子宮内膜肥厚を伴う卵巣腫瘍に対し腹腔鏡手術を施行し、成熟嚢胞性奇形腫の一部に成人型顆粒膜細胞腫の合併を認めた一例

抄録

  Mature cystic teratoma and concomitant adult granulosa cell tumor (AGCT) of the ovary is a rare condition. We report a case of mature cystic teratoma and concomitant AGCT of the ovary, which was treated by laparoscopic surgery. A 64-year-old woman presented to our hospital with postmenopausal irregular vaginal bleeding. Imaging tests revealed endometrial thickness, as well as a left ovarian tumor measuring 6 cm in diameter. Preoperative investigations including endometrial tissue biopsy and imaging tests did not reveal any evidence of malignancy. We performed successful laparoscopic surgery with a meticulous technique to prevent ovarian tumor rupture. Histopathological examination of the resected specimen showed findings of AGCT and concomitant mature cystic teratoma. The tumor was localized only to the left adnexa without intraoperative tumor rupture; therefore, the patient was deemed suitable to undergo regular follow-up, which is currently ongoing without evidence of recurrent AGCT.

  A comprehensive literature search revealed 8 cases of AGCT and concomitant mature cystic teratoma of the ovary. Predicting AGCT based on preoperative imaging tests was difficult in all cases. However, approximately 50% of these women showed either irregular vaginal bleeding or increased endometrial thickness. Clinicians should consider a malignancy such as AGCT in the differential diagnosis in women presenting with irregular vaginal bleeding or evidence of increased endometrial thickness on imaging tests.