Case Report | |
Is It Necessary to Perform Surgical Staging in Patients with Giant Immature Ovarian Teratomas Mimicking Mature Cystic Teratoma at Frozen Section | |
Ismail Guler1, Ahmet Turp1, Cagatay Taskiran1, Anıl Onan1, Hayriye Tatli2, Haldun Guner1, Bulent Tiras1 | |
1Gazi University School of Medicine, Department of Obstetrics & Gynecology, Ankara, Turkey 2Gazi University School of Medicine, Department of Pathology, Ankara, Turkey |
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IJWHR 2013; 1: 105-110 DOI: 10.15296/ijwhr.2013.17 Viewed : 4993 times Downloaded : 3668 times. Keywords : Dermoid Tumors, Frozen Section, Huge Teratoma, Immature Teratoma, Tumor Markers |
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Abstract | |
Giant mature teratomas (>20 cm in diameters) sometimes may
contain malignant immature elements or tissues. These small
foci of immature tissues could be missed at frozen section
resulting inadequate initial surgical intervention. There is no
large series in the literature either showing the accuracy of
frozen section on huge ovarian teratomas or concerning the
adequate surgical approach at the initial surgery for giant
immature teratomas diagnosed as mature cystic teratomas at
frozen section in patients with elevated tumor markers. We
presented a case with unilateral giant immature ovarian
teratoma and peritoneal gliomatosis which diagnosed as
mature cystic teratoma at frozen section. Although elevated
tumor markers (CA-125, AFP, CA-19,9 CEA, and lactate
dehydrogenase), ascites and peritoneal implants were
suggested malignant disease, staging surgery was not
performed due to the benign report of frozen section. Since the
patients having peritoneal implants of mature glial tissue have
an excellent prognosis regardless of the grade of the ovarian
teratomas, it may be suggested that surgical staging at the
initial operation may not be performed in patients with giant
immature teratoma diagnosed as mature teratoma at frozen
section despite to the elevated tumor markers, presence of
ascites or mature peritoneal implants. seems that using it in
infertile patients has beneficial effects. |
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