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 Table of Contents     
CASE REPORT
Year : 2011  |  Volume : 26  |  Issue : 2  |  Page : 107-108  

A rare case of mature teratoma. Has FDG PET/CT a role to play?


1 Department of Nuclear Medicine, Yashoda Hospital, Somajiguda, Hyderabad, Andhra Pradesh, India
2 Department of Radiology, Yashoda Hospital, Somajiguda, Hyderabad, Andhra Pradesh, India
3 Department of Surgical Oncology, Yashoda Hospital, Somajiguda, Hyderabad, Andhra Pradesh, India
4 Department of Pathology, Yashoda Hospital, Somajiguda, Hyderabad, Andhra Pradesh, India
5 Department of Medical Oncology, Yashoda Hospital, Somajiguda, Hyderabad, Andhra Pradesh, India

Date of Web Publication25-Nov-2011

Correspondence Address:
Tushar Mohapatra
2nd floor, B Block, Yashoda Hospital, Somajiguda, Hyderabad, Andhra Pradesh-500 082
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.90265

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   Abstract 

Authors describe a very rare case of mature teratoma with malignant transformation, preoperatively suggested by FDG PET/CT study. So the role of CT component in elucidating three embryonal components and hypermetabolism evident on PET part suggesting possible malignant transformation makes PET/CT a valuable modality in evaluation of these rare tumors

Keywords: Computed tomography, FDG PET/CT, teratoma


How to cite this article:
Mohapatra T, Arora A, Srikant K, Snehalata, Kumar N. A rare case of mature teratoma. Has FDG PET/CT a role to play?. Indian J Nucl Med 2011;26:107-8

How to cite this URL:
Mohapatra T, Arora A, Srikant K, Snehalata, Kumar N. A rare case of mature teratoma. Has FDG PET/CT a role to play?. Indian J Nucl Med [serial online] 2011 [cited 2019 Dec 10];26:107-8. Available from: http://www.ijnm.in/text.asp?2011/26/2/107/90265


   Introduction Top


Mature cystic teratomas account for 10-20% of all ovarian neoplasms and peak incidence in most series is age 20-40 years. [1] They are the most common ovarian germ cell tumor and also the most common ovarian neoplasm in patients younger than 20 years. In approximately 0.2-2% of cases, it may undergo malignant transformation, the majority of which are squamous cell carcinomas. [2] Mature cystic teratomas of the ovary are often discovered as incidental findings and malignancy is often discovered intraoperatively due to presence of nodal disease or on histopathology, after which a proper staging is usually necessary. There is also risk of future recurrence due to intraoperative spillage if malignancy is not known prior to surgery. [3] So a FDG PET/CT study has a role in diagnosis, predicting malignant transformation and preoperative staging. One of important differential diagnosis is intense tracer activity in the well differentiated neuronal component which is highly metabolically active similar to normal brain parenchyma. [4]


   Case Report and Image Description Top


A 60 year lady presented with abdominal mass underwent PET/CT study as part of the presurgical evaluation. CT scan shows a large abdominal mass arising from the left adnexa, with areas of focal soft tissue densities in the peripheral sheath of a mixed fluid/fat attenuation [Figure 1]. FDG metabolism appears significantly high in the solid components with a SUV max of 35.18 [Figure 2]. Gross specimen shows embryonal components including hair [Figure 3]. H and E stained section high power (40x) - sheets of polygonal cells with marked neclear pleomorphism, hyperchromasia and abundant eosinophilic cytoplasm. Individual cell keratinization is evident [Figure 4].
Figure 1: A 60 year lady presented with abdominal mass underwent PET/CT study as part of the presurgical evaluation. CT scan shows a large abdominal mass arising from the left adnexa, with areas of focal soft tissue densities in the peripheral sheath of a mixed fluid/fat attenuation

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Figure 2: FDG metabolism appears significantly high in the solid components with a SUVmax of 35.18

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Figure 3: Gross specimen shows embryonal components including hair

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Figure 4: H and E stained section high power (40×) - sheets of polygonal cells with marked neclear pleomorphism, hyperchromasia and abundant eosinophilic cytoplasm. Individual cell keratinization is evident

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   References Top

1.Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A. Mature cystic teratomas of the ovary: Case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol 2000;88:153-7.  Back to cited text no. 1
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2.Laberge PY, Levesque S. Short-term morbidity and long-term recurrence rate of ovarian dermoid cysts treated by laparoscopy versus laparotomy. J Obstet Gynaecol Can 2006;28:789-93.  Back to cited text no. 2
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3.Templeman CL, Fallat ME, Lam AM, Perlman SE, Hertweck SP, O'Connor DM. Managing mature cystic teratomas of the ovary. Obstet Gynecol Surv 2000;55:738-45.  Back to cited text no. 3
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4.Miyasaka N, Kubota T. Unusually intense (18) F-fluorodeoxyglucose (FDG) uptake by a mature ovarian teratoma: A pitfall of FDG positron emission tomography. J Obstet Gynaecol Res 2011;37:623-8.  Back to cited text no. 4
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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