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Squamous Cell Carcinoma Arising From Mature Cystic Teratoma of the Ovary
  1. An-Jen Chiang, MD*,,,
  2. Victor La, BS§,
  3. Jiaqi Peng, BS§,
  4. Ken-Jen Yu, MD, PhD*, and
  5. Nelson N.H. Teng, MD, PhD
  1. *Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China;
  2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, CA;
  3. Division of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China;
  4. §Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD; and
  5. Division of Obstetrics and Gynecology, National Defense Medical Center, Taipei, Taiwan, Republic of China.
  1. Address correspondence and reprint requests to Ken-Jen Yu, MD, PhD, Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, Kaohsiung 813, Taiwan, Republic of China. E-mail: kjyu49{at}gmail.com.

Abstract

Objective Squamous cell carcinoma (SCC) is the most common type of malignant transformation in mature cystic teratoma (MCT) of the ovary. The SCC is difficult to preoperatively diagnose. We conducted a retrospective study to seek the possible risk/prognostic factors and treatments for SCC arising from MCT of the ovary.

Methods Using an institutional database, we identified 3 women treated for SCC arising from an MCT of the ovary at the Kaohsiung Veteran General Hospital. A retrospective chart review was conducted, with information obtained from radiographs, operative reports, pathology reports, and radiation oncology records.

Results A total of 1551 cases of MCT were diagnosed at Kaohsiung Veteran General Hospital from 1990 to 2009, of which, malignant teratoma SCC type was noted in 3 cases (0.19%). The median age of the subjects was 39 years. Abdominal fullness was the most common symptom (3/3 cases). The mean diameter of the ovarian tumor was 17.3 cm, ranging from 16 to 18 cm. All 3 patients received simple right salpingo-oophorectomy or debulking surgery. Two of the patients reached stage IIIC and died.

Conclusions With our review as basis, we recommend being cautious of the following risk factors: patient age, tumor size, ultrasound characteristics, sonar tumor vessel wave form, computed tomography, and levels of SCC and CA125 tumor markers. We suggest that patients have regular ovarian ultrasound examination. Based on our literature review, stage IA patients who undergo standardized operational procedures do well without adjuvant treatment, but such patients must be confirmed accurately with complete surgical staging to be in stage IA before undergoing conservative management. The optimal approach to the management of patients with advanced stage and recurrent disease is unclear. Surgical cytoreduction with proper staging, adjuvant therapy with platinum-based or paclitaxel-based chemotherapy, and concurrent whole pelvic radiation have been recommended as possible methods of treatment.

  • Sauamous cell carcinoma
  • Dermoid cyst
  • Ca125
  • Malignant transformation

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Footnotes

  • This study was supported by grants from the Kaohsiung Veterans General Hospital: Grant nos. VGHKS99-085, VGHKS97-87, and VGHKS abroad research plan No. 97-12-30 0970010962.

  • The authors declare that there are no conflicts of interest.

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