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Gliomatosis peritonei is associated with frequent recurrence, but does not affect overall survival in patients with ovarian immature teratoma

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Gliomatosis peritonei (GP) is commonly associated with ovarian teratoma and is not thought to have an adverse prognostic effect. However, the prognostic impact and characteristics of GP remain to be clarified. In this study, we investigated the clinicopathologic features of ovarian teratoma associated with GP, and we further compared ovarian immature teratoma (IT) with GP to ovarian IT without GP. During the study period, there were a total of 16 ovarian teratomas associated with GP. Among them, 15 cases were ovarian ITs of various grades. When ovarian IT with GP (n = 15) was compared to ovarian IT without GP (n = 27), it was found that ovarian IT patients with GP had larger tumor size (median, 19 vs. 13 cm; P < 0.001), more frequent recurrence (40 %, 6/15 vs. 3.7 %, 1/27; P = 0.005), and frequently elevated preoperative CA-125 level (100 %, 12/12 vs. 50 %, 10/20; P = 0.004). All recurrences occurred within 2 years of the initial surgery. Survival curves indicated that ovarian IT patients with GP had significantly shorter recurrence-free survival compared to those without GP (P = 0.002). The 2-year recurrence-free survival rates were 59.3 and 96.3 % in IT with GP and IT without GP, respectively. However, all but one case of IT with GP are currently alive. In conclusion, GP is an adverse prognostic factor characterized by frequent recurrence in patients with ovarian IT.

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  1. Chaung JH, Chen L (1992) Ovarian teratoma with gliomatosis peritonei. J Pediatr Surg 27:662–664

    Article  PubMed  CAS  Google Scholar 

  2. Hamada Y, Tanano A, Sato M, Tsuji M, Sakaida N, Okamura A, Hioki K (1998) Ovarian teratoma with gliomatosis peritonei: report of two cases. Surg Today 28:223–226

    Article  PubMed  CAS  Google Scholar 

  3. Nielsen SN, Scheithauer BW, Gaffey TA (1985) Gliomatosis peritonei. Cancer 56:2499–2503

    Article  PubMed  CAS  Google Scholar 

  4. Umekawa T, Tabata T, Tanida K, Yoshimura K, Sagawa N (2005) Growing teratoma syndrome as an unusual cause of gliomatosis peritonei: a case report. Gynecol Oncol 99:761–763

    Article  PubMed  Google Scholar 

  5. Mann JR, Gray ES, Thornton C, Raafat F, Robinson K, Collins GS, Gornall P, Huddart SN, Hale JP, Oakhill A (2008) Mature and immature extracranial teratomas in children: the UK Children's Cancer Study Group Experience. J Clin Oncol 26:3590–3597

    Article  PubMed  Google Scholar 

  6. Robboy SJ, Scully RE (1970) Ovarian teratoma with glial implants on the peritoneum. An analysis of 12 cases. Hum Pathol 1:643–653

    Article  PubMed  CAS  Google Scholar 

  7. Stephany JD, Green VS, Gonzalez OR (2004) Pathologic quiz case: an abdominopelvic mass in a 13-year-old adolescent girl. Predominantly mature cystic teratoma with minimal immature neuroglia and gliomatosis peritonei. Arch Pathol Lab Med 128:705–706

    PubMed  Google Scholar 

  8. Kwan MY, Kalle W, Lau GT, Chan JK (2004) Is gliomatosis peritonei derived from the associated ovarian teratoma? Hum Pathol 35:685–688

    Article  PubMed  Google Scholar 

  9. Best DH, Butz GM, Moller K, Coleman WB, Thomas DB (2004) Molecular analysis of an immature ovarian teratoma with gliomatosis peritonei and recurrence suggests genetic independence of multiple tumors. Int J Oncol 25:17–25

    PubMed  CAS  Google Scholar 

  10. Hsieh YL, Liu CS (2009) Progression from an immature teratoma with miliary gliomatosis peritonei to growing teratoma syndrome with nodular gliomatosis peritonei. Pediatr Neonatol 50:78–81

    Article  PubMed  Google Scholar 

  11. Mrabti H, El Ghissassi I, Sbitti Y, Amrani M, Hachi H, Errihani H (2011) Growing teratoma syndrome and peritoneal gliomatosis. Case Rep Med 2011:123527

    CAS  Google Scholar 

  12. Culine S, Lhomme C, Kattan J, Michel G, Duvillard P, Droz JP (1995) Pure malignant immature teratoma of the ovary: the role of chemotherapy and second-look surgery. Int J Gynecol Cancer 5:432–437

    Article  PubMed  Google Scholar 

  13. Williams SD, Blessing JA, Moore DH, Homesley HD, Adcock L (1989) Cisplatin, vinblastine, and bleomycin in advanced and recurrent ovarian germ-cell tumors. A trial of the Gynecologic Oncology Group. Ann Intern Med 111:22–27

    PubMed  CAS  Google Scholar 

  14. O'Connor DM, Norris HJ (1994) The influence of grade on the outcome of stage I ovarian immature (malignant) teratomas and the reproducibility of grading. Int J Gynecol Pathol 13:283–289

    Article  PubMed  Google Scholar 

  15. Dadmanesh F, Miller DM, Swenerton KD, Clement PB (1997) Gliomatosis peritonei with malignant transformation. Mod Pathol 10:597–601

    PubMed  CAS  Google Scholar 

  16. England RA, deSouza NM, Kaye SB (2007) Gliomatosis peritonei: MRI appearances and its potential role in follow up. Br J Radiol 80:e101–104

    Article  PubMed  CAS  Google Scholar 

  17. Harms D, Janig U, Gobel U (1989) Gliomatosis peritonei in childhood and adolescence. Clinicopathological study of 13 cases including immunohistochemical findings. Pathol Res Pract 184:422–430

    Article  PubMed  CAS  Google Scholar 

  18. Khan J, McClennan BL, Qureshi S, Martell M, Iyer A, Bokhari SJ (2005) Meigs syndrome and gliomatosis peritonei: a case report and review of literature. Gynecol Oncol 98:313–317

    Article  PubMed  Google Scholar 

  19. Lipskar AM, Rothstein DH, Soffer SZ, Edelman M, Glick RD (2009) Intrathoracic glial implants in a child with gliomatosis peritonei. J Pediatr Surg 44:1817–1820

    Article  PubMed  Google Scholar 

  20. Luesley DM, Monypenny IJ, Fielding JW, Chan KK (1983) Gliomatosis peritonei associated with ovarian teratomas. Case report. Br J Obstet Gynaecol 90:668–670

    Article  PubMed  CAS  Google Scholar 

  21. Moukarram H, Chia KV (2006) Conservative treatment of an immature ovarian teratoma with gliomatosis peritonei. J Obstet Gynaecol 26:277–278

    Article  PubMed  CAS  Google Scholar 

  22. Muller AM, Sondgen D, Strunz R, Muller KM (2002) Gliomatosis peritonei: a report of two cases and review of the literature. Eur J Obstet Gynecol Reprod Biol 100:213–222

    Article  PubMed  Google Scholar 

  23. Shefren G, Collin J, Soriero O (1991) Gliomatosis peritonei with malignant transformation: a case report and review of the literature. Am J Obstet Gynecol 164:1617–1620, discussion 1620–1611

    PubMed  CAS  Google Scholar 

  24. Truong LD, Jurco S 3rd, McGavran MH (1982) Gliomatosis peritonei. Report of two cases and review of literature. Am J Surg Pathol 6:443–449

    Article  PubMed  CAS  Google Scholar 

  25. Vicus D, Beiner ME, Clarke B, Klachook S, Le LW, Laframboise S, Mackay H (2011) Ovarian immature teratoma: treatment and outcome in a single institutional cohort. Gynecol Oncol 123:50–53

    Article  PubMed  Google Scholar 

  26. Herbst AL (1992) Neoplastic disease of the ovary. In: Herbst AL, Mishell DR, Stenchever MA, Droegemueller W (eds) Comprehensive gynecology. Mosby Year Book, St. Louis, pp 937–988

    Google Scholar 

  27. Norris HJ, Zirkin HJ, Benson WL (1976) Immature (malignant) teratoma of the ovary: a clinical and pathologic study of 58 cases. Cancer 37:2359–2372

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Chang Ohk Sung or Sang Yong Song.

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Yoon, N.R., Lee, JW., Kim, BG. et al. Gliomatosis peritonei is associated with frequent recurrence, but does not affect overall survival in patients with ovarian immature teratoma. Virchows Arch 461, 299–304 (2012).

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