[Prostatic tissue in a mature cystic teratoma of the ovary: report of one case]. / Tejido prostático en teratoma quístico maduro del ovario: caso clínico.

Male accessory sexual glands arising in ovarian cystic teratoma are exceedingly rare. We report a 56-year-old female subjected to an ovariohysterectomy due to a left ovarian mass. The pathological study of the surgical piece revealed a tumor composed of different mature tissue elements and well defined nodules of benign prostatic tissue.

Recurrent conjunctival dermoid cyst with reactive lymphoid hyperplasia.

Conjunctival dermoid cysts are a rare subtype of dermoid cyst usually presenting in adulthood. The authors report a case of a recurrent conjunctival dermoid cyst with reactive lymphoid hyperplasia that was immunohistochemically demonstrated to be polyclonal. Follicular centers that were present within the cyst wall were negative for Bcl-2 and positive for the immunohistochemical markers CD20, Bcl-6, CD10, and Ki67, which helped to differentiate the lesion from a follicular lymphoma. The lesion did not recur after 14 months of follow-up.

Giant intra-abdominal mature cystic teratoma (dermoid cyst) in an adult man, with male genitourinary tissue including prostatic and penile elements.

We describe a case of a giant intra-abdominal mature cystic teratoma in a 36-year-old man, which comprised typical features of differentiated teratoma/dermoid cyst but which contained a macroscopic rudimentary penis, with vasoformative erectile tissue-like structures consistent with corpora cavernosa, as well as scrotal-type skin and prostatic tissue. The genitourinary structures were well formed both grossly and microscopically and sharply demarcated from the rest of the neoplasm, which comprised typical differentiated teratoma, without any other macroscopic foci of organoid differentiation or of other histologic differentiation. The plasticity of the cells of differentiated teratoma, which enables it to undergo multidirectional differentiation, is well recognized, but the factors determining this distinct path of differentiation remain to be established.

Prostatic tissue in mature cystic teratomas of the ovary.

We report two examples of mature cystic teratomas of the ovary containing prostatic tissue. Both were incidental findings in teratomas that were otherwise typical at clinical and pathologic levels. The prostatic tissue contained ducts and acini in a simple branching pattern similar to that seen in the peripheral zone of the prostate gland. Transitional cell elements were present in both cases and compact acini resembling Cowper's gland were noted in one. No testicular or Wolffian duct tissue was noted. The immunohistochemical staining pattern of the glands was identical to that seen in normal prostate. In a literature review, four additional cases were identified. The presence of prostatic tissue in a 46XX tumor suggests induction by locally produced androgen. Some investigators have identified luteinized stromal cells and indicated these as the source of this androgen. Other possible androgenic origins include ovarian hilar cells, adrenal cortex, and tumor cells.

Clinicopathological and immunohistochemical features of a sebaceous carcinoma arising within a benign dermoid cyst of the ovary.

Pure sebaceous neoplasms arising in dermoid cysts of the ovary are exceedingly rare. A 63-year-old female with abdominal swelling and pain underwent a right salpingo-oophorectomy that showed a unilocular cyst weighing 830 g and measuring 15x12x10 cm, filled with sebaceous material containing a few hair shafts. The cyst wall exhibited plaques protruding into the cavity of the cyst. Microscopy revealed a dermoid cyst with nests and lobules of atypical and infiltrating sebaceous cells surrounded by basaloid cells. The tumor cells stained diffusely for high-molecular-weight cytokeratins and focally for cytokeratin 7, cytokeratin 19, epithelial membrane antigen and carcinoembryonic antigen in the immunohistochemistry study. Low-molecular-weight cytokeratins, cytokeratin 20, vimentin, S100, p63, estrogen receptor, progesterone receptor, p53 and c-erbB-2 were negative in tumoral cells. The proliferative labeling index (Ki67 and proliferating cell nuclear antigen) was low. Basal cell carcinoma with sebaceous differentiation and sebaceoma must be considered in the differential diagnosis. However, the presence of obvious malignant sebaceous differentiation in nearly every tumor nest and lack of peripheral palisading and peri-tumoral myxoid stroma excluded these diagnoses. Some histogenetic concepts relevant to this case are discussed along with a brief review of this neoplasm. To our knowledge, this is the sixth case report of a sebaceous carcinoma arising in a mature cystic teratoma of the ovary.

Carcinosarcoma arising in a dermoid cyst of the ovary.

A case of carcinosarcoma arising within an otherwise benign cystic teratoma is reported. The patient, a 78 year old nulliparous woman, presented with right sided abdominal pain of short duration and subsequently underwent a bilateral salphingo-oophorectomy. Slicing of the left ovary revealed a unilocular cyst containing hair admixed with soft yellow material with a thin wall apart from a solid area at one pole. Extensive areas of necrosis and cystic degeneration were present within this mass. Histologically, the large cyst was a typical mature cystic teratoma, containing carcinomatous and sarcomatous elements. Mature cystic teratomas have been reported in association with a variety of malignant ovarian tumours such as mucinous cystadenocarcinoma and malignant germ cell neoplasms. Secondary malignant transformation within a dermoid cyst is a much rarer occurrence, estimated as less than 2% of all such lesions. Adenocarcinomas are the second most common malignancies arising within dermoid cysts. Sarcomas alone or in combination with squamous carcinoma have been described arising in a mature cystic teratoma. To the best of our knowledge, no case of sarcoma arising in association with adenocarcinoma has been described before.

Effects of pirfenidone and dermoid cyst fluid on adhesion formation.

OBJECTIVE: To evaluate the effects of pirfenidone and human dermoid cyst fluid on adhesion formation in a rat model. DESIGN: A prospective, blinded, controlled study. SETTING: Sprague-Dawley white rats in a conventional laboratory setting. INTERVENTION(S): Rats were divided into four groups according to the type of solution tested (dermoid fluid, 0.05 mg of pirfenidone, normal saline, and a combination of dermoid fluid and pirfenidone). In the first experiment, the solution (0.5 mL) was injected intraperitoneally. In the second experiment, the solution was instilled intraperitoneally after a standardized injury to the right uterine horn. The degree of adhesion formation was evaluated 2 weeks after the initial surgery. RESULT(S): Human dermoid cyst fluid caused adhesion in 4 of 10 intact rats and in 9 of 10 standardized injured rats. Pirfenidone did not decrease adhesion formation. No adhesion was found after injection of saline or pirfenidone in intact rats. The mean +/- SEM adhesion score in standardized injured rats was higher in the dermoid group (4.6 +/- 0.6) than in the pirfenidone group (2.8 +/- 0.7) or the saline group (3.8 +/- 0.5). The mean +/- SEM adhesion score in intact rats was 0.6 +/- 0.3 after dermoid fluid injection and after dermoid instillation in standardized injured rats was 4.6 +/- 0.6. CONCLUSION(S): Human dermoid fluid causes adhesion formation even in intact rats, and the adhesion is worse in the presence of serosal injury. Intraperitoneal pirfenidone does not decrease adhesion formation.

Dermal cysts of the rhino mouse develop into unopened sebaceous glands.

The rhino mouse (hr(rh)hr(rh)) is a mutant strain characterized by a wrinkled and hairless skin with epidermal utriculi (pseudocomedones) and dermal cysts. The epidermal cysts have been extensively studied. The present work focused on the dermal cysts. By electron microscopy it was found that they appear on day 20 after birth and that they originate from a pool of undifferentiated epithelial cells of the deepest part of the initial follicular unit. Progressively, the number of cells in these islets increased and a central cavity was formed. Peripheral cells differentiated into sebocyte-like cells and outer root sheath cells. Staining with Oil Red O solution indicated accumulation of lipid material in the central cavity. The dermal cysts of the adult rhino mouse were isolated and purified in several steps including enzyme digestion, centrifugation, and separation on Nylex sieves. The integrity of the isolated cysts was confirmed by histology and electron microscopy. Study of their keratin polypeptide pattern by gel electrophoresis indicated that they express the mouse keratins 5, 14, 6 and 17. Neutral lipid analysis of the dermal cyst contents showed that they were mainly composed of cholesterol esters, wax esters, lipid fractions which migrate between triglycerides and cholesterol esters but very small amounts of triglycerides, cholesterol and ceramides. In conclusion, the present results demonstrate that dermal cysts of the rhino mouse have strong similarities with sebaceous glands and outer root sheath cells. These structures can easily be isolated and could therefore serve as a 'closed sebaceous gland' model to study the physiology or differentiation of the sebaceous gland, or the effects of pharmacological agents.

Magnetic resonance imaging and quantitative analysis of contents of epidermoid and dermoid cysts.

The intracapsular cholesterol, protein, and calcium contents of epidermoid and dermoid cysts from seven patients were compared with the signal intensities on T1-weighted spin-echo magnetic resonance (MR) images. All specimens had a paste-like consistency when resected. Epidermoid and dermoid cysts demonstrated a wide range of cholesterol and calcium contents, and epidermoid cysts were not always rich in cholesterol. Five patients had cysts with lower signal intensity than white matter, which contained more than 18.3 mg/g wet weight of protein. One of these patients had the highest cholesterol content of all seven patients (22.25 mg/g wet weight) and another had the highest calcium content (0.75 mg/g wet weight). Two patients had cysts with higher signal intensity than white matter, with protein contents of lower than 4.3 mg/g wet weight. High protein content (> 18.3 mg/g wet weight) may decrease signal intensity on T1-weighted MR images, while low protein content (< 4.3 mg/g wet weight) may increase signal intensity in epidermoid and dermoid cysts with high viscosity (paste-like consistency) contents.

Radiological appearances of dermoid tumours (with emphasis on fat fluid levels).

Nine cases of dermoid tumours, one in the chest and eight in the abdomen are reported with various radiological findings on plain films, ultrasound and computed tomographic (CT) scans. The various radiological appearances at ultrasound and CT are described. The incidence and frequency of fat-fluid interfaces on ultrasound and CT scans are highlighted. Since the appearances of fat on ultrasound are variable, CT is therefore more specific in showing in fat-fluid levels. Moreover the dermoid tissue plugs seen on CT and ultrasound scans, with their surrounding fat, are highlighted as the so-called "iceberg" sign or as "target" signs. The paper concludes that the presence of fat fluid levels, a finding not previously emphasized, with a positive "iceberg" or "target" sign on CT or ultrasound scans, are pathognomonic of dermoid cysts.

[Selenium concentrations in serum, hair and tumor tissue from patients with ovarian tumors].

Selenium (Se) concentration was determined in 150 samples of serum, 135 samples of hair and 96 samples of ovarian tissue from patients with malignant or benign ovarian tumors and normal subjects. The serum Se level in patients with malignant ovarian tumors was significantly lower than that in patients with benign ovarian tumors and normal subjects. No difference of Se concentrations of hair among different groups was observed. Se level in malignant ovarian tumor tissue was significantly higher than that in benign ovarian tumor tissue and normal ovarian tissue. The low serum Se level in patients with malignant ovarian tumors was probably the result of protective migration of Se from blood to the cancer tissue.

Ovarian cystic teratoma with a pathognomonic appearance of multiple floating balls: a case report and investigation of common characteristics of the cases in the literature.

OBJECTIVE: To investigate the common characteristics of a rare entity of ovarian cystic teratoma with intracystic floating balls in conjunction with a case. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 41-year-old woman with abdominal discomfort and a 2-year obscure history of an ovarian cyst. INTERVENTION(S): Right salpingo-oopherectomy by laparotomy. MAIN OUTCOME MEASURE(S): Ultrasonography and magnetic resonance imaging (MRI). RESULT(S): Ultrasonographic examination revealed a cystic mass (>10 cm) with a unique appearance of multiple floating balls on the lower right quadrant of the abdomen. The MRI showed the same balls with a slightly high fat content. Histopathological diagnosis was mature cystic teratoma and the balls were mostly made of keratin. CONCLUSION(S): The appearance of intracystic floating balls is rarely seen but is pathognomonic for mature cystic teratoma. When this typical appearance is found on ultrasonography the value of other diagnostic tests, such as tumor markers, serological tests for echinococcosis, computerized tomography (CT), and MRI, can be considered as limited.

Tejido prostático en teratoma quístico maduro del ovario: Caso clínico / Prostatic tissue in a mature cystic teratoma of the ovary: Report of one case

Male accessory sexual glands arising in ovarian cystic teratoma are exceedingly rare. We report a 56-year-old female subjected to an ovariohysterectomy due to a left ovarian mass. The pathological study of the surgical piece revealed a tumor composed of different mature tissue elements and well defined nodules of benign prostatic tissue.

Distribution of cellular carbohydrate moieties in human dysontogenetic brain tumors, especially in craniopharyngioma and epidermoid/dermoid.

Cellular carbohydrate moieties of 65 human dysonotogenetic brain tumors (craniopharyngioma, epidermoid/dermoid, Rathke cleft cyst, germinoma and non-germinomatous germ-cell tumors) and 60 common brain tumors (glioma, meningioma, neurinoma and pituitary adenoma) were investigated histochemically using sections from Ulex europaeus (UEA-1), Dolichos biflorus (DBA), peanut (PNA) and soybean (SBA), and with anti-blood group A and LewisY (LeyY) antibodies. In craniopharyngiomas and epidermoid/dermoids, it was found that PNA and SBA binding sites existed in suprabasal cells of the epithelium, and that antigen of either blood group A or H (demonstrable by UEA-1) existed in more differentiated epithelial cells compared to the results reported in normal human skin epidermis. Rathke cleft cysts were stained with PNA or SBA, and two out of three Rathke cleft cysts also expressed either H or A antigen. In addition, DBA binding sites, as well as LeY antigen, were frequently seen in craniopharyngiomas and Rathke cleft cysts, but they were entirely absent in the epithelium of epidermoid/dermoid. On the other hand, PNA and SBA reactivities was also found in common brain tumors, while blood group A, H and LeY antigens and DBA reactivity were almost absent in these tumors. These findings demonstrate that carbohydrate moieties such as those of blood group antigens reported to be found in human skin epidermis exist in a similar form in craniopharyngioma, epidermoid/dermoid and the Rathke cleft cyst. The identification of blood group A, H and LeY antigens and DBA reactivity in brain tumors seems to be considerably limited and specific.(ABSTRACT TRUNCATED AT 250 WORDS)