Immature teratoma with associated gliomatosis peritonei: image and brief review of literature

Abstract

Immature teratomas (IT) are malignant tumors most commonly found in the ovaries of premenopausal patients. They are characterized histologically by immature neuroepithelial tissue including premature neural tubes, immature rosettes, or immature stroma. While mature teratomas are more common and considered to be benign, the fact that some of these cysts are found to have foci of IT and that patients with a history of mature teratoma excision have been diagnosed with subsequent IT ipsilaterally, contralaterally, or rarely both suggests a relationship between the diagnoses. 2 Stage and grade most strongly predict patient outcomes in IT. Grossly, these tumors are often large with areas of hemorrhage and necrosis (Figure 1). Grading is performed microscopically by quantifying the number of lowpowered fields which when aggregated contain immature neuroepithelium (Figure 1). Lowgrade/grade 1 tumors contain less than one lowpowered microscopic field of immature neuroepithelium and have an excellent prognosis. Grade 3 tumors contain more than three lowpowered fields of immature neuroepithelium, as in this case, and tend to have a more aggressive clinical course. Grade 2 tumors have between one and three lowpowered fields of immature neuroepithelium and have an intermediate prognosis. Treatment