Abstract
BackgroundOvarian mature cystic teratoma (MCT) is a common neoplasm in women. While malignant transformation of MCT is relatively rare, squamous cell carcinoma is the most frequent malignant neoplasm arising from MCT. Some tumor markers have been reported to be useful for prediction of MCT malignant transformation prior to operation. However, widely accepted use of these markers remains to be established. In the present study, we report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels.Case presentationWe present two cases of squamous cell carcinoma arising from ovarian MCT. The first case was a 45-year-old Asian woman referred to our hospital after her periodical company medical checkup, due to possible ovarian tumor. Image analysis suggested a dermoid cyst, and left salpingo-oophorectomy was performed. Because the cyst was histologically diagnosed as an invasive squamous cell carcinoma arising from an MCT, our patient underwent an additional preventative operation. The TNM classification and FIGO stage were T1aNXM0 and Ia, respectively. The second case was a 53 -year-old Asian woman who visited our hospital due to complaints of abdominal pain and urinary retention. Image analysis and laboratory data showing high serum levels of SCC antigen (normal range: < 1.5 ng/mL) and CA19-9 (normal range: < 37 U/mL), which strongly suggested malignant transformation of MCT. Frozen sections obtained during the operation were histologically analyzed to confirm malignancy, and our patient underwent an additional operation. The TNM classification and FIGO stage were T1aNXM0 and Ia, respectively.ConclusionsWe report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels.
Highlights
Ovarian mature cystic teratoma (MCT) is a common neoplasm in women
We report the usefulness of frozen section assessment during operation, as well as preoperative measurement of tumor marker levels
While malignant transformation of MCT is relatively rare [1, 2], squamous cell carcinoma (SCC) is the most frequent malignant neoplasm arising from MCT [3, 4]
Summary
Ovarian mature cystic teratoma (MCT) is a common neoplasm in women. While malignant transformation of MCT is relatively rare [1, 2], squamous cell carcinoma (SCC) is the most frequent malignant neoplasm arising from MCT [3, 4]. Our patient subsequently underwent left salpingo-oophorectomy due to suspicion of malignant transformation of the ovarian cyst. Invasive growth of SCC was pronounced in the cyst wall (Fig. 2c). Yellowish ascites was observed in the peritoneal cavity, and gross examination revealed that the cyst wall was thickened and attached to the left fallopian tube, small intestines, posterior wall of the uterus, and retroperitoneum. Malignant transformation was diagnosed, and our patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Focal and irregular thickening of the cyst wall was observed after fixation by formaldehyde (Fig. 3a). Malignant transformation was identified in the epithelial lining (Fig. 3c) These findings led to a diagnosis of SCC (well-differentiated SCC) arising from MCT. Twenty-one months postoperatively, our patient remained free of any clinically identifiable recurrence
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
