Abstract
Background: Gliomatosis peritonei (GP) is a rare condition characterized by the peritoneal dissemination of mature glial tissue, most commonly associated with an immature ovarian teratoma.
Case presentation: We report the case of a 23-year-old woman initially diagnosed with a high-grade immature ovarian teratoma in 2021, who underwent surgical treatment without adjuvant therapy. Three years later, she presented with recurrence as a mature teratoma associated with gliomatosis peritonei. Histopathological examination demonstrated mature neuroglial proliferation without evidence of immaturity or malignant transformation. No additional treatment was administered. Annual gynecological follow-up was recommended.
Discussion GP is an exceptionally rare condition, most often diagnosed incidentally. Two hypotheses have been proposed to explain its origin: implantation of glial tissue from the primary teratoma or glial metaplasia of submesothelial pluripotent cells. The available literature suggests a generally favorable prognosis, although recurrence may occur despite maturation of the lesions. Malignant transformation is exceedingly rare. Management should be individualized and relies on histological confirmation, multidisciplinary evaluation, and fertility preservation whenever appropriate.
Conclusion This case highlights the importance of long-term surveillance following treatment of immature ovarian teratoma, the potential for benign recurrence associated with gliomatosis peritonei, and the need to avoid unnecessary treatment in the absence of malignant transformation.
References
1. Ferguson AW, Katabuchi H, Ronnett BM, Cho KR. Glial implants in gliomatosis peritonei arise from normal tissue, not from the associated teratoma. Am J Pathol. 2001;159(1):51-55. https://doi.org/10.1016/S0002-9440(10)61672-0
2. Nogales FF, Preda O, Dulcey I. Gliomatosis peritonei as a natural experiment in tissu differentiation. Int J Dev Biol. 2012;56(10-12):969-974. https://doi.org/10.1387/ijdb.120172fn
3. Türkmen O, Akar Inan S, Akbay S, Halilzade Mİ, Halilzade İ, Moraloğlu Tekin Ö. Coexisting growing teratoma syndrome and gliomatosis peritonei following ovarian immature teratoma: a case report and literature review. Turk J Med Sci. 2024;54(6):1192-1197. https://doi.org/10.55730/1300-0144.5899
4. Wang D, Jia CW, Feng RE, Shi HH, Sun J. Gliomatosis peritonei: a series of eight cases and review of the literature. J Ovarian Res. 2016;9(1):45. https://doi.org/10.1186/s13048-016-0256-5
5. Shefren G, Collin J, Soriero O. Gliomatosis peritonei with malignant transformation: a case report and review of the literature. Am J Obstet Gynecol. 1991;164(6 Pt 1):1617-1620. https://doi.org/10.1016/0002-9378(91)91445-3
6. Dadmanesh F, Miller DM, Swenerton KD, Clement PB. Gliomatosis peritonei with malignant transformation. Mod Pathol. 1997;10(6):597-601.
7. Bajracharya A, Shrestha S, Singh M, Dhakal HP. Mature ovarian teratoma with gliomatosis peritonei: A rare case report. Clin Case Rep. 2021;9(9):e04879. https://doi.org/10.1002/ccr3.4879
8. Khatiwada A, Jha A, Shrivastav S, Verma S, K C S. Large ovarian mature teratoma with gliomatosis peritonei in a young female: A case report. Radiol Case Rep. 2024;19(9):3970-3974. https://doi.org/10.1016/j.radcr.2024.06.018
9. Liu C, Yan B, Wang Y, Di W, Lou W. Aggressive gliomatosis peritonei arising from ovarian mature teratoma with NF1 mutation: a case report and literature review. Cancer Manag Res. 2022;14:2979-2986. https://doi.org/10.2147/CMAR.S374987
10. Chou CY, Cheng WF, Chen CA. Mature cystic teratoma with gliomatosis peritonei. Taiwan J Obstet Gynecol. 2005;44(2):183-186. https://doi.org/10.1016/S1028-4559(09)60137-6
11. Singla G, Zaheer S, Singla S, Kolte S, Mandal AK. Gliomatosis peritonei in mature cystic teratoma. Indian J Pathol Microbiol. 2017;60(4):606-607. https://doi.org/10.4103/IJPM.IJPM_342_16
12. Das CJ, Sharma R, Thulkar S, Mukhopadhyay S, Deka D, Mannan R. Mature ovarian teratoma with gliomatosis peritonei--a case report. Indian J Cancer. 2005;42(3):165-167. https://doi.org/10.4103/0019-509X.17064
13. Gocht A, Löhler J, Sçheidel P, Stegner HE, Saeger W. Gliomatosis peritonei combined with mature ovarian teratoma: immunohistochemical observations. Pathol Res Pract. 1995;191(10):1029-1035. https://doi.org/10.1016/S0344-0338(11)80603-5
14. Marwah N, Batra A, Gupta S, Singhal SR, Sen R. Gliomatosis Peritonei Arising in Setting of Immature Teratoma of Ovary: A Case Report and Review of Literature. J Obstet Gynaecol India. 2016;66(3):192-195. https://doi.org/10.1007/s13224-015-0708-7
15. Srisajjakul S, Prapaisilp P, Bangchokdee S. Imaging features of unusual lesions and complications associated with ovarian mature cystic teratoma. Clin Imaging. 2019;57:115-123. https://doi.org/10.1016/j.clinimag.2019.05.013
16. England RA, deSouza NM, Kaye SB. Gliomatosis peritonei: MRI appearances and its potential role in follow up. Br J Radiol. 2007;80(953):e101-104. https://doi.org/10.1259/bjr/16457460
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