Are they Spherules of Ovarian Cystic Teratoma or Daughter Cysts of Echinococcosis?

 

 Buy Article Permissions and Reprints

Zusammenfassung

Ein Teratom ist ein Keimzelltumor, der 15 - 20 % aller Ovarialkarzinome ausmacht. Der Tumor entsteht möglicherweise aus der ektodermalen Differenzierung totipotenter Zellen oder aus mitotischen Keimzellen. Wir stellen den Fall einer 37-jährigen Patientin vor, bei der man sonographisch multiple kugelige Strukturen innerhalb eines großen intraabdominellen Tumors sehen konnte. Als präoperative sonographische Diagnose wurde eine riesige Echinokokkuszyste mit Tochterzysten vermutet. Der Tumor der Patientin wurde operativ reseziert und die pathologische Untersuchung ergab ein Teratom. Der ungewöhnliche Befund von multiplen kugeligen Strukturen innerhalb der Zyste wurde durch multiple rundliche Anteile eines reifen Ovarialteratoms hervorgerufen, die zahlreichen beweglichen Talgdrüsen sowie abgeschilferten Keratinformationen entsprachen.

Abstract

Teratoma is a germ cell tumour which accounts for approximately 15 - 20 % of all ovarian cancers. The tumour is possibly derived from ectodermal differentiation of totipotent cells or mitotic germ cells. We present a case of a 37-year-old female patient with multiple spherical structures floating in a large pelvic-abdominal cystic mass seen on sonographic images. A giant echinococcal cyst gravid with its daughters was the presumed preoperative sonographic diagnosis. The patient underwent excision of the lesion, and the pathological diagnosis was teratoma. The striking feature of multiple spherical structures in the cyst was caused by multiple spherules of a mature ovarian cystic teratoma which were representing numerous mobile sebaceous cysts and desquamative keratin formations.

References

• 1 Ceken K, Yavuz A, Alimoglu E. et al . Renal cystic teratoma.  Ultraschall in Med. 2005;  26 197
  PubMedGoogle Scholar
• 2 Kämmer J C, Oldenkott B. Zum Stellenwert der sonographischen Diagnostik beim retroperitonalen Teratom des Erwachsenen (The Value of Ultrasound in Diagnosing Mature Retroperitoneal Teratoma in Adults).  Ultraschall in Med. 2000;  21  38-40
  PubMedGoogle Scholar
• 3 Schuetz 3rd M J, Elsheikh T M. Dermoid cyst (mature cystic teratoma) of the cecum. Histologic and cytologic features with review of the literature.  Arch Pathol Lab Med. 2002;  126 97-99
  PubMedGoogle Scholar
• 4 Sakurai Y, Uraguchi T, Imazu H. et al . Submucosal dermoid cyst of the rectum: Report of a case.  Surg Today. 2000;  30 195-198
  CrossrefPubMedGoogle Scholar
• 5 Vermeulen B J, Widgren S, Gur V. et al . Dermoid cyst of the pancreas. Case report and review of the literature.  Gastroent Clin Biol. 1990;  14 1023-1025
  PubMedGoogle Scholar
• 6 Aderjou E A, Adekunle O O, Madubuko G C. Mesenteric dermoid cyst simulating hepatocellular carcinoma in a Nigerian male: A case report.  East Afr Med J. 1980;  57 508-511
  PubMedGoogle Scholar
• 7 Torreggiani W C, Brenner C, Micallef M. et al . Case report: Caecal volvulus in association with a mesenteric dermoid.  Clin Radiol. 2001;  56 430-432
  CrossrefPubMedGoogle Scholar
• 8 Goldmakher G, Lee S, Coughlin B. Mature cystic teratoma of the mesentery.  Applied Radiology online. 2005;  34
  PubMedGoogle Scholar
• 9 Friedman A C, Pyatt R S, Hartman D S. et al . CT of benign cystic teratomas.  AJR. 1982;  138 659-665
  PubMedGoogle Scholar
• 10 Skaane P, Huebener K H. Computed tomography of cystic ovarian teratomas with gravity-dependent layering.  J Comput Assist Tomogr. 1983;  7 837-841
  PubMedGoogle Scholar
• 11 Togashi K, Nishimura K, Itoh K. et al . Ovarian cystic teratomas: MR imaging.  Radiology. 1987;  162 669-673
  CrossrefPubMedGoogle Scholar
• 12 Buy J N, Ghossain M A, Moss A A. et al . Cystic teratoma of the ovary: CT detection.  Radiology. 1989;  171 697-701
  CrossrefPubMedGoogle Scholar
• 13 Muramatsu Y, Moriyama N, Takayasu K. et al . CT and MR imaging of cystic ovarian teratoma with intracystic fat balls.  J Comput Assist Tomogr. 1991;  15 528-529
  PubMedGoogle Scholar
• 14 Otigbah C, Thompson M O, Lowe D G. et al . Mobile globules in benign cystic teratoma of the ovary.  Br J Obstet Gynaecol. 2000;  107 135-138
  PubMedGoogle Scholar
• 15 Fujitoh H, Akiyosi S, Takoda S. et al . Hepatobiliary and pancreatic imaging: retroperitoneal mature cystic teratoma with a fat ball.  J Gastroenterol Hepatol. 1998;  13 540, 549
  PubMedGoogle Scholar
• 16 Hession P R, Simpson W. Case report: mobile fatty globules in benign cystic teratoma of the mediastinum.  Br J Radiol. 1996;  69 186-188
  PubMedGoogle Scholar
• 17 Kukura V, Čanić T, Duić Ž. et al . Die transvaginale Behandlung von Ovarialzysten mittels Alkoholsklerosierung (Transvaginal Sclerosing Therapy of Cystic Ovarian Lesions with Alcohol).  Ultraschall in Med. 2004;  25  363-366
  PubMedGoogle Scholar
• 18 Kadrev A V, Mitkov V V, Ozerskaya I A. Diagnostic and treatment of benign ovarian cysts by transvaginal ultrasound-guided needle aspiration.  Ultraschall in Med. 2005;  26 S106
  PubMedGoogle Scholar

M. El Fortia

Department of Radiology, Misurata Teaching Hospital, Misurata

P.O. Box 1782

Libya

Email: elfortia@doctor.com