Malignant transformation in mature cystic teratoma of the ovary: report of five cases and review of the literature (original) (raw)
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International Journal of Gynecologic Cancer, 2010
Objectives:Mature cystic teratoma (MCT) of the ovary rarely undergoes malignant transformation (MT). Malignant transformation carries a significantly worse prognosis than epithelial ovarian cancer, regardless of whether postoperative chemotherapy or radiotherapy is applied. The rarity of this tumor has posed a significant challenge to developing standardized postoperative management protocols. The aim of this study was to review our experience with MT and to describe our current treatment practices.Methods:A retrospective chart review of these patients was performed that identified 20 women treated for MT of MCT at our centers between 1988 and 2008.Results:The median age was 52.5 (range, 29-77) years. Fifteen patients had squamous cell carcinoma (SCC), and 5 patients had other histological subtypes. The International Federation of Gynecology and Obstetrics stage distribution was as follows: 11 were stage I, 4 were stage II, 4 were stage III, and 1 was stage IV. All patients underwen...
Oncology Reports, 2008
The aim of this study was to seek for factors which lead to the early diagnosis of malignant transformation from mature cystic teratoma. Fourteen patients with malignant transformation from mature cystic teratoma of the ovary were analyzed retrospectively for precise clinicopathology and prognosis. The results demonstrated that although all the patients with stage Ia disease were disease-free, only 2 out of 7 patients were stage Ic to IV and disease-free in the follow-up period. Pre-operative imaging correctly diagnosed tumors as malignant in all stage Ic to IV cases, but only in 2 out of 4 stage Ia cases with magnetic resource and none of the 2 cases with computed tomography, respectively. In malignant cases, elevation of the serum SCC and CEA was observed in 90.9 and 88.9%, respectively. On the other hand, in benign cases, a false positive elevation of the serum SCC and CEA was observed in 23.5 and 14.3%, which turned out to be normal in 40 and 52.9% cases in the repeated study, respectively. In conclusion neither imaging analysis nor tumor markers including SCC and CEA accurately diagnose malignant transformation of mature cystic teratoma in its early stage, suggesting that a combination of diagnostic means is important. In the followup cases, repeated measurement of serum markers proved useful in ruling out false positive cases.
Ovarian mature cystic teratoma with malignant transformation: two case reports
Journal of Medical Case Reports, 2021
Background: Mature Cystic Teratoma (MCT) is a benign tumor that can lead to malignant transformation (MT) in 1-3% of cases. Management of MT is a big challenge for gynecologic oncologists due to the lack of specific diagnostic and treatment protocols. Case presentation: We reported two Iranian cases of MT of MCT with two different stages and prognosis. Our both cases presented the same symptoms, including chronic abdominal pain and distention, loss of appetite, and weight loss. In case number 1, despite the large size of the tumor, the disease was at stage Ia and had a good prognosis; while, case number 2 was at stage IIIc of the disease with a poor prognosis. Conclusion: The stage of the disease is the most important prognostic factor, and early diagnosis and treatment are very critical for better survival.
Malignant transformation arising from mature cystic teratoma of the ovary: A report of six cases
Journal of Obstetrics and Gynaecology Research, 2012
Objectives: Mature cystic teratoma (MCT) of the ovary rarely undergoes malignant transformation (MT). Malignant transformation carries a significantly worse prognosis than epithelial ovarian cancer, regardless of whether postoperative chemotherapy or radiotherapy is applied. The rarity of this tumor has posed a significant challenge to developing standardized postoperative management protocols. The aim of this study was to review our experience with MT and to describe our current treatment practices. Methods: A retrospective chart review of these patients was performed that identified 20 women treated for MT of MCT at our centers between 1988 and 2008. Results: The median age was 52.5 (range, 29Y77) years. Fifteen patients had squamous cell carcinoma (SCC), and 5 patients had other histological subtypes. The International Federation of Gynecology and Obstetrics stage distribution was as follows: 11 were stage I, 4 were stage II, 4 were stage III, and 1 was stage IV. All patients underwent an initial laparotomy. Eleven patients received adjuvant treatment: 8 were treated with chemotherapy, 2 with concurrent chemoradiation therapy, and 1 with radiation therapy. Platinum-based chemotherapy was the first-line regimen. The overall 1-year survival rate was 70%. Significant correlations between overall survival and age, stage, and residual tumor were presented (P = 0.044, P = 0.0107, P G 0.0001, respectively). Eight patients with advanced stage died of their disease. Four patients, however, were treated with adjuvant chemotherapy or concurrent chemoradiation therapy and survived more than 1 year. One stage III patient had a disease-free interval of 2 years. Two cases of SCC treated with combination platinum/ taxane chemotherapy temporarily responded. In the other 2 cases of SCC, concurrent chemoradiation therapy with nedaplatin also resulted in tumor regression. Conclusions: The prognosis of MT is highly dependent on age, stage, and optimal cytoreduction. Adjuvant treatment has not been standardized, although our experience supports the use of combination platinum/taxane chemotherapy.
Multiple malignant transformations of an ovarian mature cystic teratoma
ecancermedicalscience, 2020
Background: Malignant transformation of mature cystic teratomas (MCTs) is a rare phenomenon. The most common histology of a malignant transformation is squamous cell carcinoma, and there are limited reports of multiple malignancies arising in a single MCT. Further data are necessary to guide management of these atypical cases. Case: We present the case of a 48-year-old with MCT containing a malignant papillary thyroid carcinoma (PTC) arising in the context of struma ovarii and a carcinoid tumour. Conclusion: Malignant transformations of MCTs are exceedingly rare with no guidelines on management. We use this case to demonstrate an approach for the workup and management of malignantly transformed MCTs.
Squamous cell carcinoma arising in a mature cystic teratoma of the ovary
Clinical Case Reports
Introduction. Malignant transformation in a mature cystic teratoma of the ovary is a rare complication. Squamous cell carcinoma is the most common transformation. We describe a new case of squamous cell carcinoma arising in a mature cystic teratoma. Case Report. A premenopausal 52-year-old female patient is diagnosed with vaginal bleeding. According to examination made on the women and the pelvic scanning, 7 cm mass is found on the right adnexa of the patient. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic lymph node dissection, and debulking were the treatments completed on the patient. According to histopathological diagnosis, squamous cell carcinoma arising in a mature cystic teratoma is diagnosed as a reason for the mass in the right adnexa of the patient. Conclusion. The prognosis of the malign transformation of MCT depends on surgery stage; however it is extremely poor. The patient should receive chemotherapy regardless of stage. We have decided to administer second cycle carboplatin and paclitaxel treatments on the patient.
Squamous cell carcinoma in mature cystic teratoma of the ovary
Medicinski pregled, 2012
Introduction. Malignant transformation is a rare complication of mature cystic teratoma, with squamous cell carcinoma as the most common malignancy (in 75% of cases). In this article we present a case of a well-differentiated squamous cell carcinoma arising in a mature cystic teratoma and discuss the morphological and clinico-pathological features of malignant transformation in teratoma. Case Report. An 80-year-old woman with symptoms of acute abdomen underwent left salpingo-oophorectomy. Gross examination showed a cystic mass measuring 20 cm in diameter, with papillary formation on its internal surface. Histology revealed a well-differentiated squamous cell carcinoma arising in mature cystic teratoma. Squamous epithelium surrounding the tumor was dysplastic. Conclusion. Squamous cell carcinoma in mature cystic teratoma is a rare pathologic event and in most cases it is an accidental pathohistological finding.
Malignant transformations in ovarian teratomas: a report of four cases
JPMA. The Journal of the Pakistan Medical Association, 2014
Mature cystic teratoma (MCT) is a common ovarian neoplasm in young females. A secondary malignant transformation occurs rarely in cystic teratomas at an older age. These secondary malignant neoplasms most commonly are squamous cell carcinomas (SCCs). Various mechanisms are reported, but the exact aetiology is unknown. We report three cases of SCC arising in cystic teratoma and one case of papillary thyroid neoplasm as secondary transformation. The SCCs were arising from the cyst wall, while the papillary thyroid malignancy arose from the normal-looking thyroid epithelium. Histologically, all SCC cases were poorly differentiated. Poor prognostic features for secondary transformations include size more than 10 cm, older age and rapid growth. Data is scarce regarding their appropriate treatment. However, surgical debulking is necessary. Platinum-based adjuvant regimens and taxanes are recommended in cases of advanced disease. In this paper we review and share our experience with this r...
Squamous cell carcinoma transformation in mature cystic teratoma of the ovary: a systematic review
BMC Cancer, 2019
Background: 0.17-2% of mature cystic teratoma of the ovary (MCTO) undergo malignant transformation, of which 80% are squamous cell carcinoma (SCC) transformation in MCTO. We aim to investigate the clinical characteristics and treatment of SCC transformation in MCTO Methods: We systematically searched PubMed database and individual patient data about SCC transformation in MCTO were extracted. The published cases were combined with 6 cases of SCC transformation in MCTO from Qilu Hospital, Shandong University. Results: The incidence of SCC transformation in MCTO was 0.3%. A total of 435 cases of SCC transformation in MCTO were enrolled in the analysis. The mean age of diagnosis was 53.5 (range 19-87) years old. The most common clinical manifestations were abdominal pain (47.3%) and abdominal mass (26.0%). StageI,II, III and IV accounted for 50.0, 18.8, 26.8 and 4.4% of all cases, respectively. Patients with stage I had significantly better prognosis than stage II, III and IV patients (P < 0.01). Hysterectomy can improve overall survival (P < 0.01). For patients younger than 45 years old with stageIA orIC, there was no difference in mortality between fertility-sparing and radical surgery (P = 1.00). Adjuvant chemotherapy can improve survival in patients with advanced stage (P = 0. 02), and chemotherapy with platinum was related to better prognosis (P = 0.02). Conclusion: SCC transformation in MCTO is a rare malignancy mainly occurs in older age. FIGO stage is an independent prognostic factor. Hysterectomy and platinum-based chemotherapy are associated with better survival. Fertility-sparing surgery is feasible for young patients with early stage.
Malignant degeneration of cystic teratoma of the ovary: two cases report
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
The malignant degeneration of mature ovarian teratomas is a rare phenomenon. Case reported two cases of squamous cell carcinoma developed on mature teratoma of the ovary in patients aged 54 and 41 who were seen for chronic pelvic pain. Their pelvic ultrasound showed cystic double-component images with sizes of 103 and 95 mm respectively suggestive of dermoid cysts, and the anatomopathological study of the pieces of adnexectomy confirmed the diagnosis. Although no clinical, radiological or biological signs are specific, ovarian dermal cyst degeneration is suspected in the presence of a large dermoid cyst in a postmenopausal or peri-menopausal woman. The careful anatomo-pathological study of the cyst in this case makes it possible to pose the diagnosis of certainty. A rare complication of the dermoid cyst, its prognosis is pejorative and depends mainly on its clinical stage at the time of diagnosis and the quality of its surgical treatment which must be as radical as possible.