Chia‑Shuen Lina, Ci Huangb, Pei‑Chen Lib, Yung‑Hsiang Hsuc, Dah‑Ching Dingb,d*
aSchool of Medicine, Tzu Chi University, Hualien, Taiwan, bDepartment of Obstetrics and Gynecology, Hualien Tzu Chi Hospital , Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan, cDepartment of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan, dInstitute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Teratoma of the ovary is the most frequently encountered germ cell tumor. It usually occurs in young women. Gliomatosis peritonei (GP) is mature neural glial tissue implanted onto the peritoneal surface. We present a case of a mature teratoma accompanied by GP and massive ascites in postmenopausal women. A 54‑year‑old, G0P0, woman presented in the gynecology outpatient department with abdominal distension for 6 months. Computed tomography scan of the abdomen and pelvis displayed an ovarian mass about 20 cm × 18 cm with peritoneal seeding, ascites, and enlarged paraaortic lymph nodes. A total hysterectomy and bilateral adnexectomy were performed. The pathology showed the left ovary contained a dermoid cyst. The biopsy of the peritoneal nodule displayed glial tissue confirming the diagnosis of GP. The patient remained in good condition 6 months postoperatively. We suggest GP be considered in patients presenting with teratomas and massive ascites. The radiological diagnosis is challenging due to the rarity of GP. Continued
follow‑up of patients with teratomas and GP is mandatory due to the potential of malignant transformation.
Keywords: Ascites, Gliomatosis peritonei, Teratoma