2009;279:105–8.
  • Chen JM, Gao HY, Wang Q, Li Q. Expression and clinical significance of tumor markers in ovarian mature cystic teratoma. Clin Exp Obstet Gynecol. 2016;43(3):397-400.
  • Seracchioli R, Venturoli S, Colombo FM, Govoni F, Missiroli S, Bagnoli A. Fertility and tumor recurrence rate after conservative laparoscopic management of young women with early-stage borderline ovarian tumors. Fertil Steril. 2001;76(5):999-1004.
  • Laberge PY, Levesque S. Short-term morbidity and long-term recurrence rate of ovarian dermoid cysts treated by laparoscopy versus laparotomy. J Obstet Gynaecol Can. 2006;28(9):789-793.
  • Harada M, Osuga Y, Fujimoto A, et al. Predictive factors for recurrence of ovarian mature cystic teratomas after surgical excision. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):325-328.
  • Song YN, Zhu L, Lang JH. Recurrent mature ovarian teratomas: retrospective analysis of 20 cases. Zhonghua Yi Xue Za Zhi. 2007;87:1184–1186.
  • El-Agwany AS, Moneim ASA. Multiple bilateral huge synchronous ovarian mature cystic teratomas: A rarely encountered condition in practice. The Egyptian Journal of Radiology and Nuclear Medicine. 2015;46(1):195-197.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Cases
Authors

Eser Ağar 0000-0002-3364-799X

Early Pub Date April 29, 2023
Publication Date April 29, 2023
Acceptance Date March 9, 2023
Published in Issue Year 2023 Issue: 19

Cite

JAMA Ağar E. Multiple and Bilateral Mature Cystic Teratoma: A Rare Case Report. IGUSABDER. 2023;:327–333.

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