Rare case of squamous cell carcinoma arising in a recurrent ovarian mature cystic teratoma of a young woman

Abstract

Rationale:Malignant transformations of ovarian mature cystic teratomas (MCTs) occur rarely, especially in young women. Although it is extremely difficult to diagnose them, serum tumor marker level testing in combination with the use of imaging techniques may be useful in preoperative diagnosis.Patient concerns:We present the case of a 31-year-old Chinese woman with the malignant transformation of an ovarian MCT. The patient had a history of oophorocystectomy due to an MCT of the right ovary 6 years prior and a gemellary pregnancy owing to in vitro fertilization and embryo transfer. Her serum CA19-9 levels were persistently mildly elevated after the first surgery.Diagnoses:She was diagnosed with ovarian squamous carcinoma, arising from an MCT (International Federation of Gynecology and Obstetrics stage IA).Interventions:A right salpingo-oophorectomy and omentectomy were performed and the patient underwent chemotherapy.Outcomes:The patient was disease-free at the 6-month follow-up.Lessons:The malignant transformation of MCTs usually occurs in postmenopausal women with poor prognoses; it is very rarely observed in young women. Although the early detection and complete surgical resection of the tumor are crucial to survival, preoperative diagnosis of this malignancy is difficult. This case reiterates the fact that malignant transformation of MCTs can occur at any age. Rapid tumor growth along with persistently elevated tumor marker levels may be indicative of the malignant transformation of MCTs.

Mature cystic teratoma of ovary with squamous cell carcinoma arising from it

“…It is mostly observed in postmenopausal women with an average age of 58.2 years as compared to 37.5 years in MCT . Some cases of malignant transformation of MCT have been reported in younger patients . Preoperative detection of malignant transformation of MCTs is challenging due to nonspecific tumor markers and imaging findings …”

Malignant Transformation of a Mature Ovarian Teratoma: A Case Report and Review of the Literature

“…Due to the different components of a teratoma, there can be various malignant transformations, such as squamous cell carcinomas (75%-80%), adenocarcinomas (7%), sarcomas (7%), basal cell carcinomas, sebaceous gland carcinomas, malignant melanomas, small cell lung cancers, transitional cell carcinomas, clear cell carcinomas, and gliomas [1,[3][4][5][6] . The patholog-ical diagnosis confirmed that this case was a teratoma accompanied by the malignant transformation of a sebaceous gland carcinoma, which is very rare.…”

“…However, the most common symptoms are a palpable abdominal mass, abdominal distension, and hypogastralgia, while the mild symptoms include lumbago, dysuria, weight loss, rupture, or torsion of the cyst. With a malignant transformation invading the surrounding organs or lymph nodes, clinical symptoms, such as a stomachache, leg pain, and lower extremity and vulvar edema, are aggravated [1,3,8] . In this case, the tumor in the left ovary was detected by B-mode ultrasound, and there were no clinical symptoms.…”

“…A mature teratoma is the most common benign germ cell tumor of the ovary, and it can be further divided into solid and cystic types, the cystic type of which is very common. It mainly occurs in women of childbearing age, with a median age of 30 years old [1] . One part of a mature teratoma can cause a malignant transformation.…”

“…One part of a mature teratoma can cause a malignant transformation. However, the malignant transformation rate is low, accounting for 1%-3% of all teratomas, and these are usually found in pre and postmenopausal women [1,2] . Here, we have described the case of a mature teratoma with a malignant transformation along with its clinicopathological features.…”