A male infant presented with bilateral scrotal masses 7 months after removal of an immature gastric teratoma. Surgical and histology reports were examined to judge completeness of resection. Gliomatosis peritonei gp is implantation of mature glial deposits over peritoneal surface that mimic peritoneal tuberculosis tb. Pdf gliomatosis peritonei is the metastatic implantation of mature glial tissue within the peritoneal cavity of patients with ovarian teratomas.
Objectives ovarian immature teratoma may be associated with peritoneal spread that could, after adjuvant chemotherapy, develop into disease exclusively composed of mature implants growing teratoma syndrome andor gliomatosis peritonei gp, defined as the presence of pure mature glial tissue. From the archives of the afip radiological society of. Peritoneal and nodal gliomatosis with endometriosis. Gliomatosis peritonei of the scrotal sac associated with an. Aug 25, 2017 if the histology shows mature glial cells it is mostly considered benign good prognosis prognosis and need for therapy depends on biopsy and histological analysis for immature glial cells if malignant cells found then chemotherapy needed on ct, gliomatosis peritonei manifests as softtissue peritoneal nodules and. Gliomatosis peritonei with endometriosis externa sciencedirect. It is challenging to diagnose coexisting abdominal t. It is mainly associated with ovarian teratomas, especially in immature ovarian teratoma. May 02, 2018 gliomatosis peritonei gp is a rare condition characterized by mature glial tissue implants widespread in the peritoneum, which is occasionally followed by treatment for immature teratoma im. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and douglas pouch, where gliomatosis coexisted with endometriosis.
Gliomatosis peritoneal, recidiva, tratamiento y seguimiento. Gliomatosis peritonei gp is an infrequent occurrence, exclusively associated with a mature or immature teratoma of the ovary. National taiwan university hospital, taipei, taiwan. Alexander m1, cope n, renninson j, hong a, simpson rh, hirschowitz l. Glial tissue in such cases is usually low grade although there have been cases of malignant evolution described. Okamoto d, ishigami k, yoshimitsu k, irie h, tajima t, asayama y, et al. Progression from an immature teratoma with miliary. Figure 1 multiple gliomatosis peritonei nodules over the peritoneum, mesentery and subdiaphragm area, massive ascites, and the main mass of the growing mature teratoma over the lower abdomen. Immature teratoma of the ovary with gliomatosis peritonei.
This case is intended to identify and study about this rare. Case report growingteratomasyndromeandperitonealgliomatosis. The metastatic lesions which were found in the mediastinal and cervical lymph nodes as well. Gliomatosis peritonei gp is characterized by the presence of. Chemotherapy induced normalisation of alphafetoprotein rate whereas there. Gliomatosis peritonei was diagnosed at the original surgery in 15 of 21 71% patients and at secondary surgery in 6 of 21 29% patients table 2. It is controversial whether glial tissues are derived from maturation of the associated teratomatous tissue that has implanted in the peritoneum, or glial differentiation of subperitoneal stem cells. Gliomas of different grade and cell of origin astrocytes, oligodendrocytes. Mature ovarian teratoma with gliomatosis peritonei a case report. Immature teratoma is a type of ovarian germ cell tumor diagnosed in young women. Cliomatosis peritonei, the occurrence of mature glial peritoneal implants, is a rare complication that is observed almost exclusively in the setting. Gliomatosis peritonei, a rare condition often associated with immature ovarian teratoma, is characterized by the presence of mature glial tissue in the peritoneum.
Between 1985 and 2011, ten patients having ovarian teratoma with gp were treated at our institution. Teratoma with gliomatosis peritonei taiwanese j obstet gynecol june 2005 vol 44 no 2 183 mature cystic teratoma with gliomatosis peritonei chingyu chou, yihleong chang1, wenfang cheng, chinan chen department of obstetrics and gynecology, and 1department of pathology, national taiwan university hospital, taipei, taiwan. Up to now 86 cases of this entity have been published. Pg occurs almost exclusively in combination with an ovarian teratoma, whateverits grade. Extensive histopathologic sampling of peritoneal implants is essential to exclude the presence of other teratomatous or germ cell elements, a. Is gliomatosis peritonei derived from the associated ovarian. Germ cell tumors may also lead to lifethreatening complications such as extensive hemorrhage from choriocarcinoma metastases or the rupture of mature teratomas, cases in which timely diagnosis is crucial. Rarely, also have mature glial tissue present in lymph nodes nodal gliomatosis, usually with associated gliomatosis peritonei prognosis is good and the presence of nodal gliomatosis does not warrant chemotherapy j ovarian res 2016. Gliomatosis peritonei, the occurrence of mature glial peritoneal implants, is a rare complication that is observed almost exclusively in the setting of ovarian teratoma. Paripex indian journal of research volume8 issue10. Relationship between endometriosis, endometrioid adenocarcinoma, gliomatosis peritonei, and carcinoid tumor in a patient with recurrent ovarian teratoma.
Pelvic gliomatosis within foci of endometriosis semantic. Gliomatosis peritonei gp, a rare condition related to ovarian teratomas, is characterized by miliary implants of mature glial tissues on the peritoneum or omentum. Gliomatosis peritonei gp is a rare disease characterized by many peritoneal and omental implants composed of mature glial tissue. The purpose of this study was to describe the features, treatment, and prognosis of gp. Jul 29, 2016 background gliomatosis peritonei gp is a rare condition characterized by mature glial tissue implants widespread in the peritoneum. Department of obstetrics and gynecology, and 1department of pathology. Mature cystic teratoma with gliomatosis peritonei core. Mature cystic teratoma with gliomatosis peritonei sciencedirect.
The primary ovarian tumor, resected 8 months prior to death, consisted of a grade 3 teratoma with a small occult focus compatible with endodermal sinus tumor. Gp is a condition that has only been described relatively recently, with 100 cases reported in. Gliomatosis peritonei is thought to be genetically unrelated to the associated teratoma and might be derived from nonteratomatous cells, such as through metaplasia of submesothelial cells 2. A search of the pathology files at the university of texas, md. Gliomatosis peritonei was diagnosed at the same time as primary ovarian neoplasm in 16 patients and secondary surgery in 5 patients. Gliomatosis peritonei, the miliary implants of mature glial tissue on the peritoneum, is an infrequently reported complication of ovarian teratoma. However, very few specific series are devoted to the outcomes of pure gp. Case mature ovarian teratoma with gliomatosis peritonei. Cystic structures contained serous fluid with yellow sebaceous material and keratinous debris.
Ovarian teratoma, immature teratoma, gliomatosis peritonei. Mature and immature solid teratomas involving uterine. Gliomatosis peritonei is a rare condition that occurs almost exclusively in the setting of ovarian immature teratoma. However, the presence of gliomatosis peritonei supports the theory of a peritoneal spread from a previous ovarian teratoma during childhood 3, 4. The present study reported a case of gp with fluorodeoxyglucose fdg accumulation and contrast enhancement followed by treatment for im. Gliomatosis peritonei gp is an unusual condition in which nodules of mature astroglia, often miliary and microscopic in size, are widespread in the peritoneum and abdominal lymph nodes. Gliomatosis peritonei gp is a rare condition characterized by mature glial. Gliomatosis peritonei gp indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. We retrospectively evaluated 21 patients with gliomatosis peritonei and studied their clinicopathologic features and immunophenotype. Immature teratoma with gliomatosis peritonei associated with pregnancy.
Ovarian tumors with gliomatosis peritonei gp were designated stage iii. A unique case of gliomatosis peritonei in a man, following. Gliomatosis peritonei, a rare condition often associated with. Histopathology revealed an immature teratoma grade 3 associated with massive gliomatosis peritonei of omentum and pouch of douglas. An unique association of gliomatosis with endometriosis externa was found without the usual symptoms of endometriosis. Mature ovarian teratoma with gliomatosis peritonei a. Staging this was performed as in the second ukccsg gct study 9 appendix table a1, online only. The clinicopathologic features of four such cases associated with ovarian teratoma of all grades are described herein. She noticed an abdominal swelling for some weeks and this had become painful over the few days before admission. It gliomatosis peritonei represents 3% of all teratomas, 1% of all ovarian cancers gliomatosis peritonei gp can be defined as the meta and 20% of malignant ovarian germ cell tumors 6.
Pdf immature teratoma with gliomatosis peritonei associated. Pdf immature ovarian teratoma with unusual gliomatosis. Gliomatosis peritonei is a rare complication of ovarian teratomas characterized by peritoneal implants of glial tissue. Gliomatosis peritonei gp is characterized by the presence of benign, mature neuroglial implants throughout the peritoneum and is typically accompanied by mature or immature ovarian teratomas.
Mature and immature extracranial teratomas in children. After surgical excision, histology showed gliomatosis peritonei. Gliomatosis peritonei, a rare condition that occurs almost exclusively in the setting of ovarian immature teratoma, is characterized by the occurrence of nodules of mature glial tissues in the peritoneum. Gliomatosis peritonei, under this name first reported by neuhauser in 1906, is defined as the implantation of nodular predominantly mature glial tissue within the peritoneal cavity in patients with ovarian teratomas. One patient developed glioma arising from gliomatosis peritonei. Mature teratoma with gliomatosis peritonei with abdominal. We report herein a case of mature teratoma of the ovary with gp with imaging features and pathological correlation. Gliomatosis peritonei is characterized by the occurrence of nodules of mature glial tissues in the peritoneum gliomatosis peritonei is a rare condition that occurs almost exclusively in the setting of ovarian immature teratoma it is controversial whether glial tissues are derived from maturation of the associated teratomatous tissue that has implanted in the peritoneum, or.
We report a case of an 18yearold girl treated for growing teratoma syndrome after chemotherapy for malignant germ cell tumor of the ovary associated with peritoneal gliomatosis. Also, 11 of 21 patients had metastatic immature teratoma n4, metastatic mature teratoma n2, or both n5. Dec 10, 2009 gliomatosis peritonei gp is an unusual condition in which nodules of mature astroglia, often miliary and microscopic in size, are widespread in the peritoneum and abdominal lymph nodes. Eventually, tumor deposits may diffusely stud both visceral and parietal peritoneum. The primary ovarian neoplasms in this study were immature teratomas n14, mixed germ. Gliomatosis peritonei gp is a rare condition associated with ovarian teratomas of any grade, in which benign glial implants develop on the peritoneal surface. Gliomatosis peritonei is the implantation of miliary glial tissue within the peritoneal cavity of patients with ovarian teratomas. Thus far, only about 100 cases have been reported 1. A unique case of gliomatosis peritonei in a man, following a.
The case history of a 10yearold black girl with gliomatosis peritonei, grade o, is presented. Jan 10, 2002 gliomatosis peritonei, under this name first reported by neuhauser in 1906, is defined as the implantation of nodular predominantly mature glial tissue within the peritoneal cavity in patients with ovarian teratomas. Growing teratoma syndrome and peritoneal gliomatosis. Up to now 86 cases of this rare entity have been reported. We report here the case of a 46yearold patient who presented with simultaneous immature teratoma in the endometrium and mature teratomas in the ovary in association with gliomatosis peritonei but with no evidence of gestational origin. This tumor is no longer recognized as a formal diagnosis, rather gliomatosis cerebri refers to a special pattern of diffuse and extensive growth of glioma cells, invading multiple lobes of the brain. Introduction immature teratoma is the currently preferred term for the malignant ovarian teratoma usually seen in. Gliomatosis peritonei gp is a rare condition characterized by mature glial tissue implants widespread in the peritoneum. Gliomatosis cerebri diagnosis and treatment national.
Immature ovarian teratoma grade 3 associated ith massive. Journal of the society of laparoendoscopic surgeons, year1997, volume1, pages267 268. Gliomatosis peritonei is a very rare complication of an immature teratoma ofthe ovary, with only 32 reported cases in 1. Gliomatosis peritonei of the scrotal sac associated with. Gliomatosis peritonei was confirmed in the omentum, a rare finding about 88 cases have been reported so far worldwide. Gliomatosis peritonei, which is characterized by mature glial tissue in the peritoneum. Gliomatosis peritonei is thought to be genetically unrelated to the associated teratoma and might be derived from nonteratomatous cells, such as through metaplasia of submesothelial cells.
Gliomatosis cerebri diagnosis and treatment national cancer. Although its presence is believed to suggest a more favorable prognosis in cases of high. Because of its rarity, we report our experience with a 34 year old lady with a 4500 gm mass presenting with pain abdomen. In addition to the small number of reported gliomatosis peritonei cases, a condition easily mistaken for perit.
It is characterisized by the occurrence of nodules of mature glial tissues in the peritoneum, omentum and bowel wall. Case mature ovarian teratoma with gliomatosis peritonei a. Lymph node metastasis with mature glial tissue in combination with gliomatosis peritonei is very rarely reported. Gliomatosis peritonei with bilateral ovarian teratomas. Secondary tumors and tumorlike lesions of the peritoneum have overlapping imaging features when compared with each other and primary peritoneal tumors. It has been found to occur almost exclusively in females with ovarian teratomas, though there are stray reports of its association with pregnancy, ventriculoperitoneal shunts performed for hydrocephalus. Mature ovarian teratoma with gliomatosis peritonei a case.
The glial implants demonstrated distinct circumferential and intra glial fibrosis resolution. Mri appearances and its potential role in follow up. Retroperitoneal teratomas are relatively rare and account for up to 11% of primary retroperitoneal tumours. Gliomatosis peritonei osseous metaplasia cartilagenous metaplasia melanosis splenosis. Gliomatosis peritonei gp is the implantation of neural tissue in the peritoneum. Backgroundgliomatosis peritonei gp is a rare condition characterized by mature glial tissue implants widespread in the peritoneum. The primary tumour was resected and a second look operation carried out 3 months later. However, the presence of gliomatosis peritonei supports the theory of a peritoneal. We assessed the pathology, treatments, and outcomes along with. The first case from india was reported in 1981 by joshi et al, henceforth, only four cases have been reported.
Histopathologic examination revealed features of a mature teratoma. Miliary tumors were also noted on the omentum and peritoneal surfaces. The growing teratoma syndrome gts is defined as a detection of an enlarged mass during or after chemotherapy treatment for germ cell tumor. Gliomatosis peritonei gp is a rare condition that occurs almost exclusively in the setting of ovarian immature teratoma. This rare condition is associated with ovarian teratoma and is often identified at primary or secondary surgery. Gliomatosis cerebri is a primary central nervous system cns tumor. Knowledge of peritoneal anatomy, normal fluid circulation within the. However, little is known about the characteristics and prognosis of gp. Gp is a condition that has only been described relatively recently, with 100 cases reported in the english literature.
We report an unusual presentation of gliomatosis peritonei arising from a rare lesion of immature gastric teratoma. Ct scan, gliomatosis peritonei, ovarian mature teratoma. Gliomatosis peritonei gp, glial fibrillary acidic protein gfap, immature teratoma. Gliomatosis peritonei associated with immature ovarian teratoma. An autopsy case of a malignant gliomatosis peritonei originating from cystic ovarian teratoma of a 22. The majority of reported cases have focused on the pathology a. Feb 01, 1988 a case of gliomatosis peritonei developed 9 years after the removal of an immature ovarian teratoma is reported. There is no clear guidance as to how often and for how long these patients should be followed up. Presentation of a patient who underwent fertilitysparing.
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