Bahall Vishal, De Barry Lance, Sookdeo Rachael, Barrow Mickhaiel
Obstetrics and Gynaecology, The University of the West Indies, Saint Augustine, TTO.
Obstetrics and Gynaecology, San Fernando General Hospital, San Fernando, TTO.
Cureus. 2023 Dec 5;15(12):e49945. doi: 10.7759/cureus.49945. eCollection 2023 Dec.
Gliomatosis peritonei (GP) is a rare condition characterised by mature glial nodules that implant in the peritoneum, lymph nodes, or omentum. GP is typically associated with mature or immature ovarian teratomas and usually affects adolescent females. Although neuroglia may be a standard feature of mature ovarian teratomas, widespread peritoneal glial nodules, ascites, and pleural effusion are rare, particularly in the paediatric population. We report a case of a giant left mature ovarian teratoma associated with GP and omental splenunculus in a 12-year-old female who presented with constipation, an adnexal mass, ascites, pleural effusion, and elevated CA-125 levels. The patient successfully underwent fertility-sparing surgery in the form of a left salpingo-oophorectomy, omentectomy, and resection of peritoneal glial deposits. In light of the current scarcity of data on this clinical entity in the literature, we hope to raise awareness of this rare presentation of mature ovarian teratoma, the challenges associated with preoperative diagnosis, and the impact of fertility-sparing surgery on potential oncological and reproductive outcomes in a paediatric patient.
腹膜胶质细胞瘤(GP)是一种罕见疾病,其特征是成熟的神经胶质结节植入腹膜、淋巴结或大网膜。GP通常与成熟或不成熟的卵巢畸胎瘤相关,且通常影响青春期女性。虽然神经胶质可能是成熟卵巢畸胎瘤的一个标准特征,但广泛的腹膜神经胶质结节、腹水和胸腔积液很少见,尤其是在儿科人群中。我们报告一例12岁女性患者,患有巨大的左侧成熟卵巢畸胎瘤并伴有GP和网膜副脾,该患者出现便秘、附件肿块、腹水、胸腔积液以及CA-125水平升高。患者成功接受了保留生育功能的手术,术式为左侧输卵管卵巢切除术、大网膜切除术以及腹膜神经胶质沉积物切除术。鉴于目前文献中关于这一临床实体的数据稀缺,我们希望提高对成熟卵巢畸胎瘤这种罕见表现、术前诊断相关挑战以及保留生育功能手术对儿科患者潜在肿瘤学和生殖结局影响的认识。