EP22.39: Like gold dust: immature cystic teratoma – a case report

An immature teratoma is a rare malignant germinal tumour composed of three germ cell layers (ectoderm, endoderm, and mesoderm), histologically defined by the presence of immature tissue, predominantly primitive neuroepithelium. The scarcity of cases has hindered the establishment of well-defined ultrasound features for this immature tissue, which is mainly described as large, unilateral, cystic-solid tumour. This case report aims to detail its clinical and ultrasound features. A 25-year-old woman complained of lower abdominal pain. The ultrasound revealed a solid formation (141x104x115 mm) with irregular margins, a heterogeneous echostructure with hyperechoic vascularised areas (colour score 3) mixed with anechoic cystic areas. No ovarian parenchyma was visualised. Oncological markers were as follows: Ca19-9 73.4 UI/ml, CA15-3 31.9 U/ml, CA125 205 U/ml; HE 4 56.45 pmol/L; CEA 2.3 ng/mL. The patient had previously undergone bilateral cystectomy for endometriomas and was under hormonal treatment. The patient underwent right adnexectomy, omentectomy, peritonectomy of the pelvis and right paracolic gutter, pelvic lymphadenectomy, appendectomy, sigma-rectum resection, and colorectal anastomosis. The final diagnosis and stage were high-grade immature teratoma G3, IC2. After a multidisciplinary meeting, adjuvant chemotherapy was administered according to established protocols and the patient was counselled on oncofertility. Immature cystic teratoma is a rare malignant ovarian tumour, affecting mainly young women and necessitating thorough diagnostic evaluation and comprehensive surgical management. In this case the ultrasonographic aspect of the tumour was a solid tumour with hyperechoic vascularised areas mixed with anechoic cystic areas. Further studies are warranted to elucidate the ultrasound features of immature cystic teratomas. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.