Mature Teratoma in a Supernumerary Ovary in a Child: Report of the First Case

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.

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Simultaneous intracranial and testicular germ cell tumors: illustrative case

Journal of Neurosurgery: Case Lessons ◽

10.3171/case2067 ◽

2021 ◽

Vol 1 (3) ◽

Author(s):

Lei Han ◽

Jie Lu ◽

Luxiong Fang ◽

Songtao Qi ◽

Ye Song

Keyword(s):

Germ Cell ◽

Mature Teratoma ◽

Germ Cell Tumors ◽

Testicular Tumor ◽

Cystic Teratoma ◽

Pineal Region ◽

Illustrative Case ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

First Case

BACKGROUNDSimultaneous intracranial and testicular germ cell tumors (GCTs) are extremely rare, leading to a lack of adequate experience in their treatment. Therefore, the authors report a case of this kind of GCT.OBSERVATIONSA 5-year-old boy was admitted to the hospital with headache and vomiting. Computed tomography and magnetic resonance imaging suggested the possibility of a GCT in the pineal region. The value of the serum tumor marker alpha-fetoprotein (AFP) was 5,396.1 μg/L, and β-human chorionic gonadotropin levels were within the normal range. Subsequently, the tumor was removed, and the final pathological result was a mixed GCT. Therefore, chemotherapy and radiation were added. However, the authors found a testicular tumor on ultrasound at the same time, and pathology after surgery suggested a mature cystic teratoma. Following treatment, the patient recovered well, and AFP levels dropped to normal values.LESSONSTo the authors’ knowledge, this report is the fourth case of simultaneous intracranial and testicular GCTs and the first case of a simultaneous mixed GCT in the pineal region and mature teratoma of the testis. A combination of surgery, chemotherapy, and radiation therapy for mixed GCTs in the pineal region and surgical excision for testicular reproductive cell tumors are effective in these patients, but long-term monitoring is required.

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Duodenal mature teratoma causing partial intestinal obstruction: A first case report in an adult

World Journal of Clinical Cases ◽

10.12998/wjcc.v8.i8.1489 ◽

2020 ◽

Vol 8 (8) ◽

pp. 1489-1494

Author(s):

Tharintorn Chansoon ◽

Napat Angkathunyakul ◽

Rangsima Aroonroch ◽

Jakrapan Jirasiritham

Keyword(s):

Case Report ◽

Intestinal Obstruction ◽

Mature Teratoma ◽

First Case ◽

Partial Intestinal Obstruction

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Ovarian Germ Cell Tumor with Myasthenia Gravis: Co-incidence or a Possible link?

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2021.6.4.525-527 ◽

2021 ◽

Vol 6 (4) ◽

pp. 525-527

Author(s):

Jhanzeb Iftikhar ◽

Fareeha Sheikh ◽

Nazish Khalid ◽

Muhammad Abubakar Sarwar ◽

Musa Azhar ◽

...

Keyword(s):

Myasthenia Gravis ◽

Germ Cell ◽

Germ Cell Tumor ◽

Mature Teratoma ◽

Surgical Excision ◽

Cell Tumor ◽

Ovarian Teratoma ◽

First Case ◽

Complete Surgical Excision ◽

Ovarian Teratomas

Teratomas are a common form of germ cell tumor. Teratomas are commonly found in the gonadal organs, such as the ovaries and testes. Treatment of choice for ovarian teratomas is complete surgical excision, which exhibits a good prognosis in benign teratomas; however, chemotherapy treatment is needed for malignant components. Neurological paraneoplastic presentation of gynecological tumors is rare; however, ovarian tumors account for 10% of this presentation. In literature, paraneoplastic limbic encephalitis, anti-N-methyl-D-aspartate receptor encephalitis, and paraneoplastic cerebellar degeneration have been reported in ovarian teratomas and tumors; however, myasthenia gravis has been reported only twice. In both of those cases, manifestation of myasthenia gravis was preceding the diagnosis of ovarian cancer. We describe the first case of a 21-year-old female who presented with new-onset myasthenia gravis after finishing chemotherapy for ovarian teratoma. Another unusual aspect of our case is the rare co-occurrence of gliomatosis peritonei with mature teratoma.

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P53 and PIK3CA Mutations in KRAS/HER2 Negative Ovarian Intestinal-Type Mucinous Carcinoma Associated with Mature Teratoma

Case Reports in Obstetrics and Gynecology ◽

10.1155/2020/8863610 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Sarah Bouri ◽

Philippe Simon ◽

Nicky D’Haene ◽

Xavier Catteau ◽

Jean-Christophe Noël

Keyword(s):

Recurrent Disease ◽

Mature Teratoma ◽

Mucinous Carcinoma ◽

Intestinal Type ◽

Molecular Profile ◽

Pik3ca Mutations ◽

First Case ◽

Therapeutic Outcomes ◽

Generation Sequencing ◽

P53 Genes

Primary ovarian intestinal-type mucinous carcinomas associated with mature teratoma are rare and represent less than 3% of all primary ovarian neoplasms. The molecular profile of these tumors is still controversial. We report here the first case of mucinous ovarian tumor in which mutation of the PIK3CA and P53 genes could be demonstrated by the next generation sequencing technique without KRAS mutation or HER2 amplification. Our data suggest that these mucinous carcinoma variants probably present an extremely complex molecular biology profile that should be known in the future to stratify therapeutic outcomes and potential targeted therapies, particularly in recurrent disease.

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First Case of Mature Teratoma and Yolk Sac Testis Tumor Associated to Inherited MEN-1 Syndrome

Frontiers in Endocrinology ◽

10.3389/fendo.2019.00365 ◽

2019 ◽

Vol 10 ◽

Cited By ~ 1

Author(s):

Sabrina Chiloiro ◽

Ettore Domenico Capoluongo ◽

Giovanni Schinzari ◽

Paola Concolino ◽

Ernesto Rossi ◽

...

Keyword(s):

Mature Teratoma ◽

Yolk Sac ◽

Men 1 ◽

First Case ◽

Testis Tumor

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Primary medulla oblongata teratomas

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.6.peds1423 ◽

2014 ◽

Vol 14 (3) ◽

pp. 296-300 ◽

Cited By ~ 1

Author(s):

Da Li ◽

Shu-Yu Hao ◽

Zhen Wu ◽

Li-Wei Zhang ◽

Jun-Ting Zhang

Keyword(s):

Medulla Oblongata ◽

Histopathological Examination ◽

Mature Teratoma ◽

Radiographic Findings ◽

First Case ◽

Cystic Component ◽

Long Term Follow Up ◽

History Of

Medulla oblongata teratomas are rare. The authors report 2 new cases of teratomas that occurred exclusively in the medulla oblongata. The first case was in a 9-year-old boy who presented with a 6-month history of neck pain and repeated paroxysmal vomiting. Based on preoperative radiographic findings, the initial diagnosis was of an intraaxial medulla oblongata hemangioblastoma. Intraoperatively, the cystic component of the tumor was gray, gelatinous, and soft in consistency. The solid component was light pink, rubbery, and nodular in appearance, with an identifiable boundary. The lesion was completely removed. Histopathological investigation revealed a mature teratoma. Postoperatively, the patient was supported with ventilator assistance and received a tracheotomy, but died of intracranial infection. The second case was in a 10-year-old boy with intermittent headache for 1 month. Radiographs revealed an exophytic cystic and solid lesion with dorsal involvement of the medulla oblongata. The lesion was predominantly solid, pinkish gray, tenacious, and moderately vascularized, with clearly delineated surgical dissection planes. The histopathological examination confirmed a diagnosis of immature teratoma. Total resection was achieved, followed by postoperative chemotherapy. He was alive without recurrence of the lesion or symptoms at 59 months after surgery. Resection of medulla oblongata teratoma is challenging, with inherent surgical risks that are contingent on the tumor growth pattern. Teratomas should be considered in the differential diagnosis of brainstem lesions. Chemotherapy has been suggested for immature teratomas. Long-term follow-up and larger studies of teratomas in unusual locations are required to improve practitioners' understanding of this disease's treatment and outcomes.

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Thoracoscopic Removal of a Bulky Cystic Mediastinal Mature Teratoma in a 4-Year-Old Child: Report of One Case and Few Surgical Tricks

European Journal of Pediatric Surgery ◽

10.1055/s-0032-1308697 ◽

2012 ◽

Vol 22 (04) ◽

pp. 318-320 ◽

Cited By ~ 1

Author(s):

Daniela Codrich ◽

Maria Lembo ◽

Jurgen Schleef

Keyword(s):

Mature Teratoma ◽

Child Report

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Malignant transformation of intracranial mature teratoma to yolk sac tumor after late relapse

Journal of Neurosurgery ◽

10.3171/jns.2007.106.6.1067 ◽

2007 ◽

Vol 106 (6) ◽

pp. 1067-1069 ◽

Cited By ~ 7

Author(s):

Satoshi Utsuki ◽

Hidehiro Oka ◽

Takao Sagiuchi ◽

Satoru Shimizu ◽

Sachio Suzuki ◽

...

Keyword(s):

Malignant Transformation ◽

Third Ventricle ◽

Mature Teratoma ◽

Germ Cell Tumors ◽

Yolk Sac ◽

Yolk Sac Tumor ◽

Late Relapse ◽

Computed Tomography Images ◽

First Case ◽

History Of

✓ The recurrence of intracranial mature teratomas as germ cell tumors of different histological types is rarely reported. The authors describe the first case of the malignant transformation of an intracranial mature teratoma into a yolk sac tumor in a 16-year-old boy who presented with a 1-month history of anorexia and somnolence. Seven years prior to this presentation, the boy had undergone surgery for extirpation of a mature pineal teratoma. Computed tomography images obtained at his second presentation revealed a homogeneously enhanced mass within the third ventricle. The tumor was resected and the results of a histological examination were consistent with a yolk sac tumor. After resection, the patient underwent radiation therapy followed by chemotherapy with cisplatin and etoposide but died of tumor progression 15 months after his second hospitalization.

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