ABSTRACT
The development of a somatic neoplasm within an ovarian dermoid cyst (mature cystic teratoma) is a rare, but well described, phenomenon which occurs in approximately 1% of all cases. Any of the tissue components of a dermoid cyst has the potential to undergo neoplastic transformation with carcinoid tumors and squamous cell carcinomas being among the most common neoplasms. We report a case of a ganglioneuroblastoma arising within an ovarian dermoid cyst, an association which, as far as we are aware, has not been described previously.
Subject(s)
Dermoid Cyst/diagnostic imaging , Ganglioneuroblastoma/diagnostic imaging , Ovarian Neoplasms/diagnostic imaging , Teratoma/diagnostic imaging , Cell Transformation, Neoplastic , Dermoid Cyst/pathology , Dermoid Cyst/surgery , Female , Ganglioneuroblastoma/pathology , Ganglioneuroblastoma/surgery , Humans , Immunohistochemistry , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Salpingo-oophorectomy , Teratoma/pathology , Teratoma/surgery , Ultrasonography , Young AdultABSTRACT
OBJECTIVES: Evaluative assessment is needed to inform improvement of Part 4 Maintenance of Certification (MOC), a large-scale program that aims to improve physician knowledge, engagement, and skills in quality improvement (QI). We sought to determine if Part 4 MOC participation improves perceived educational and clinical outcomes by piloting a new physician survey. METHODS: We administered a new online survey (MOC Practice, Engagement, Attitude, and Knowledge Survey) to physicians at the beginning and end of a Part 4 MOC project sponsored by a pediatric hospital's American Board of Medical Specialties' portfolio program during 2015. Participants worked in academic and community settings and in various accredited specialties. The main outcome was change in survey response on a 5-point Likert scale (1 = best) for 3 learning domains (QI engagement and attitude; QI method application, and improved patient care). RESULTS: Of 123 complete responses and a 97% response rate, mean baseline responses were positive or neutral (2.2, 2.3, 1.9, respectively). Responses improved in QI engagement and attitude (-0.15, z score = -2.78, P = .005), QI method application (-0.39, z score = -7.364, P < .005), and improved patient care (-0.11, z score = -1.728, P = .084). CONCLUSIONS: A Part 4 MOC physician survey provides valuable data to evaluate and improve the learning activity. In this children's hospital program, physicians view Part 4 favorably. Participation was associated with modest improvements in perceptions of QI engagement and attitude, application of QI methods, and patient care. Systematic evaluation of all Part 4 MOC projects and programs has the potential to improve the program nationally.
