Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

A case of Gliomatosis Peritonei after 10 years following Operation of Immature Teratoma of the Ovary / 부인종양

Gliomatosis peritonei, the implantation of neuroglial tissue upon the peritoneal surface, is a rare event most often associated with solid or immature teratoma of the ovary in young girls. The majority of cases occur in association with teratomas containing immature element. However malignant transformation of the glial tissue has been reported. Here we experienced a case of mature glial implants presenting in an 27-year-old female, 10 years after initial diagnosis and removal of an ovarian immature teratoma, and report this case with brief review of literatures.

A Case of Immature Teratoma of the Ovary with Gliomatosis Peritonei / 대한산부인과학회잡지

Immature teratoma is composed of varying quantities of immature differentiating among anyone or all three germ layer. The pure immature teratoma accounts for fewer than 1% of all ovarian cancer, but it is the second most common germ cell malignancy. About 50% of pure immature teratomas of the ovary occur in women between the ages of 10 and 20 years, and they rarely occur in postmenopausal women. The most frequent site of dissemination is the peritoneum, and much less commonly, the retroperitoneal lymph node. Among the tumors with embryonal elements, those containing neural tissues demonstrate most clearly the importance of the ability to mature. Gliomatosis peritonei is the most dramatic demonstration of the significance of maturation, because most patients with these tumors have survived, even with this disseminated disease. The purpose of this paper is to report on a immature ovarian teratoma with predominantly mature glial tissues in peritoneum which we have experienced in this hospital recently with brief review of the literature.

A Case of Gliomatosis Peritonei / 대한산부인과학회잡지

Gliomatosis peritonei is the implantation of glial tissue with the piertoneal cavity associa-ted with ovarian teratoma. Although the mechanism of implantation is unknown, it probably occurs most commonly from extrusion of mature glial tissue through capsular defects in the tumor. Previous reports have emphasized improved outcomes when these implants are found to be mature, even if the ovarian component is immature. We experienced one case of ovarian immature teratoma(Grade I) with gliomatosis peritonei, which was treated with conservative surgery.