Case of Squamous Cell Carcinoma Transformation in Ovarian Mature Cystic Teratoma
A Case Report
Keywords:
Teratoma, oveary, squamous cell carcinoma
Abstract
Mature cystic teratoma (MCT) is the commonest benign tumour arising in an ovary. Malignant transformation in a MCT of ovary is exceptionallyrare, seen only in1-2% cases.The most common malignant transformation in a benign teratoma of ovary is squamous cell carcinoma. The other malignant transformations in teratoma include adenocarcinoma, melanoma and basal cell carcinoma. The patients having this malignant transformation in teratoma have a very low 5-year survival rate of 20% approximately. Here; we describe a case of advanced-stage squamous cell carcinoma arising in a mature cystic teratoma in a 34-year-old woman.This solid high grade malignancy was missed in the pre-operative imaging which showed a right adnexal mass with echogenic foci within and septations, and was reported as a dermoid cyst. The intraoperative frozen section too taken from the thin portion of the cyst wall was reported as cystic teratoma. However in the staging laparotomy,right salpingo-oophorectomy and left oophorectomy, specimen the patient was reported to have moderately differentiated squamous cell carcinoma arising in a benign mature cystic teratomawith extensive tumour necrosis with omental tumour deposits.In view of initial incomplete surgery and advanced stage, decision of completion cytoreductive surgery was taken. The patients with mature cystic teratoma with high age (post-menopausal), a size of more than 10 cm and increased serum tumour markers should be suspected to have a malignant transformation and should be investigated thoroughly.References
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2. Shakuntala PN, Pallavi VR, Meenakshi S, Anil M, Umadevi K, Bafna UD. De novo Ovarian Squamous Cell Carcinoma. A Case Report and Review of Literature. Indian Journal of Surgical Oncology. 2013;4(3):269-271. doi:10.1007/s13193-013-0236-9.
3. Spannuth WA, Rocconi RP, Kirby TO, Huh WK, Conner MG. Gamma mode of infiltration associated with poor prognosis in malignant teratoma of the ovary: a case report. GynecolOncol. 2005; 98: 155 - 157.
4. Berek J.S. Epithelial ovarian cancer. In: Berek J.S., Hacker N.F., editors. Practical Gynecologic Oncology. fourth ed. Lippincott Williams & Wilkins; Philadelphia: 2005. p. 443.
5. Hackethal, Brueggmann D., Bohlmann M.K., Franke F.E., Tinneberg H.R., Münstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. Lancet Oncol. 2008;9:1173–1180.
6. Tseng CJ, Chou HH, Huang KG, Chang TC, Liang CC, Lai CH, et al. Squamous cell carcinoma arising in mature cystic teratoma of the ovary. GynecolOncol. 1996; 63: 364 - 370.
7. Kikkawa F, Nawa A, Tamakoshi K, Ishikawa H, Kuzuya K, Suganuma N, et al. Diagnosis of squamous cell carcinoma arising from mature cystic teratoma of the ovary. Cancer. 1998; 82: 2249 - 2255.
8. Shariat-Torbaghan S, Emami-Aleagha M, Sedighi S, Azadbakht F, Keshvari A, Hajarizadeh B, Rosai J. Squamous cell carcinoma arising in an ovarian mature cystic teratoma: a case report. Arch Iran Med. 2009 Mar;12(2):186-9.
9. Peterson WF. Malignant degradation of benign cystic teratomas of the ovary: a collective review of the literature. ObstetGynecolSurv. 1957; 12: 793 - 820.
10. Dos Santos L, Mok E, Lasonos A, Park K, Soslow RA, Aghajanian C, et al. Squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case series and review of the literature. GynecolOncol. 2007; 105: 321 - 324.
Published
2019-03-27
Issue
Section
Case Report
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