Presentation
Female with abdominal pain and increased superior abdominal circumference. She had a history of a right ovarian mature teratoma managed surgically 7 months earlier.
Patient Data
A mass-like heterogeneous lesion next to the right border of the liver with multiple cystic areas and calcifications, poor vascular flow at the Doppler application.
Intraperitoneal heterogeneous mass located next to the liver, with cystic, fat and solid components, multiple calcifications. Associated with mesenteric nodules and ascites. Ovaries are normal.
Case Discussion
Gliomatosis peritonei is a rare condition in which mature glial tissue is implanted on the peritoneum. Only less than 100 cases have been described in the literature.
There are two theories for the implantation: one is glial implants arise from the teratoma, whereas in the other, pluripotent stem cells in the peritoneum or subcoelomic mesenchyme undergo glial metaplasia.
On CT or MRI, the implants can be from little soft tissue nodules to big implants with other immature components or teratomatous look-alike. They have predilection to subdiaphragmatic surface, paracolic gutters and omentum.
All grades of ovarian teratomas have been associated with gliomatosis peritonei, with immature teratomas being the most commonly associated. This is a rare case of mature teratoma associated with a big implant with teratomatous component and mature glial tissue.
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