Giant teratomas with benign glial abdominal seeding, mimicking diffuse abdominal carcinomatosis

Teratomas of children represent an important part of oncology. A small percentage of teratomas in this age group is malignant and associated with a rather poor prognosis. In most cases, the malignant element is a mature ectodermal derivative, i.e., epidermal epithelium. Abdominal seeding associated with teratomas is usually considered clinically and pathologically malignant. In a few cases, the teratomatous masses are associated with abdominal seeding of essentially mature neuroglial elements and chances of long survival are good. Therefore, recognition of neurogenic teratomatous tumors associated with glial seeding is important since it will preclude unnecessary surgery and irradiation or chemotherapy. Conservative management seems to entail a good prognosis even if occasional postsurgical complications such as adhesions, fibrous bands or obstructions occur. The two presented cases illustrate the clinical and pathological entity of large ovarian teratomas associated with neuroglial abdominal seeding and their good prognosis at four and five years respectively following surgery alone. These two cases support the experience in the other 25 cases reported in the world literature that these lesions are benign clinically and pathologically.