Extragonadal immature teratoma of the uterus

Background: With fewer than 20 cases of extragonadal teratomas since 1929, treatment guidelines remain unclear. Case Presentation: A 27-year-old nulliparous female presented with vaginal bleeding and malodorous discharge. Transvaginal ultrasound and pelvic MRI revealed a 4 cm prolapsing echogenic ce...

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Main Authors: Katherine Jane C. Chua, Maryam Ali, Alice Barr, Rebecca Brooks, Nell V. Suby
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925000323
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author Katherine Jane C. Chua
Maryam Ali
Alice Barr
Rebecca Brooks
Nell V. Suby
author_facet Katherine Jane C. Chua
Maryam Ali
Alice Barr
Rebecca Brooks
Nell V. Suby
author_sort Katherine Jane C. Chua
collection DOAJ
description Background: With fewer than 20 cases of extragonadal teratomas since 1929, treatment guidelines remain unclear. Case Presentation: A 27-year-old nulliparous female presented with vaginal bleeding and malodorous discharge. Transvaginal ultrasound and pelvic MRI revealed a 4 cm prolapsing echogenic cervical mass that was FDG avid on PET CT. Biopsy confirmed a grade 1 polypoid immature teratoma arising from either the uterus or cervix. She underwent a total laparoscopic hysterectomy, bilateral salpingectomy, omentectomy, and primary optimal tumor debulking to R0. Bilaterally ovaries appeared grossly normal and were preserved. On final pathology, the patient was staged using FIGO ovarian cancer criteria as Stage IIIA2 grade 2 immature teratoma of the uterus. The patient received three cycles of bleomycin, etoposide, and cisplatin. The patient is 11 months post-surgery and currently undergoing surveillance. Conclusion: Given the rarity of uterine immature teratomas, management of this case was extrapolated from existing recommendations for immature ovarian teratomas. Unlike in prior case reports where surgical approach was via an exploratory laparotomy, our patient underwent optimal debulking via minimally invasive surgery with ovarian preservation and adjuvant chemotherapy. Given the chemosensitive nature of germ cell tumors, further fertility sparing options for extragonadal immature teratoma may be further explored.
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spelling doaj-art-ac801e0c13e440bcae170434e65615232025-08-20T02:27:47ZengElsevierGynecologic Oncology Reports2352-57892025-04-015810170710.1016/j.gore.2025.101707Extragonadal immature teratoma of the uterusKatherine Jane C. Chua0Maryam Ali1Alice Barr2Rebecca Brooks3Nell V. Suby4University of California Davis Medical Center, Department of Gynecology Oncology, Sacramento, CA, United States; Corresponding author at: 4860 Y Street, Ste. 2500, Sacramento, CA 95817, United States.University of California Davis Medical Center, Department of Gynecology Oncology, Sacramento, CA, United StatesUniversity of California Davis Medical Center, Department of Gynecology Oncology, Sacramento, CA, United StatesUniversity of California Davis Medical Center, Department of Gynecology Oncology, Sacramento, CA, United StatesKaiser Permanente Northern California, Department of Gynecology Oncology, Sacramento, CA, United StatesBackground: With fewer than 20 cases of extragonadal teratomas since 1929, treatment guidelines remain unclear. Case Presentation: A 27-year-old nulliparous female presented with vaginal bleeding and malodorous discharge. Transvaginal ultrasound and pelvic MRI revealed a 4 cm prolapsing echogenic cervical mass that was FDG avid on PET CT. Biopsy confirmed a grade 1 polypoid immature teratoma arising from either the uterus or cervix. She underwent a total laparoscopic hysterectomy, bilateral salpingectomy, omentectomy, and primary optimal tumor debulking to R0. Bilaterally ovaries appeared grossly normal and were preserved. On final pathology, the patient was staged using FIGO ovarian cancer criteria as Stage IIIA2 grade 2 immature teratoma of the uterus. The patient received three cycles of bleomycin, etoposide, and cisplatin. The patient is 11 months post-surgery and currently undergoing surveillance. Conclusion: Given the rarity of uterine immature teratomas, management of this case was extrapolated from existing recommendations for immature ovarian teratomas. Unlike in prior case reports where surgical approach was via an exploratory laparotomy, our patient underwent optimal debulking via minimally invasive surgery with ovarian preservation and adjuvant chemotherapy. Given the chemosensitive nature of germ cell tumors, further fertility sparing options for extragonadal immature teratoma may be further explored.http://www.sciencedirect.com/science/article/pii/S2352578925000323Extragonadal malignant immature teratomaMinimally invasive primary debulkingChemosensitive germ cell tumor
spellingShingle Katherine Jane C. Chua
Maryam Ali
Alice Barr
Rebecca Brooks
Nell V. Suby
Extragonadal immature teratoma of the uterus
Gynecologic Oncology Reports
Extragonadal malignant immature teratoma
Minimally invasive primary debulking
Chemosensitive germ cell tumor
title Extragonadal immature teratoma of the uterus
title_full Extragonadal immature teratoma of the uterus
title_fullStr Extragonadal immature teratoma of the uterus
title_full_unstemmed Extragonadal immature teratoma of the uterus
title_short Extragonadal immature teratoma of the uterus
title_sort extragonadal immature teratoma of the uterus
topic Extragonadal malignant immature teratoma
Minimally invasive primary debulking
Chemosensitive germ cell tumor
url http://www.sciencedirect.com/science/article/pii/S2352578925000323
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AT alicebarr extragonadalimmatureteratomaoftheuterus
AT rebeccabrooks extragonadalimmatureteratomaoftheuterus
AT nellvsuby extragonadalimmatureteratomaoftheuterus