METASTATIC IMMATURE OVARIAN TERATOMA WITH PERITONEAL CARCINOMATOSIS DUE TO GLIOMATOSIS: A 10-YEAR FOLLOW-UP SINCE DIAGNOSIS llacabegona@gmail.com

PW01-06

METASTATIC IMMATURE OVARIAN TERATOMA WITH PERITONEAL CARCINOMATOSIS DUE TO GLIOMATOSIS: A 10-YEAR FOLLOW-UP SINCE DIAGNOSIS

6

Mexico

Oral or Poster

Immature ovarian teratoma with peritoneal carcinomatosis due to gliomatosis peritonei (GP) requires distinction between mature glial tissue and immature or malignant elements, as prognosis and treatment differ markedly. Pure GP is benign and managed with conservative resection and surveillance, whereas immature or malignant components necessitate aggressive oncologic therapy.

A 30-year-old female was diagnosed during cesarean section (July 2015) with grade 2 immature ovarian teratoma. One month later, she developed abdominal distension and lower limb edema. Contrast-enhanced CT revealed a 20 × 30 cm right hepatic mass with peritoneal carcinomatosis and ascites. Liver biopsy confirmed immature teratoma. She began BEP chemotherapy but showed early progression and myelotoxicity, prompting right hepatectomy and oophorectomy (R2 cytoreduction). Histopathology reported glial tissue with immature elements.

CA 125 remained within normal limits. In February 2016, CT showed pulmonary nodules, recurrent abdominal and pelvic disease, and inguinal lymphadenopathy. Biopsy confirmed immature teratoma with microscopic glial tissue. Second-line BEP failed, complicated by neutropenic colitis and septic shock. In May 2016, CT confirmed no response. In July 2016, laparoscopic cytoreduction of pelvic lesions and enterolysis was performed with favorable recovery. Histology confirmed GP with immature teratoma. Tumor markers remained normal despite radiologic progression.

Immature teratoma with GP may behave aggressively when immature elements coexist, showing poor chemotherapy response. Accurate histologic characterization is crucial for guiding therapy. Cytoreduction can provide symptom relief when systemic therapy fails, and close long-term follow-up is essential for recurrence detection.