title: Immature ovarian teratoma in an adolescent: a case report and review of the literature.
abstract: BACKGROUND
  Benign cystic teratomas are relatively common tumors in reproductive age women, but can occur at any age. While the incidence of malignant elements in a teratoma is low (approximately 1-2%), the survival of patients with immature teratoma is poor. Definitive diagnosis is mandatory.
  
  
  METHODS
  We describe a case of a 13-year-old African American female, gravida 0, presenting with a large pelvic mass, determined to be a benign cystic teratoma by intra-operative frozen section. However, due to the size of the tumor and the preponderance of neural elements we performed a full surgical staging procedure (excluding hysterectomy and complete removal of adnexa). The final pathology report revealed foci of immature neural tissue, with a final diagnosis of an immature cystic teratoma Stage Ia.
  
  
  CONCLUSIONS
  Foci of immature neural elements can be readily missed on frozen section, especially with a large tumor. Full surgical staging at the time of initial laparotomy is justified when encountering an apparently mature cystic teratoma with a preponderance of neural elements on frozen section.
authors.affiliation: Department of Obstetrics and Gynecology, Section of Pediatric and Adolescent Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: J I
authors.initials: JI
authors.lastname: Einarsson
authors.forename: C L
authors.initials: CL
authors.lastname: Edwards
authors.forename: R K
authors.initials: RK
authors.lastname: Zurawin
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007813:Laparotomy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013724:Teratoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery