A Rare Case of Adenocarcinoma Arising From Ovarian Mature Cystic Teratoma With Para-Aortic Lymph Node Metastasis

Abstract

A 72 year-old woman suffering from abdominal pain, was referred to our clinic with the finding of palpable pelvic mass. Transvaginal ultrasonography revealed a 107x95 mm cyst with hypo and hyperechogenities in the right ovary suggesting cystic teratoma. She was operated to rule out an ovarian or endometrial malignancy. An exploratory laparotomy, total abdominal hysterectomy, bilateral salpingoophorectomy and appendectomy were performed. Intraoperative frozen section examination of the right adnexal mass and the uterus was benign. However, the final pathologic diagnosis was adenocarcinoma arising from mature cystic teratoma. Afterwards, a staging laparotomy comprising bilateral pelvic, paraaortic lymphadenectomy and omentectomy was undertaken. Omentum and all lymph nodes were tumor free except a solitary grossly enlarged one at para-aortic region. Postoperatively 6 courses of adjuvant chemotherapy composed of paclitaxel and carboplatin were administered. At postoperative 33rd month follow-up, the patient is disease free. To the best our knowledge, this is one of the preliminary cases which an adenocarcinoma derived in a dermoid cyst with paraaortic lymph node metastasis. Copyright © 2013 by Türkiye Klinikleri.