J Gynecol Oncol.  2008 Dec;19(4):275-278. 10.3802/jgo.2008.19.4.275.

An ovarian mucinous cystadenocarcinoma arising from mature cystic teratoma with para-aortic lymph node metastasis: a case report

• Park JH
• Whang SO
• Song ES
• Choi SJ
• Lee WY

• KMID: 2173420
• DOI: http://doi.org/10.3802/jgo.2008.19.4.275

Abstract

Malignant transformation of a mature cystic teratoma (MCT) is an uncommon complication. The most common form of malignant transformation of a MCT is squamous cell carcinoma, representing 75% of malignant transformations. The frequency of malignant transformation of MCT to adenocarcinoma is just 6.8%. To the best of our knowledge, no case of para-aortic lymph node metastasis in mucinous adenocarcinoma arising from MCT has been reported before. The prognosis of malignant transformation of the MCT is very poor. Here, we report an unusual case of a 41-year-old woman with mucinous adenocarcinoma arising from MCT with para-aortic lymph node metastasis.

Keyword

Mucinous cystadenocarcinoma; Mature cystic teratoma; Para-aortic lymph node

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Mucinous
Adult
Carcinoma, Squamous Cell
Cystadenocarcinoma, Mucinous
Female
Humans
Lymph Nodes
Mucins
Neoplasm Metastasis
Prognosis
Teratoma
Mucins

Figure

• 

  Fig. 1 Pelvic CT shows a 15×9 cm sized multiseptated solid-cystic mass with internal calcification and fatty component in the left ovary.

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  Fig. 2 (A) Macroscopic appearance of ovarian tumor shows muliseptated myxoid and mucinous areas and Rokitansky's protubernace composed of osteocartilagenous tissue and hair tufts admixed yellow sebaceous material. The ovarian surface is clear. (B) The cystic portion of the ovary consists of well differentiated mucinous adenocarcinoma (inset; H&E, ×200), which is intimately associated with dermoid tissue mature cystic teratoma (H&E, ×100).

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  Fig. 3 (A) The tumor cells of the well differentiated mucinous adenocarcinoma is positive for cytokeratin 20 (left lower) and negative for cytokeratin 7 (right lower), suggesting the mucinous tumor must have arisen in the colonic type epithelium of the matue cystic teratoma. (B) The left para-aortic lymph node shows metastasis from poorly differentiated adenocarcinoma. The tumor cells are positive for cytokeratin 7 (left lower) and some of them are positive for cytokeratin 20 (right lower), suggesting that the tumor has originated from the solid area of the ovarian lesion (H&E, ×100).

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