Abstract
Background0.17–2% 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 MCTOMethodsWe 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.ResultsThe 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).ConclusionSCC 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.
Highlights
Mature cystic teratoma of the ovary (MCTO) may occur in 10–20% of women during their lifetime [1]
A total of 435 cases of squamous cell carcinoma (SCC) transformation in MCTO were enrolled in the analysis
SCC transformation in MCTO is a rare malignancy mainly occurs in older age
Summary
Mature cystic teratoma of the ovary (MCTO) may occur in 10–20% of women during their lifetime [1]. The biological behavior of MCTO is benign, while 0.17–2% of MCTO may undergo malignant transformation [2]. There are various histological types of malignant transformation such as squamous cell carcinoma (SCC), †. University, 107 West Wenhua Road, Ji’nan, Shandong 250012, People’s. Gynecology Oncology Key Laboratory, Qilu Hospital, Shandong University, Ji’nan, Shandong 250012, People’s Republic of China adenocarcinoma, small cell carcinoma, sarcoma, malignant melanoma and mixed histology [3]. SCC transformation in MCTO is most common, accounting for 80% of all malignant transformation [4]. The clinical manifestations of SCC transformation in MCTO are not specific. Acute abdomen may occur due to tumor torsion or rupture [8]. Preoperative imaging investigation and laboratory tests are not specific, either
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