Pneumatosis-Like (Cystoid) Pattern in Ovarian Mature Teratoma: A Rare Histopathological Presentation in a 40-Year-Old Woman

Abstract

Mature cystic teratoma is the most common ovarian germ-cell tumor, typically showing a combination of ectodermal, mesodermal, and endodermal tissues. A rare morphological variant, recently described in the literature, is the pneumatosis-like or cystoid pattern, characterized by numerous microcystic spaces imparting a spongy appearance. Case: We report the case of a 40-year-old woman presenting with pelvic pain and a sensation of heaviness. Pelvic ultrasonography revealed a wellcircumscribed adnexal mass measuring 55 × 42 mm, suggestive of a mature teratoma. Gross examination confirmed a spongy lesion containing multiple microcystic cavities. Microscopic evaluation demonstrated microcystic spaces lined by attenuated epithelium within mature teratomatous components, corresponding to the pneumatosis-like variant. Conclusion: This case highlights a rare morphological presentation of mature teratoma. Recognizing this unusual variant is essential to avoid confusion with cystic neoplasms or artifacts.