Mumtaz Muhammad Khan, Naveed Sharif, Sajjad Ahmad.
Morphological spectrum of mature ovarian teratoma.
Gomal J Med Sci Jan ;12(2):76-80.

Background: Teratomas are usually derived from all the three germinal layers. They present as cysts filled with abundant sebaceous material with hair and may contain cartilage, teeth and bone. Solid teratomas pose diagnostic problems especially when the usual ectodermal components are missing on histological examination. The aim of the study is to determine the morphological spectrum of mature ovarian teratoma and to create awareness about the unusual features. Material & Methods: A prospective study consisting of 247 cases of ovarian lesions received at the Department of Pathology, Peshawar Medical College, Peshawar, from January 2012 to October 2013 from its attached teaching hospitals. The patients’ data, gross appearance of the ovarian lesions and microscopic findings were recorded. Results: A total of 247 cases were included in this study out of which 234(94.7%) were benign and 13(5.3%) malignant. The commonest benign lesion was hemorrhagic luteal cyst in 50(20.2%) cases, followed by follicular cyst and serous cystadenoma in 49(19.8%) each. The mature teratoma was found in 42(17%) of cases. Left sided were 27(64.3%) and right sided 15(35.7%). About 90.5% were cystic and more than half of the lesions (71.4%) were monolocular. The multiloculation usually comprised of 3 to 4 compartments but in two cases, tiny cysts were found to be scattered all over the cut surface along with solid areas. The size was less than 10 cm diameter in 64.3% of the lesions. On gross examination, cheesy material with hair was found in 32(76.2%), serous fluid in 4(9.5%), mucinous fluid in 3(7.1%) and chocolate colored fluid in one (2.4%) and teeth and bone in 5(11.9%) cases. Histologically, all of the mature teratomas consisted of tissues derived from ectoderm and mesoderm. Eight (19%) of them in addition also showed tissues derived from endoderm. Conclusion: The possibility of mature teratoma must be considered both grossly and microscopically in an ovarian tumor even in the absence of usual ectodermal elements and sebaceous secretions.

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