Grade 4 immature teratoma followed by portal vein embolization and hepatectomy with recurrence: A case report

Abstract

Introduction: Immature teratomas or in another way malignant germ cell tumors are considered a very rare type of aggressive ovarian cancers. Of teratomas it represents 1%. In ovarian cancers it still presents 1% and as an overall it presents 35.6% of all malignant ovarian germ cell tumors. In most cases it has been found during the first two decades of life. Case Report: The present case describes a case of a patient who was diagnosed with immature teratoma that was treated surgically and discovered sooner to have a liver metastasis that was treated with hepatic embolization and hepatectomy. Furthermore, she developed recurrence with lung metastasis that was intended to be treated with chemotherapy. Conclusion: Prognosis of this type of cancer is reported to be good as long as it is discovered and treated early in the course. Patients usually present before metastasis. In terms of liver metastasis our patient had a hepatic embolization followed by a right hepatectomy which when compared to other reported cases almost all had a hepatectomy without embolization. Five months later our patient presented with lung metastasis which is uncommon specially after the patient had a right hepatectomy. Based on these findings our patient had a very short disease-free period which is not typical for this kind of disease. Platinum-based chemotherapy is considered the standard of care as an adjuvant therapy. This patient showed resistance to cisplatin where up to our knowledge there were no reported cases that had resistance to this regimen.