Extragonadal immature teratoma of the uterus

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-02-22 DOI:10.1016/j.gore.2025.101707

Katherine Jane C. Chua , Maryam Ali , Alice Barr , Rebecca Brooks , Nell V. Suby

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引用次数: 0

Abstract

Background

With fewer than 20 cases of extragonadal teratomas since 1929, treatment guidelines remain unclear.

Case Presentation

A 27-year-old nulliparous female presented with vaginal bleeding and malodorous discharge. Transvaginal ultrasound and pelvic MRI revealed a 4 cm prolapsing echogenic cervical mass that was FDG avid on PET CT. Biopsy confirmed a grade 1 polypoid immature teratoma arising from either the uterus or cervix. She underwent a total laparoscopic hysterectomy, bilateral salpingectomy, omentectomy, and primary optimal tumor debulking to R0. Bilaterally ovaries appeared grossly normal and were preserved. On final pathology, the patient was staged using FIGO ovarian cancer criteria as Stage IIIA2 grade 2 immature teratoma of the uterus. The patient received three cycles of bleomycin, etoposide, and cisplatin. The patient is 11 months post-surgery and currently undergoing surveillance.

Conclusion

Given the rarity of uterine immature teratomas, management of this case was extrapolated from existing recommendations for immature ovarian teratomas. Unlike in prior case reports where surgical approach was via an exploratory laparotomy, our patient underwent optimal debulking via minimally invasive surgery with ovarian preservation and adjuvant chemotherapy. Given the chemosensitive nature of germ cell tumors, further fertility sparing options for extragonadal immature teratoma may be further explored.

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子宫腺外未成熟畸胎瘤

背景：自1929年以来，性腺外畸胎瘤少于20例，治疗指南仍不明确。病例介绍：一名27岁的未产女性，因阴道出血和恶臭分泌物而就诊。经阴道超声和盆腔MRI显示4厘米脱垂的回声宫颈肿块，PET扫描显示FDG明显。活检证实子宫或宫颈发生1级息肉样未成熟畸胎瘤。她接受了腹腔镜全子宫切除术、双侧输卵管切除术、网膜切除术和原发性最佳肿瘤切除至R0。双侧卵巢大体正常，保存完好。在最终病理中，患者根据FIGO卵巢癌标准分期为IIIA2期2级未成熟子宫畸胎瘤。患者接受三个周期的博来霉素、依托泊苷和顺铂治疗。患者术后11个月，目前正在接受监测。结论考虑到子宫未成熟畸胎瘤的罕见性，本病例的处理方法可从现有的未成熟卵巢畸胎瘤的治疗建议中推断出来。与之前的病例报告不同，我们的患者通过微创手术、卵巢保留和辅助化疗实现了最佳的减容。考虑到生殖细胞肿瘤的化学敏感性，我们可以进一步探索保留生殖力的方法来治疗输卵管外未成熟畸胎瘤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.