Ovarian Mature Cystic Teratomas in Women over 50 Years of Age: Coincidental Malignancy

Abstract

Abstract

Objective: This study was conducted to find the optimal management for mature cystic teratomas (MCTs) in women age 50 or older. Design: This was a retrospective longitudinal study. Materials and Methods: Demographic, clinical, biochemical, radiology, surgical, and pathology data were collected retrospectively from the current authors' electronic patient records for all women over age 50, with preoperative imaging and histologic diagnoses of mature cystic teratomas. The review period was from 2000 to 2014. Results: There were 32 cases identified with an age range of 50–83 and a median age of 54. In 18 (56%) patients, the presenting symptom was abdominal pain, and, in 14 (44%) patients, the MCTs were found incidentally during imaging performed for various clinical indications. Radiologic assessment in 30/32 identified fat and/or calcifications within the ovaries but did not predict associated malignancies. Somatic and synchronous coincidental malignancy was found in 3 cases (9%). Two of the 8 patients with somatic malignancies had MCTs measuring 10 cm or more in diameter, and 1 synchronous malignancy was associated with an MCT measuring 2 cm. The histologies in these cases were carcinoid tumor, papillary carcinoma in struma ovarii, and adult granulosa-cell tumor, respectively. Conclusions: MCTs, although uncommon in postmenopausal women, are associated with an increased risk of concurrent coincidental malignancy within the ovaries. As radiologic and biochemical investigations were not helpful for identifying cases with coincidental malignancies, conservative management for mature cystic teratomas in women over age 50 is not appropriate. (J GYNECOL SURG 32:104)