Peritoneal Nodules in a Pediatric Patient with Benign Teratoma. A Case Report and Review of Literature

J Pediatr Adolesc Gynecol. 2018 Dec;31(6):632-636. doi: 10.1016/j.jpag.2018.07.001. Epub 2018 Jul 7.

Abstract

Background: Mature ovarian teratomas are common in children. These well differentiated tumors are typically confined to the ovary. In rare cases, they can rupture leading to granulomatous peritonitis that mimics carcinomatosis. Ovarian tumors with peritoneal/omental implants suggest malignant pathology with a different prognosis.

Case: A 15-year-old girl presented with 5 months of abdominal pain, and weight loss. Computed tomography (CT) imaging of the abdomen revealed a large mass filling the abdomen. Slightly elevated lactate dehydrogenase (LDH) and carcinoma antigen 125 (CA125). On laparotomy an ovarian tumor with peritoneal and omental implants was identified. Left salpingo-oophorectomy, omentectomy, and peritoneal washing were performed. Pathology revealed a benign cystic teratoma.

Summary and conclusion: Although ovarian teratomas are typically benign, they might mimic carcinomatosis. In patients with unexpected finding of peritoneal implants, histologic diagnosis is recommended before proceeding with a full oncologic ovarian resection.

Keywords: Benign teratoma; Peritoneal implants; Teratoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / pathology*
  • Adolescent
  • CA-125 Antigen / blood
  • Carcinoma / diagnosis
  • Diagnosis, Differential
  • Female
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Omentum / pathology*
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / pathology
  • Peritoneal Neoplasms / complications
  • Peritoneal Neoplasms / diagnosis*
  • Peritoneal Neoplasms / pathology
  • Teratoma / complications
  • Teratoma / diagnosis*
  • Teratoma / pathology

Substances

  • CA-125 Antigen
  • L-Lactate Dehydrogenase

Supplementary concepts

  • Teratoma, Ovarian