Mature Cystic Teratoma with Co-existent Mucinous Cystadenocarcinoma in the same Ovary-A Diagnostic Dilemma
Published: December 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.9118
Sanjeet Roy, Sramana Mukhopadhayay, Mayank Gupta, Anuradha Chandramohan
1. Assistant Professor, Department of Pathology, Chrisitan Medical College, Vellore, Tamil Nadu, India.
2. Assistant Professor, Department of Pathology, Chrisitan Medical College, Vellore, Tamil Nadu, India.
3. Associate Professor, Department of Pathology, Chrisitan Medical College, Vellore, Tamil Nadu, India.
4. Associate Professor, Department of Diagnostic Radiology and Imaging, Chrisitan Medical College, Vellore, Tamil Nadu, India.
Correspondence
Dr. Sramana Mukhopadhayay,
Assistant Professor, Department of Pathology, Chrisitan Medical College, Vellore-632004, Tamil Nadu, India.
E-mail: drsramana@gmail.com
Mature cystic teratoma co-existing with a mucinous cystadenocarcinoma is an infrequently encountered entity with only a handful of cases reported till date. The possibilities in such a case are either a malignant transformation of a benign teratoma into adenocarcinoma or a collision tumor between a mature cystic teratoma and a mucinous tumour of either a primary ovarian surface epithelial-stromal origin or a secondary from a primary gastrointestinal tract tumour. The importance of distinguishing between the two entities has significant bearing on subsequent therapeutic management. We report a rare case of a mature cystic teratoma co-existing with a mucinous cystadenocarcinoma in the same ovary in a 44-year-old lady. Contrast Enhanced Computed Tomography (CECT) imaging of the left ovarian mass was suggestive of a teratoma but an intra-operative frozen section examination was reported as an adenocarcinoma with a cystic teratoma. Gross examination of the surgical specimen revealed a dermoid cyst with another multi-septated cystic lesion containing mucoid material. Histopathological examination showed a mature cystic teratoma and an associated well differentiated mucinous cystadenocarcinoma. The latter displayed a CK7-ve/CK20+ve immunoprofile. In absence of clinical, biochemical or radiological findings of a primary lower gastrointestinal tract tumour, the immunoprofile suggested the possibility of adenocarcinomatous transformation in a benign teratoma.
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