Effects of mature cystic teratoma on reproductive health and malignant transformation: A retrospective analysis of 80 cases.

OBJECTIVE: Examining the cases of mature cystic teratoma (MCT) that are diagnosed and treated in our clinic regarding their association with fertility; and detecting the rate of malignant degeneration and the types of malignancies.

MATERIAL AND METHODS: Patients, operated due to adnexal mass between April 2012 and August 2017 and diagnosed with MCT, were retrospectively examined. Mean age of the 80 cases, which met the criteria, was 30.60±10.5. 9 were suffering from infertility, according to hospital records. 67% of these (6 cases) were accompanied by endometriosis and MCT was bilateral in 55.5% of them (5 cases). Malignant degeneration was present in 6.25% of the cases (5 cases), all were monodermal tumors. Malignant degeneration was more common among the cases with adnexal masses larger in diameter (9.1±2.9 cm) and with postmenopausal age. Tumor markers were in normal range for the patients that developed malignancy. Malignant degeneration was not present among the infertile patients with endometriosis.

RESULTS: Although MCTs do not seem to affect the ovarian reserve negatively, the complaint of infertility is prominent in case of concurrent presence of endometriosis. During assessment, concurrent endometriosis should be considered. Imaging findings, large adnexal masses and postmenopausal period are important for the assessment of MCT concerning malignant degeneration. It should not be overlooked: tumor markers may be normal.

CONCLUSION: MCTs can be present concurrent with endometriomas. In such cases the complaints of infertility are more distinct. In MCT malign degeneration, mass diameter, complex mass internal structure and postmenopausal status are important factors.