Adenocarcinoma With Breast/Adnexal and Upper Gastrointestinal Differentiation Arising in an Ovarian Mature Cystic Teratoma: A Case Report and Review of the Literature.
Mature cystic teratomas are the most common type of ovarian germ cell tumors. In about 1% of cases, usually among postmenopausal women, a mature cystic teratoma can undergo malignant transformation. Among malignant transformations, squamous cell carcinoma is the most common histology, comprising approximately 80% of cases. In this report, we present the unique case of a 55-yr-old woman with a pelvic mass found to be a mature cystic teratoma with malignant transformation to adenocarcinoma with breast/adnexal, upper gastrointestinal, and neuroendocrine differentiation. The predominant malignant component was the adenocarcinoma exhibiting breast/skin adnexal differentiation, which was found to involve the omentum and a right para-aortic node. We provide an in-depth review of the pathologic findings, as well as a review of the current literature on malignant transformation to adenocarcinoma. This report aims to open a conversation regarding the management of these patients, with a specific focus on the role of molecular analysis and targeted therapies.
Departments of Obstetrics and Gynecology (L.W.) Gynecologic Oncology (G.L.W., A.K.) Pathology (M.C.O.K., C.S.K.), Stanford Hospital and Clinics, Stanford, California.
Lindsay
L
Wheeler
Gina L
GL
Westhoff
Mary C
MC
O'Keefe
Christina S
CS
Kong
Amer
A
Karam
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017239:Paclitaxel / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013724:Teratoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D017239:Paclitaxel; D002945:Cisplatin