Immature ovarian teratoma in pregnancy: case report and literature review

Abstract

Immature ovarian teratoma is a malignant tumor derived from germ cells of somatic differentiation. Incidence of these malignancies is low, and rare in pregnancy, usually appearing in young patients and often asymptomatic. We report the case of a 21-year-old patient with 25 weeks' gestation who presented at the obstetric emergency room with a left adnexal mass on routine ultrasound. A second ultrasound performed two days later revealed a heterogeneous adnexal mass with cystic-solid contents and septum, 9.5 cm in the largest diameter, peritoneal implants, and ascites. A laparotomy was performed two weeks later, with unilateral salpingo-oophorectomy and maximal surgical debulking. Histological analysis revealed a grade III immature ovarian teratoma with no malignant cells in the ascites. Following surgery, the patient underwent 3 courses of adjuvant chemotherapy with BEP (bleomycin, etoposide, cisplatin), the first two beginning prior to delivery. Labor induction was  initiated at 36 weeks' gestation. The newborn had an Apgar score of 8/8, with no gross signs of adverse effects from chemotherapy. Patient remains in remission 14 months after surgery. The current case report can contribute to understanding of this disease, which is infrequently reported and with limited available scientific information.