Adenocarcinoma With Breast/Adnexal and Upper Gastrointestinal Differentiation Arising in an Ovarian Mature Cystic Teratoma: A Case Report and Review of the Literature

Int J Gynecol Pathol. 2016 Jan;35(1):72-7. doi: 10.1097/PGP.0000000000000218.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Cell Transformation, Neoplastic
  • Cisplatin / therapeutic use
  • Female
  • Gastrointestinal Neoplasms / drug therapy
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Middle Aged
  • Neoplasms, Germ Cell and Embryonal / drug therapy
  • Neoplasms, Germ Cell and Embryonal / pathology*
  • Neoplasms, Germ Cell and Embryonal / surgery
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Paclitaxel / therapeutic use
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery
  • Teratoma / drug therapy
  • Teratoma / pathology*
  • Teratoma / surgery
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Paclitaxel
  • Cisplatin

Supplementary concepts

  • Ovarian Germ Cell Cancer
  • Teratoma, Ovarian