HISTOLOGY AS A GOLD STANDARD IN DIAGNOSING GLIOMATOSIS PERITONEI ASSOCIATED WITH IMMATURE TERATOMA OF OVARY

Dr. Anu Singh, Dr. D. S. Chauhan*, Dr. Arvind Ahuja, Dr. Vikas Jindal, Dr. Vinita Singh, Dr. Sunita Singh

ABSTRACT

Gliomatosis peritonei (GP) is an infrequent occurrence, exclusively associated with mature or immature teratoma of the ovary. GP is defined as miliary implantation of glial tissues on the surface of the visceral or parietal peritoneum with secondary maturation into glial nodules. A 19 year-old female presented with rapidly enlarging lump in right lower abdomen over the last 2 months. Her past and family history were unremarkable. Local examination revealed a huge mass in abdominopelvic region. Rest of the general and systemic examination were within normal limits. Contrast enhanced computed tomography (CECT) whole abdomen revealed a mass with altered signal intensity lesion in abdomen and pelvis extending into adjacent bowel loops measuring 17.8× 17.1 × 10 cm showing areas of calcification. Serum tumor markers were elevated. Patient underwent laparotomy followed by right salpingo-oophorectomy and excision of nodules on peritoneal surface, omentum and pouch of Douglas. On histopathology examination, a diagnosis of immature teratoma (grade 3) with GP was rendered. GP with an immature teratoma of the ovary is associated with favourable prognosis, although more frequent recurrence is noted. Extensive sampling and multiple biopsies followed by histopathology is the gold standard because it can be mistaken for intra-abdominal carcinomatosis or tuberculosis, and a close follow-up is required to monitor recurrence and rare malignant transformation.

Keywords: Gliomatosis peritonei, Histopathology, glial, implants.