Teratomas of the ovary: a clinico-pathological evaluation of 87 patients from one institution during a 10-year period

Aim: To present the classification and diagnostic problems encountered between teratomas and other ovarian tumors as well as with other benign entities diagnosed and treated in our institution.

Methods: We analysed retrospectively the clinical and pathological characteristics of 87 teratomas examined in our hospital during the last ten years.

Results: Teratomas constituted 5% of all ovarian tumors. The age range was from 11-69 years old (median: 35). The most frequent symptom was lower abdominal pain in 68% of patients. A pelvic mass was noted in 3% of cases. A pregnancy was present in 3% of patients. In ten cases the tumors were bilateral. Tumor size ranged from 1-16 cm in diameter (median: 7.17 cm). The treatment consisted of cystectomy in 66% of the cases, oophorectomy in 23% or hysterectomy with both adnexa in 11% of cases. Fifty-seven cases presented with a histological diagnosis of mature teratoma, biphasic or triphasic type, three cases with monodermal teratoma, ten cases with ovarian neoplasms of mixed type, 15 cases with epidermal cysts, and two cases with benign cysts. Malignant changes within the teratomas were seen in 5% cases.

Conclusion: Teratomas are common ovarian tumors at any age, especially during the reproductive age, with a low rate of complications and malignant transformation. The treatment should be based on patient age, fertility status, tumor size, the cystic or solid nature of the tumor and bilaterality.

Teratomas; Ovary; Epidermal cyst; Treatment; Classification

[1] Rosai and Ackerman's "Surgical pathology". In: J. Rosai (ed.), The Ovary, 9'h edition, Vol. II, Edinburgh, Mosby-Elsevier, 2004, 1649 [2] World Health Organization Classification of Tumors. Pathology and Genetics: Tumors of the Breast and Female Genital Organs, Ed Fataneh A. Tavassoli & Peter Devilee, Tumors of the ovary and peritoneum, 2003, 113, Lyon, IARC Press.

[3] Comerci J. Jr., Licciardi F., Bergh P.A., Gregori C., Breen J.L.: "Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature". Obstet. Gynecol., 1994, 84, 22.

[4] Peterson W.F., Prevost E.C., Edmunds F.T., Hundley J.M, Morris F.K.: "Benign cystic teratomas of ovary; clinico-statistical study of 1,007 cases with review of the literature". Am. J. Obstet. Gynecol., 1955, 70, 368.

[5] Payne D., Muss H.B., Homesley H.D., Jobson V.W., Baird F.G.: "Autoimmune hemolytic anaemia and ovarian dermoid cysts. Case report and review of the literature". Cancer, 1981, 48, 721.

[6] Kikkawa F., Nawa A., Tamakoshi K., Ishikawa H., Kuzuya K., Suganuma N. et al.: "Diagnosis of squamous cell carcinoma arising from mature cystic teratoma of the ovary". Cancer, 1998, 82, 2249.

[7] Stamp G.W., McConnell E.M.: "Malignancy arising in cystic ovarian teratomas: a report of 24 cases". Br. J. Obstet. Gynaecol., 1983, 90, 671.

[8] Kelley R.R., Scully R.E.: "Cancer developing in dermoid cysts of the ovary". Cancer, 1961, 14, 989.