Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Sichuan Province, No. 20 Section Three, South Renmin Road, Chengdu, 610041, People's Republic of China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan Province, Chengdu, People's Republic of China.
BMC Pregnancy Childbirth. 2022 Jun 27;22(1):519. doi: 10.1186/s12884-022-04857-y.
Immature ovarian teratoma is one of the three common malignant ovarian germ cell tumors. However, immature ovarian teratoma in pregnancy is very rare. Due to the rare occurrence, there is little evidence regarding its diagnosis, optimal management, and prognosis. Hence, we present a case of immature teratoma diagnosed during pregnancy, and analyze its clinicopathological features, management and prognosis.
A 28-year-old woman underwent a sonographic examination revealed no abnormality in the bilateral adnexal area before 29 weeks gestational age (WGA). At 29 WGA, ultrasound demonstrated a 9.7 × 8.5 × 6.4 cm complex structure in the left adnexal area. At 30 WGA, repeated ultrasound revealed rapid growth of tumor mass, measuring 25.0 × 15.0 × 13.7 cm. An elective cesarean section combined with exploratory laparotomy was performed at 33 WGA. Intraoperative frozen pathological examination suggested left ovarian immature teratoma. Then, she underwent a complete staging surgery. Subsequently, the patient received 4 cycles of bleomycin-etoposide-cisplatin (BEP) chemotherapy. After 18 months of follow-up, there is no sign of tumor recurrence till now.
This case report suggests that the benefits and risks of timely treatment for patients and fetuses should be fully assessed by a multidisciplinary team. The early diagnosis, the timing of surgery and chemotherapy, the choice of chemotherapy for BEP will determine the prognosis. Surgery and combination chemotherapy with BEP play an important role in the treatment of immature teratomas in pregnancy, and could gain successful and satisfactory outcomes for mother and fetus.
卵巢未成熟畸胎瘤是三种常见的卵巢恶性生殖细胞肿瘤之一。然而，妊娠合并卵巢未成熟畸胎瘤非常罕见。由于其发病率低，关于其诊断、最佳管理和预后的证据很少。因此，我们报告了一例妊娠期间诊断为未成熟畸胎瘤的病例，并分析其临床病理特征、处理和预后。
一名 28 岁女性在 29 孕周（GA）前进行超声检查时双侧附件区未见异常。在 29 孕周时，超声显示左侧附件区有一个 9.7×8.5×6.4cm 的复杂结构。在 30 孕周时，重复超声显示肿瘤体积迅速增大，大小为 25.0×15.0×13.7cm。在 33 孕周时，行选择性剖宫产术联合探查性腹腔镜检查。术中冷冻病理检查提示左侧卵巢未成熟畸胎瘤。随后，她接受了全面分期手术。之后，患者接受了 4 个周期的博来霉素+依托泊苷+顺铂（BEP）化疗。随访 18 个月后，目前无肿瘤复发迹象。
本病例报告表明，多学科团队应充分评估及时治疗对患者和胎儿的利弊。早期诊断、手术和化疗时机、BEP 化疗方案的选择将决定预后。手术和联合 BEP 化疗在妊娠合并未成熟畸胎瘤的治疗中起着重要作用，可以为母婴带来成功和满意的结局。
