Malignant transformation is extremely a rare complication of mature cystic teratoma and it usually occurs in postmenopausal women. The most common form of malignant transformation is squamous cell carcinoma. Carcinoid tumors are rare tumors of the diffuse neuroendocrine system and it represents about 0.1% of all ovarian neoplasms.
In this report, a carcinoid tumor arising from a mature cystic teratoma in a 33 year old nulligravid is presented. Adnexal mass was detected during physical examination. She underwent exploratory laparotomy. The left ovary was cystically enlarged to 10 × 9 × 8 cm with intact, thick whitish capsule and areas with normal ovarian tissues. The uterus, right ovary, bilateral fallopian tubes and appendix were grossly normal. Intraoperative diagnosis of Dermoid cyst was made, hence, left oophorocystectomy was done. On cut section, the cyst contained sebum and hair strands. Histopathologic diagnosis revealed a carcinoid tumor arising from a mature cystic teratoma. Immunohistochemical staining showed positivity for chromogranin and synaptophysin. Based on morphological and immunohistochemical staining, the tumor was diagnosed as a carcinoid tumor arising from a mature cystic teratoma. Our patient did not present with carcinoid syndrome.
Malignant transformation is a rare complication of mature cystic teratomas. Preoperative diagnosis of Mature Cystic Teratoma of the ovary can be made through history, physical examination and radiologic findings. The treatment of carcinoid tumor is surgical excision regardless of histologic type. Thorough histopathologic examination and extensive sampling of a dermoid cyst is necessary to detect malignant transformation.
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