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Rare Case of Ovarian Immature Teratoma with Gliomatosis Peritonei at Follow-Up: Dilemma with F-18 FDG PET CT Imaging

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Gliomatosis peritonei (GP) is a rare condition, associated with immature teratomas, which are a type of germ cell tumors of the ovary. GP is essentially the presence of peritoneal and rarely thoracic implants with mature glial tissue. These lesions show up as contrast avid lesions with high SUV (standardized uptake value) on F-18 FDG PET/CT scans and are difficult to differentiate from residual/recurrent malignant lesions.


To focus on the role and limitations of F-18 FDG PET/CT in the diagnosis of gliomatosis peritonei.


We present a case of immature teratoma of the ovary with gliomatosis peritonei, which was diagnosed during follow-up after primary surgery and adjuvant chemotherapy. The diagnostic dilemma of the FDG avid lesions demonstrated during follow-up, and the steps taken to confirm the diagnosis are discussed.


High SUV and contrast avid lesions were seen on follow-up PET/CT. Biopsy was performed and confirmed benign glial tissue.


Gliomatosis peritonei lesions show up as contrast avid lesions with high SUV (standardized uptake value) on F-18 FDG PET/CT scans. It is difficult to differentiate this benign tissue from residual/recurrent malignant lesions based on imaging only. Biopsy is often required to establish a diagnosis.

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  1. Magudia K, Menias CO, Bhalla S, Katabathina VS, Craig JW, Hammer MM. Unusual imaging findings associated with germ cell tumors. Radiographics. 2019;39(4):1019–35.

    Article  PubMed  Google Scholar 

  2. Liang L, Zhang Y, Malpica A, et al. Gliomatosis peritonei: a clinicopathologic and immunohistochemical study of 21 cases. Mod Pathol. 2015;28(12):1613–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Yokoyama T, Takehara K, Yamamoto Y, Okame S, Shiroyama Y, Yokoyama T, Nogawa T, Sugawara Y. The usefulness of 18F-FDG-PET/CT in discriminating benign from malignant ovarian teratomas. Int J Clin Oncol. 2015;20(5):960–6.

    Article  CAS  PubMed  Google Scholar 

  4. Maher F. Immunolocalization of GLUT1 and GLUT3 glucose transporters in primary cultured neurons and glia. J Neurosci Res. 1995;42:459–69.

    Article  CAS  PubMed  Google Scholar 

  5. Dejanovic D, Hansen NL, Loft A. PET/CT variants and pitfalls in gynecological cancers. Semin Nucl Med. 2021;51:593–6.

    Article  PubMed  Google Scholar 

  6. Miyasaka N, Kubota T. Unusually intense 18F-fluorodeoxyglucose (FDG) uptake by a mature ovarian teratoma: A pitfall of FDG positron emission tomography. J Obstet Gynaecol Res. 2011;37:623–8.

    Article  PubMed  Google Scholar 

  7. Ohara T, Yamanoi K, Inayama Y, Ogura J, Sakai M, Suzuki H, Hirayama T, Yasumoto K, Suginami K. Gliomatosis peritonei with 18F-fluorodeoxyglucoseaccumulation and contrast enhancement secondary to immature teratoma: a case report. Mol Clin Oncol. 2018;9(1):40–3.

    PubMed  PubMed Central  Google Scholar 

  8. Lavoie JM, Lacroix-Poisson F, Hoang LN, Wilson DC, Seckl MJ, Tinker AV. 18F FDG positron-emission tomography findings of gliomatosis peritonei: a case report and review of the literature. Gynecol Oncol Rep. 2017;20:105–7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Yoon NR, 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. 2012;461:299–304.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

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We wish to sincerely thank the patient for consenting to share her case and the multidisciplinary team who were involved in the management of this case.

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Correspondence to Anbukkani Subbian.

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Subbian, A., Kamaleshwaran, K.K. & Ramkumar, E. Rare Case of Ovarian Immature Teratoma with Gliomatosis Peritonei at Follow-Up: Dilemma with F-18 FDG PET CT Imaging. Indian J Gynecol Oncolog 21, 46 (2023).

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