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      Giant Mature Ovarian Cystic Teratoma in a Pediatric Patient: Case Report and Literature Review

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          Abstract

          Mature cystic teratomas, also called dermoid cysts, are the most common germ-cell ovarian neoplasms in children. On average, ovarian dermoid cysts are slow-growing neoplasms with a mean size between 6.4 and 7.0 cm that enlarge at a rate of 1.8 mm/year; however, these can reach large dimensions. Giant ovarian tumors are defined as those having a maximum diameter equal to or more than 15 cm; these represent a therapeutic challenge as they increase the risk of wide wound size and surgical invasiveness. In this paper, we present a case of a 10-year-old Hispanic female that complained of abdominal pain, distension, and nausea. Physical examination revealed a mass on the left side of the abdomen and an axial computed tomography found a large pelvic tumor extending to the abdominal region. After a laparotomy approach, pathology evaluation confirmed the diagnosis of mature cystic teratoma. The patient recovered thoroughly and had no complications at a 6-month follow-up. We conducted a literature review including English and Spanish reports about giant ovarian teratomas; we retrieved 16 cases from 2003 to 2023. We concluded that giant ovarian tumors may be underreported, particularly in resource-limited areas where tumors might grow unrecognized, and that English-language bias might play a substantial role in literature reviews involving case reports and case series.

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          Most cited references28

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          CARE 2013 Explanations and Elaborations: Reporting Guidelines for Case Reports.

          Well-written and transparent case reports (1) reveal early signals of potential benefits, harms, and information on the use of resources; (2) provide information for clinical research and clinical practice guidelines (CPGs), and (3) inform medical education. High-quality case reports are more likely when authors follow reporting guidelines. During 2011-2012 a group of clinicians, researchers, and journal editors developed recommendations for the accurate reporting of information in case reports that resulted in the CARE (CAse REport) Statement and Checklist. They were presented at the 2013 International Congress on Peer Review and Biomedical Publication, have been endorsed by multiple medical journals, and translated into nine languages. This explanation and elaboration document has the objective to increase the use and dissemination of the CARE Checklist in writing and publishing case reports. Each item from the CARE Checklist is explained and accompanied by published examples. The explanations and examples in this document are designed to support the writing of high-quality case reports by authors and their critical appraisal by editors, peer reviewers, and readers. This article and the 2013 CARE Statement and Checklist, available from the CARE website [www.care-statement.org] and the EQUATOR Network, [www.equator-network.org] are resources for improving the completeness and transparency of case reports.
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            Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature.

            To evaluate the clinical and pathologic presentation of mature cystic teratomas and the trends in management over a 14-year study period. Tumor registry data and medical records between January 1, 1975 and December 31, 1989 were analyzed with respect to patient age, tumor size, bilaterality, malignant transformation, and treatment. Five hundred seventy-three tumors were removed from 517 patients. The median and mean (+/- standard deviation) age was found to be 30 and 32 +/- 11.3 years, respectively. Three hundred ten (60%) of the patients were asymptomatic. The mean tumor size was 6.4 +/- 3.5 cm. The bilaterality rate was 10.8%. The rate of torsion was 3.5%; larger tumors underwent torsion more frequently than smaller tumors (P = .029). The rate of malignant transformation was 0.17%. The mean cyst diameter for patients undergoing cystectomy was 5.7 +/- 2.4 cm; for oophorectomy, 8.0 +/- 4.1 cm; and for hysterectomy, 6.1 +/- 3.8 cm. Oophorectomies were performed for larger tumors when compared to cystectomies (P = .01). The number of hysterectomies was stable throughout the study period, whereas the number of oophorectomies decreased and the number of cystectomies increased markedly. Contralateral ovarian biopsy was common (48.5%) early in the study period. By 1989, the biopsy rate was less than 1%. We found the prevalence rates of symptomatic tumors, torsion, and malignant degeneration to be less than those previously reported by most other investigators. In addition, there has been an important change over the past 14 years in the management of these neoplasms, with an increased tendency for ovarian preservation, as evidenced by the more frequent use of cystectomy and a decrease in contralateral ovarian biopsy.
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              Mature cystic teratomas of the ovary: case series from one institution over 34 years.

              To evaluate bilaterality, complications and malignant changes of mature cystic teratomas of the ovary. Retrospective study of 501 patients operated at Hacettepe University Hospital between the years of 1964 and 1998. The median age was 35 years (range 13-76). One hundred and six cases (21.1%) were asymptomatic. The mean tumor diameter was 7.0+/-4.5 cm. The decision for cystectomy or oophorectomy was related with the patient age, gravidity and parity. The bilaterality rate when both ovaries were evaluated histopathologically was 13.2% (44/331). Total complication rate was 10.7%, torsion being the most frequent (4.9%). The rate of malignant transformation was 1.4%. Ovarian mature cystic teratomas are common tumors especially during the reproductive period with low rates of covert bilaterality, complications and malignant transformation. The treatment should be directed on the basis of age, fertility desire or presence of another pelvic pathology rather than the size or bilaterality.
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                Author and article information

                Journal
                Case Rep Oncol
                Case Rep Oncol
                CRO
                CRO
                Case Reports in Oncology
                S. Karger AG (Basel, Switzerland )
                1662-6575
                6 October 2023
                Jan-Dec 2023
                6 October 2023
                : 16
                : 1
                : 1066-1072
                Affiliations
                [a ]Mexican Oncology Association, Zapopan, Mexico
                [b ]Department of Medicine, Universidad Autónoma de Guadalajara School of Medicine, Zapopan, Mexico
                [c ]Oncology Unit, Zapopan, Mexico
                Author notes
                Correspondence to: Carlos Murillo-Zepeda, cmurilloz@ 123456edu.uag.mx
                Article
                534141
                10.1159/000534141
                10601794
                37900852
                a9a8e530-38ca-471f-a97d-0a4a5508e710
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ( http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                History
                : 14 July 2023
                : 12 September 2023
                : 2023
                Page count
                Figures: 2, Tables: 1, References: 28, Pages: 7
                Funding
                The study was carried out with the authors’ resources and/or the institution they represent.
                Categories
                Case Report

                Oncology & Radiotherapy
                ovarian teratoma,benign teratoma,dermoid cyst,giant,pediatric
                Oncology & Radiotherapy
                ovarian teratoma, benign teratoma, dermoid cyst, giant, pediatric

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