A Case of Sebaceous Carcinoma Arising within a Benign Ovarian Cystic Teratoma

Abstract

Background: Mature cystic teratoma, also known as dermoid cyst, is the most common germ cell tumor of the ovary. Malignant change in a component of a mature ovarian teratoma is rare, occurring in less than 2% of cases, with squamous cell carcinoma corresponding to 80% of such neoplasms. Pure sebaceous carcinoma is exceedingly rare, with only 6 reported cases thus far. Case Report: A 74-year-old woman presented with lower abdominal pain due to a palpable mass in the right abdomen. Abdominal and pelvic ultrasound as well as computed tomography demonstrated a heterogenic tumor of the right ovary. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histological examination of the tumor showed features of a well-differentiated sebaceous carcinoma arising within a mature cystic teratoma. Conclusions: This is an extremely rare ovarian malignancy of which the clinical behavior and optimal management are not well established. Differential diagnosis with other malignant neoplasms arising in mature cystic teratomas is exceedingly important for treatment and prognosis.

Sebaceous carcinoma arising within an ovarian mature cystic teratoma: A case report with discussion of clinical management and genetic evaluation

“…At the time of this publication, only nine cases of sebaceous carcinoma arising within a mature teratoma have been reported, with an estimated incidence of 1–2 per 1,000,000 per year ( Betta and Cosimi, 1984 ; Chumas and Scully, 1991 ; Changchien et al, 1994 ; Papadopoulos et al, 1995 ; Vartanian et al, 2002 ; Ribeiro-Silva et al, 2003 ; Venizelos et al, 2009 ; An et al, 2013 ; Moghaddam et al, 2013 ). Sebaceous carcinoma originates from the adnexal epithelium of sebaceous glands.…”

“…They are generally benign, with only 1–2% of cases undergoing malignant transformation ( Ayhan et al, 2000 ). Sebaceous carcinomas are rare, with the majority of described cases occurring in the eyelid; sebaceous carcinomas arising within a mature teratoma are exceedingly uncommon, with only nine cases described to date (Search engine: PubMed; Search terms: sebaceous carcinoma AND mature cystic teratoma OR teratoma OR dermoid cyst) ( Betta and Cosimi, 1984 ; Chumas and Scully, 1991 ; Changchien et al, 1994 ; Papadopoulos et al, 1995 ; Vartanian et al, 2002 ; Ribeiro-Silva et al, 2003 ; Venizelos et al, 2009 ; An et al, 2013 ; Moghaddam et al, 2013 ). A notable association exists between sebaceous carcinoma and Muir-Torre syndrome, a hereditary autosomal dominant cancer-predisposition syndrome associated with sebaceous tumors as well as the development of internal malignancies of the gastrointestinal and genitourinary tract.…”

Sebaceous Carcinoma Arising in Mature Cystic Teratoma of Ovary

“…Prognosis of sebaceous carcinomas arising in an ovary remains unclear due to their rarity, although none of the patients in prior reports appear to have developed recurrence or metastases aside from one case. That patient was diagnosed as stage IIIB and required postoperative chemotherapy (cyclophosphamide and adriamycin) but subsequently died of urinary obstruction and sepsis,6 whereas the other six women were alive at 4-72 months of follow-up 7-12. Although our patient has been lost to follow-up, her general condition was poor with associated secondary sepsis.…”

“…Sebaceous carcinoma arising within a MCT has been rarely reported. To our knowledge, there have been only seven prior reports of sebaceous carcinoma arising within a MCT of the ovary 6-12. Here, we present an additional case of a sebaceous carcinoma, along with a sebaceous adenoma, arising within a MCT, as well as a review of the previous reports.…”

Endoscopic management of a sebaceous carcinoma arising in a mature cystic teratoma of the ovary

“…MCT represent up to 58% of benign ovarian tumors and typically occur in young women [4]. Malignant transformation is rare and occurs in 1-3% of cases [12]. It usually arises in postmenopausal women and can develop from any element of the dermoid cyst, but mainly from the ectodermal tissue.…”