ISSN: 2642-6145
Authors: Niwa K*, Mori S, Kuwabara K, Gotoh N, Nagata K, Takenaka M, Niwa K, Futamura N and Tanaka T
An ovarian teratoid carcinosarcoma transformed from mature cystic teratoma, closely resembling its nasopharyngeal one, and occurs in advanced clinical stages, and behaves in a highly aggressive manner. An extremely rare case of primary ovarian teratoid carcinosarcoma is reported with cytological, pathological and immunohistochemical findings. A 49-year-old woman presented to our hospital, complaining of prolonged menstruation. Enhanced computed tomography showed ovarian mature cystic teratomas, however rt-ovarian tumor had invaded to the surface of the rectum, suggesting malignant transformation, and adenomyosis was also suspected. Optimal surgery could be performed. The imprint and ascitic cytology specimens revealed two different patterns of atypical cells suggestive of adenocarcinoma and pleomorphic sarcoma. Pathological findings of the small part of the right ovary revealed adenocarcinoma and pleomorphic sarcoma, immunohistochemically, positive for AE1/ AE3, vimentin and Pax-8, and negative for desmin for the both above components. Her genomic instability score was 73, showing homologous recombination deficiency (HRD) positive showing positive, but tumor BRCA1/2 mutations showed no clinically significant mutations. Thus, final diagnosis was primary rt-ovarian teratoid carcinosarcoma, pT3CN1M0, optimal surgical state, HRD positive and BRCA1/2 no mutations. The patient received the six courses of the chemotherapy with ifosfamide and cisplatin. And niraparib, a PARP inhibitor, monotherapy started. The patient was free from tumor recurrence twelve months after the first visit.
Keywords: Ovary; Teratoid Carcinosarcoma; Immunohistochemistry; Ifosfamide and Cisplatin; PARP Inhibitor
