Resumen
Introducción: los teratomas maduros pertenecen al grupo de los tumores de ovario de estirpe germinal; por lo general, tienen un comportamiento benigno. La transformación maligna ocurre en un rango de 0.2 a 1% de los tumores. El objetivo es mostrar los resultados de peritonectomía con HIPEC en el tratamiento de un teratoma maduro con diferenciación maligna con células en anillo de sello.
Caso clínico: mujer de 43 años de edad, con diagnóstico de teratoma maduro maligno con células en anillo de sello. Se realizó cirugía de citorreducción primaria optima; histerectomía total, salpingooforectomía bilateral, peritonectomía, apendicectomía, colecistectomía y esplenectomía, además de quimioterapia hipertérmica intraoperatoria (HIPEC).
Conclusiones: la transformación maligna de un teratoma maduro del ovario es un evento raro, pero no excepcional. Se utilizó HIPEC posterior a la citorredución óptima y hubo buenos resultados, ya que la paciente lleva un periodo libre de enfermedad de 36 meses. Es necesario el reporte de casos a fin de comparar diversos tipos de tratamiento para mejorar resultados oncológicos.
Abstract
Background: Mature teratomas belong to the group of germ line ovarian tumors; they generally have benign behavior. Malignant transformation occurs in 0.2% to 1% of tumors. The objective is to show the results of peritonectomy with HIPEC in the treatment of a mature teratoma with malignant differentiation with signet ring cells.
Clinical case: 43-year-old woman diagnosed with mature malignant teratoma with signet ring cells. It was performed optimal primary cytoreduction surgery, total hysterectomy, bilateral salpingo-oophorectomy, peritonectomy, appendectomy, cholecystectomy and splenectomy adding intraoperative hyperthermic chemotherapy (HIPEC).
Conclusions: Malignant transformation of a mature teratoma of the ovary is a rare event, but not exceptional. HIPEC was used after optimal cytoreduction, with good results, since the patient is in a disease-free period of 36 months. It is necessary to report cases in order to compare different types of treatment to improve oncological results.
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