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Malignancies arising in mature teratomas of the ovary

Patrycja Ziober-Malinowska, Marcin Bobiński, Krzysztof Kułak, Jan Kotarski, Rafał Tarkowski

Affiliacja i adres do korespondencji
Curr Gynecol Oncol 2016, 14 (4), p. 204–211
DOI: 10.15557/CGO.2016.0025
Streszczenie

Mature teratomas are common ovarian tumors. Malignant transformation of dermoid cysts is a very rare phenomenon observed in only 0.17–2% of patients. Squamous cell carcinoma is the most common form of malignant transformation within ovarian dermoid tumors, accounting for more than 80% of cases. Adenocarcinomas, fibrosarcomas, carcinoid and mixed tumors also occur. Peritoneal gliomatosis is a rare condition, which also should be considered in patients diagnosed with teratoma. There are no sensitive and specific methods for the preoperative differential diagnosis of malignant vs. benign tumors arising in teratomas. Higher risk of malignancy is seen in large tumors, in women over 45 years of age, at elevated tumor markers (CA-125, CA 19-9, CEA, SCC-Ag in particular) and in the case of the presence of solid fragments in cysts. Extended diagnostic imaging using magnetic resonance or positron emission tomography is helpful in such cases. The treatment of mature teratoma, regardless of whether there is a suspicion of focal malignancy, involves surgical excision of the tumor. In the case of suspected malignant transformation in a perimenopausal woman, unilateral salpingooophorectomy in accordance with the principles of oncological aseptics should be considered as the minimum therapeutic management. Sparing surgery can be considered in young patients, nulliparas in particular, due to the very low risk of malignant transformations.

Słowa kluczowe
ovarian teratoma, ovarian cancer, neoplastic transformation