Pulmonary papillary proliferation within a mature cystic teratoma of the ovary: a rare case report and review of literature

Background: Mature cystic teratomas are the most common germ cell tumors of the ovary. Both malignant and benign tumors may arise inside mature teratomas. Only 42 cases of pulmonary papillary adenomas are described in the literature, with only two cases of pulmonary papillary adenoma inside a mature cystic teratoma of the ovary. Case Report: This case report highlights the presence of a pulmonary papillary adenoma in a mature cystic teratoma of the ovary in a 28-year-old woman, which is the third case documented in the literature. This report also includes a review of the literature discussing its histomorphological and immunohistochemical features. Conclusion: Pulmonary papillary adenomas within ovarian mature cystic teratomas represent an exceedingly rare phenomenon warranting further research

Ovarian teratoma in the mare: a review and two cases

A 4-year-old Belgian Warmblood mare suffering from pelvic flexure impaction was diagnosed with a teratoma of the left ovary. The enlarged ovary was identified several days after treatment of the impaction. Surgical removal of the affected ovary was performed and histo pathological examination confirmed the presence of a teratoma. The features of another ovarian teratoma, which was an accidental finding at slaughter, are also described

Struma Ovarii Associated with Pseudo- Meigs’Syndrome

Struma ovarii is a specialized ovarian teratoma composed predominantly of mature thyroid tissue. It is associated with pleural effusion and ascites (Pseudo-Meigs’ syndrome) in 5% of cases. Majorities of the strumas are benign, however occasionally malignant transformation may be seen. We report a case of a 45 years old postmenopausal woman who presented with gradually increasing dyspnoea and distention of abdomen of five months duration. USG abdomen revealed a bulky right ovary with a solid and cystic components and ascites. Her chest X-ray showed bilateral pleural effusion. Hence, clinical diagnosis of malignant ovarian tumor was kept; however, both the ascetic & pleural fluids were cytologically negative for malignant cells. The patient was operated forhysterectomy with bilateral salpingo-ophorectomy. The histopathological examination of the ovarian mass confirmed the diagnosis of struma ovarii. Postsurgical follow up of patient showed spontaneous regression of pleural effusion and ascites. The coexistence of an ovarian tumor, ascites and bilateral pleural effusion that resolves spontaneously on resection of the ovarian mass is known as pseudo-Meigs’ syndrome. Patient with pseudo-Meigs’ syndrome may present a diagnostic problem as they masquerade as carcinoma with malignant effusions. In addition, the coexistence of struma ovarii and pseudo-Meigs’ syndrome is a very rare event

Co‐existing monophasic teratoma and uterine adenocarcinoma in a female dog

Ovarian teratomas are occasionally reported in dogs; the rarest type is the monophasic teratoma,composed of tissues originating from only one germ layer. Canine endometrial adenocarcinomas are also rare in dogs and mainly affect geriatric females. This report describes case of co-existing ovarian teratoma and uterine adenocarcinoma in a 10-year old nulliparous female Boxer presented with lethargy, anorexia and purulent vaginal discharge. Abdominal ultrasonography evidenced pyometra and a mass in the left ovary. This was composed of a uniform whitish tissue with multiple cystic structures. The histology revealed an atrophy of the ovarian parenchyma, compressed by a proliferation of well-differentiated nervous tissue staining positively to vimentin, S100 and neuronal specific enolase (NSE), and negatively to keratin and inhibin. The left uterine horn, whose diameter was markedly increased, showed foci of endometrial cellular atypia, evident nucleoli and mitoses, at light microscopy. To our best knowledge, this is the first report of a coexisting ovarian monophasic teratoma and endometrial adenocarcinoma, two rare reproductive neoplasia in dogs

The enigma of struma ovarii

Since its first description in the early part of the twentieth century, struma ovarii has elicited considerable interest because of its many unique features; however, at present a number of aspects remain enigmatic. Although the typical presentation is that of a pelvic mass, unusual clinical manifestations such as hyperthyroidism, ascites, and Meigs\u27 syndrome have been recognised. Uncommon macroscopic and especially histological patterns in struma can cause difficulties in diagnosis. Cystic strumas are challenging to diagnose both macroscopically and histologically. Proliferative changes within struma can be misdiagnosed as cancer. In regard to the occurrence of thyroid-type carcinoma in struma ovarii, precise terminology should be utilised, and the term \u27malignant struma ovarii\u27 should be avoided because it has been used for several different pathological entities. Papillary carcinoma is the most commonly occurring thyroid-type carcinoma in ovarian struma; however, cases of follicular carcinoma are not infrequent. Histological malignancy in struma does not necessarily equate with biological malignancy, and the majority of thyroid-type carcinomas do not spread beyond the ovary. Strumal carcinoid, a neoplasm apparently unique to the ovary containing elements of both struma and carcinoid, has been misdiagnosed as \u27malignant struma ovarii\u27 in the past. The differential diagnosis of extra-ovarian spread of struma includes the usual types of thyroid cancer, minimal deviation follicular carcinoma, and peritoneal strumosis. This review emphasises articles both recent and past that have significantly advanced our knowledge of struma ovarii and related neoplasms

Mixed Adeno and Neuroendocrine Carcinoma of the Ovary: Case Report

Reporting two cases of mixed adenocarcinoma and neuroendocrine carcinoma of the ovary. A case report two cases of an ovarian cyst suspect Malignancy after complete surgical staging in woman aged 39 year old and 72 year old. By this case report, we want to know prognosis of the Malignancy. Mixed adenocarcinoma and neuroendocrine carcinoma of the ovary of the first case arised from mature cystic teratoma, and second case as metastatic process from gastrointestinal tract. Mixed adenocarcinoma and neuroendocrine carcinoma is rare hystologic type of ovarian cancer. Need further exploration to know the survival of this hystologic type

Significant simultaneous changes in serum CA19-9 and CA125 due to prolonged torsion of mature cystic teratoma of the ovary

Mature cystic teratoma is a common benign neoplasm of the ovary. Complications occur in approximately 20% of cases. Clinical manifestations, laboratory findings, and imaging studies can assist in making a diagnosis of ovarian torsion of mature cystic teratoma. Furthermore, serum tumor markers may be helpful for diagnosing mature cystic teratoma and its torsion and, thus, can lead to early surgical intervention. A 56-year-old woman presented with a huge pelvic mass and pelvic pain. Serum CA19-9, CA125, and carcinoembryonic antigen levels were abnormally elevated at >700 U/ml, 282.5 U/ml, and 3.94 U/ml, respectively. The tumor was surrounded by extensive adhesions and showed inflammatory changes. The serum levels of these markers returned to normal levels after surger

De novo primary squamous cell carcinoma of the ovary: A case of a rare malignancy with an aggressive clinical course

Ovarian squamous cell carcinoma is a rare malignancy and the occurrence is attributable to malignant transformation of an existing ovarian dermoid cyst. The de novo occurrence of squamous cell carcinoma of the ovary, in the absence of an antecedent ovarian dermoid, is extremely rare. The case of a 31 year old Asian woman, evaluated for abdominal distension and discomfort is presented. Abdominal CT was suggestive of a malignant neoplastic process. Laparotomy confirmed a malignant tumour with involvement of the right adnexa and extension into the omentum and bowel. Surgical debulking, hysterectomy, bilateral salpingo-ophorectomy and total omentectomy and bowel resection was performed. Histopathology demonstrated squamous cell carcinoma arising from the right ovary with no co-existing ovarian dermoid. The postoperative period was significant for disease progression despite adjuvant chemotherapy

Hypercalcemia Associated with a Malignant Brenner Tumor Arising from a Mature Cystic Teratoma

A 60-year-old woman presented with abdominal pain and weight loss and was found to have serum calcium of 15.0 mg/dl. Serum parathyroid hormone-related peptide (PTHrP) returned elevated. Imaging suggested bilateral mature cystic teratomas. Her hypercalcemia was treated initially with intravenous saline, as well as intramuscular and subcutaneous calcitonin. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, and final pathology revealed malignant Brenner tumor in association with a mature cystic teratoma. Her postoperative PTHrP returned less than assay, and her total and ionized calcium fell below normal, requiring supplemental calcium and vitamin D. At follow-up one month after discharge, her calcium had normalized. We present the first reported case of hypercalcemia occurring in association with a malignant Brenner tumor. Malignancy-associated hypercalcemia occurs via four principal mechanisms: (1) tumor production of PTHrP; (2) osteolytic bone involvement by primary tumor or metastasis; (3) ectopic activation of vitamin D to $1,25-(OH)_2$ vitamin D, and (4) ectopic production of parathyroid hormone. PTHrP-mediated hypercalcemia is the most common mechanism and was responsible in this case. In patients with paraneoplastic hypercalcemia who undergo surgical treatment, close monitoring and management of serum calcium is necessary both pre- and postoperatively

Management of adnexal torsion

Objective: To evaluate clinical findings, operative reports, the pathological results of patients with diagnosis of adnexal torsion. Methods: Fourteen patients with diagnosis of adnexal torsion who presented to our clinic between January 2009 and March 2013 were included in this retrospective analysis. Data including clinical findings, operative reports, the pathological results were recorded. Results: The mean age of the patients was 28.1 ± 10.5 with a range of 16 to 52 years. All patients underwent ultrasonography, and a pelvic mass appearance was detected in all cases. The mean diameter of the mass was 8,04±2,96 cm. All of the patients had lower abdominal pain, nausea and vomiting. Six patients were operated laparoscopically, while eight patients had laparotomy. Detorsion and cystectomy was performed in 7 (50.0%) of the patients. Two of patients were pregnant in operation time that treated by cystectomy and detorsion of the ovaries successfully in the first and third trimester (one by laparoscopy). There was one patient of isolated fallopian tube torsion due to hydrosalpinks treated by laparoscopic salpingectomy. Two of the patients had paratubal cyst and tubal torsion. Detorsion and cystectomy by laparoscopy and salpingectomy by laparotomy were performed for these patients respectively. The most common histopathology was serous cystadenoma (28,6%). Conclusion: Adnexal torsion is a rare gynecologic emergency of women and occur in reproductive ages mostly. Prompt diagnosis and conservative treatment is important for the safety of ovaries and fallopian tubes and future fertility. J Clin Exp Invest 2014; 5 (1): 7-1