Immature teratoma in pregnancy

Savaş Karakuş; Şerife Özlem Genç; Dilay Karademir; Gamze Sönmez; Tahsin Takcı; Buğra Okşaşoğlu; Neşe Yeldir; Handan Aker; Ali Yanık

doi:10.7197/223.vi.553455

EN

Immature teratoma in pregnancy

Abstract

Objective: The most common genital neoplasms in the reproductive period are over tumors. Limitation of radiological examinations done during pregnancy and the concentration of the examination on the fetus in general may lead to missed malignancies. The purpose of the study is to discuss the approach to adnexal masses seen in pregnancy.

Case: A 26-year-old woman with a 39-week gestation had a groin pain. CA125 value: 60 U / ml, CA19-9: 385,5 U / ml, AFP: 115,1 U / ml. After birth with C / S, the right ovary was observed to have a mass of approximately 15 cm It was followed. The mass was excised and a frozen section was sent. It was reported to be compatible with the resultant mature teratoma. Upon reporting the final pathologic outcome as immature teratoma grade 1, post-operative positron emission tomography (PET-CT) imaging and tumor marker screening were planned. PET CT imaging and tumor markers were negative.

Conclusions: 90% of adnexal masses below 6 cm are functional cysts between the 16-18th gestational weeks. They usually fall back on their own. Malignancy rate after operation is 4-6% in persistent. Except for the presence of acute symptoms or the suspicion of serious malignancy; Surgical intervention should be postponed to the middle of the 2nd trimester (16-18th week). The presence of ovarian cysts with symptomatic ovarian mass presence, overtorsion, overcyst rupture, acute abdomen, diffuse ascites, rapid growth pattern in pregnancy requires urgent surgical intervention. Frozen section should be sent during the operation if surgical intervention is required. The frozen section determines intraoperative behavior. The number of cross sections during frozen process is limited. In frozen conditions, as many as three sections can be taken in the laboratory, large-diameter tumors have a higher rate of false diagnosis in the frozen specimen. As in this case, inadequate sampling leads to false negative results in borderline and malign lesions showing focal development. Although this delay in diagnosis causes adjuvant delay in treatment, ovarian cancer that is detected in pregnancy is usually over-limited (stage 1), so the outcome is not badly affected. Most of them are germ cell tumors and low malignant potential epithelial tumors. It usually shows early stage, low grade, unilaterality. Often, unilateral oophorectomy and surgical staging are sufficient.

Keywords

Adnexial mass,adnexal mass approach in pregnancy

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