Ovarian Squamous Cell Carcinoma Research Articles

Primary ovarian squamous cell carcinoma arising from an epidermoid cyst of Ovary- A rare case report with review of literature

Primary ovarian squamous cell carcinoma is a rare entity that usually arises from the malignant transformation of a mature cystic teratoma, endometriosis or Brenner’s tumor. The denovo occurrence of primary squamous cell carcinoma of the ovary without prior lesion is a rare entity accounting for less than 1%. However, ovarian squamous cell carcinoma arising from an epidermoid cyst is an infrequent entity and only one case has been reported in literature. The prognosis of such cases is quite poor and there are no definite guidelines for treatment. Here we present a case of a 50-year-old female diagnosed with primary ovarian squamous cell carcinoma arising from an epidermoid cyst of the ovary who was treated with surgery followed by chemotherapy along with the review of literature.

Pure primary ovarian squamous cell carcinoma with homologous recombination deficiency: a case report

Pure primary ovarian squamous cell carcinoma with homologous recombination deficiency: a case report

Recurrent early-stage squamous cell carcinoma cervical cancer presenting with isolated ovary metastasis: a rare case report

Introduction: Ovarian metastatic squamous carcinoma of the cervix is rare, accounting for about 0.4%. This study reports a single case of metastatic recurrent cervical cancer in the ovary. Case presentation: A 46-year-old patient with a history of cervical cancer T1b2N0M0 underwent a radical hysterectomy, bilateral pelvic lymph node dissection, and ovarian preservation. One year later, the patient was admitted to the hospital because of abdominal pain in the left iliac fossa; the abdominal computed tomography image showed a left ovarian tumour. The patient underwent laparoscopic left oophorectomy. Postoperative histopathology confirmed ovarian squamous cell carcinoma. From this case, we would like to review the literature on epidemiology, diagnosis, treatment, and prognosis. Clinical discussion: Ovarian preservation during surgery in patients with cervical cancer offers many benefits, but careful patient selection is required. However, it should be selected carefully and closely monitored. Conclusions: Clinicians should be aware of this situation of ovarian metastasis in patients with early cervical cancer undergoing ovarian-conserving surgery.

Ovarian squamous cell carcinoma associated with teratoma: a report of six cases with genomic analysis

Ovarian squamous cell carcinoma (SCC), particularly the sarcomatoid variant, arising from teratoma is a rare malignant tumour with unfavourable clinical outcomes. Its molecular genetic alterations have not been well-documented to date. This study aims to characterise the molecular features and to provide potential therapeutic targets in this rare entity. We analysed the clinicopathological and immunohistochemical features of six primary ovarian SCC. These cases were subject to targeted next-generation sequencing to detect genomic features. We found that all six ovarian SCC (four conventional and two sarcomatoid SCC) were associated with mature cystic teratomas. Patient 3 (FIGO stage IIIa) and Patient 4 (stage IIb) died of disease at 10 and 11 months, respectively. The remaining patients (three with stage I and one with IIc) including the two with sarcomatoid SCC, were alive with no evidence of disease at 28-72 months. All patients showed PD-L1 expression (tumour proportion score: range 10-78%, median 41%; combined positive score: range 12-85, median 42) and a high tumour mutation burden (range 13.4-25.7 mutations/Mb, median 16.5). The most frequently recurrent mutations included PIK3CA (4/6), TP53 (4/6), TERT promoter (4/6), CDKN2A (3/6). Mutations in homologous recombination repair pathway genes (BLM, ATM, BRCA1, BRIP1 and ATM) were found in 5/6 patients. The sarcomatoid SCC shared a similar mutational profile with conventional SCC, and no recurrent genetic mutations exclusively in sarcomatoid SCC were identified. Our study suggests the potential benefits of immune checkpoint inhibitors and/or PARP inhibitors in patients with primary ovarian SCC on account of PD-L1 expression and genomic features. Ovarian sarcomatoid SCC may be clonally related to the conventional SCC. A multiple-institutional, clinical and molecular study will consolidate these findings in the future.

Unilateral ovarian recurrence 5 years after hysterectomy for microinvasive squamous cervical cancer stage IA1: a rare case report

BackgroundOvarian metastasis or recurrence of cervical microinvasive squamous cell carcinoma (SCC) is very rare. We report a case of unilateral ovarian recurrence 5 years after hysterectomy for the SCC stage IA1 without lymph vascular space invasion (LVSI).Case presentationA 49-year-old female patient suffered from a dull pain in the left lower abdomen for 3 months. And five years ago, she received a laparoscopic hysterectomy for the treatment of stage IA1 (without LVSI) SCC of the cervix. The level of squamous cell carcinoma antigen (SCC-Ag) in serum was significantly elevated (10.60 ng/mL). Pelvic magnetic resonance imaging (MRI) revealed a left ovarian solid tumor measuring 5.5 × 3.9 × 5.6 cm with heterogeneous enhancement. During laparotomy, the left ovarian tumor was measured about 5.0 × 4.5 × 3.0 cm and seemed densely adherent to the posterior peritoneal wall, including the left ureter. The tumor and pelvic lymph node were carefully removed. Postoperative anatomy revealed a solid mass with a greyish-white section. Postoperative pathology showed recurrent moderately differentiated ovarian SCC with negative pelvic lymph nodes. Immunohistochemistry showed that the tumor cells were positive for P16, P63, P40, and CK5/6 markers, and the positive rate of Ki67 was about 80%.ConclusionsOvary preservation is reasonable and appropriate in young patients with microinvasive SCC. Ovarian recurrence is rare, but gynecological oncologists should not overlook its possibility. The serum SCC-Ag is an important indicator for monitoring postoperative disease progression.

Ovarian Squamous Cell Carcinoma Arising from Mature Cystic Teratoma: A Case Report

Mature cystic teratoma of the ovary (MCTO) is the most common ovarian germ cell tumor. Its malignant transformation is a rare complication that occurs in almost 2% of the MCTs. MCTO is benign and usually appears between 30 and 40 years of age, but patients with malignant ovarian MCT are 10–15 years older than those with benign MCT. The most common malignant transformation in MCTO is Squamous Cell Carcinoma (SCC) which is rarely diagnosed with pre-operative imaging. We report the case of a postmenopausal woman, presenting with severe abdominal pain and a large palpable mass in her abdomen. She was diagnosed postoperatively with SCC arising from MCTO which was confirmed histopathologically. The patient received postoperative chemotherapy and was well at 6-month follow-up after chemotherapy. MCTO is benign, but can rarely become malignant in older ages. So MCTO-arising SCC should be considered in elderly women with abdominal pain and mass, and also some other evident features such as large tumor diameter, elevated serum markers, and solid components in Magnetic resonance imaging (MRI).

A case of ovarian squamous cell carcinoma in situ arising in mature teratoma

A case of ovarian squamous cell carcinoma in situ arising in mature teratoma

Insights of clinical significance from solid tumor profiles with FoundationOneCDx.

3126 Background: FoundationOne CDx (F1CDx) is a US FDA-approved companion diagnostic test to identify patients who may benefit from treatment in accordance with the approved therapeutic product labeling for 28 drug therapies. Tumor profiling with F1CDx detects genomic findings with evidence of additional clinical significance. This study analyzes the breadth and impact of clinical decision insights from F1CDx clinical reports across solid tumors. Methods: F1CDx consecutive reports (n = 109,695) were retrospectively analyzed for the type and frequency of clinically significant predictive, prognostic, and diagnostic genomic alterations and signatures in common cancer types and across solid tumors. Predictive markers were defined as therapeutically relevant markers in drug labels or NCCN guidelines or targets of ESCAT evidence Tier I/II (Mateo et al., 2018; PMID: 30137196). Prognostic and diagnostic markers were determined in accordance with NCCN, ESMO, or WHO guidelines. We also describe the frequency and targets of interventional clinical trials with targeted therapies or immune checkpoint inhibitors that were matched to tumor profiles based on clinical or strong preclinical evidence. Results: Predictive genomic findings of clinical significance were identified in more than half of non-small cell lung cancer (NSCLC), colorectal cancer (CRC), breast cancer (BC), and melanoma (MEL) tissue samples; over a third of ovarian cancer (OC), urothelial carcinoma (UC), and head and neck squamous cell carcinoma (HNSCC); approximately a fourth of prostate cancer (PC), gastro-esophageal adenocarcinoma (GEA), cholangiocarcinoma (CA), and glioma (GL) samples; and one in 18 pancreatic adenocarcinoma (PA) samples (Table). Prognostic markers were reported for patients with NSCLC (18%), CRC (10%), BC (16%), PC (25%), CA (8.1%), MEL (24%), GL (74%), or HNSCC (7.1%). Diagnostic markers were frequently detected for patients with GL and noted for patients with BC, GEA, or MEL (Table). Interventional clinical trials were evidence-matched to most F1CDx tumor profiles (89%, range 82% in PC to 99% in PA), with the targets of approved therapies accounting for a small subset of targets in clinical development. Conclusions: F1CDx reports support clinical decision making by interpreting predictive, prognostic, and diagnostic markers according to professional guidelines as well as investigational markers for the enrollment in clinical trials. [Table: see text]

Primary ovarian squamous cell carcinoma: clinicopathological features and prognostic analysis of fifteen cases

Objective: To assess the clinical features and treatment outcomes in patients with primary ovarian squamous cell carcinoma (POSCC). Methods: Fifteen patients with primary ovarian squamous cell carcinoma diagnosed from January 2009 to December 2018 in Cancer Hospital of the University of Chinese Academy of Sciences were collected. The expression of p16, hMLH1, hMSH2, hMSH6 and PMS2 in POSCC was detected by immunohistochemistry, and the status of high-risk human papillomavirus (HPV) by RNAscope test. Results: Squamous cell carcinoma with different degrees of differentiation was found in 15 cases, including three cases with high differentiation and 12 cases with medium to low differentiation. There were four cases with in situ squamous cell carcinoma, four cases with teratoma, one case with endometrial carcinoma/atypical hyperplasia, and one case with endometriosis. p16 was expressed in five cases (5/15), indicating coexisting high-risk HPV infection. There was no high-risk HPV infection in the remaining 10 cases, and p16 staining was negative. There was no deficient mismatch repair protein in all cases. The overall survival time (P=0.038) and progression free survival (P=0.045) of patients with high-risk HPV infection were longer than those without HPV infection. Conclusions: POSCC is more commonly noted in postmenopausal women and often occurs unilaterally. Elevated serological indexes CA125 and SCC are the most common finding. Morphologically, the tumors show variable degrees of differentiation, but the current data suggest that the degree of differentiation cannot be used as an independent prognostic index. High-risk HPV infection may be associated with the occurrence of POSCC, and that the prognosis of POSCC patients with HPV infection is better than that of patients without infection.

Ovarian Cystadenocarcinoma with an Osteosarcoma Component

Ovarian cystadenocarcinoma with an osteosarcoma component, is a very rare tumor. We aimed to describe a case of an osteosarcoma arising in an ovarian squamous cell carcinoma.

Abstract CT154: Isatuximab (Isa) plus atezolizumab (Atezo) in patients (pts) with advanced malignancies: Results from a Phase 1/2 open-label multicenter study

Abstract Background: The CD38 monoclonal antibody Isa is approved for the treatment of multiple myeloma, but there are no data on its efficacy in solid tumors. A mechanism of immune resistance to anti-PD-1/PD-L1 therapy caused by CD38 expression in tumor cells has been described in the preclinical setting, providing a rationale for testing a combination of Isa+Atezo (anti-PD-L1 antibody) in the clinic to prevent therapy resistance and further enhance antitumor efficacy. The present study assessed safety and efficacy of Isa+Atezo in pts with epithelial ovarian cancer (EOC; n = 18), glioblastoma multiforme (GBM; n = 33), hepatocellular carcinoma (HCC; n = 27), or squamous cell carcinoma of the head and neck (SCCHN; n = 29), not amenable to local therapy with curative intent. Methods: Phase 1 (NCT03637764) assessed safety and confirmed the recommended Phase 2 dose (RP2D) of Isa according to a 21-day dose-limiting toxicity (DLT) observation period. Pts received Isa 10 mg/kg intravenously (IV) every week for 3 weeks followed by once every 3 weeks + Atezo 1200 mg IV every 3 weeks. Phase 2 used a Simon's 2-stage design to assess the overall response rate (ORR; EOC, HCC, SCCHN cohorts) or progression-free survival at 6 months (PFS-6; GBM cohort). Interim analysis was performed at 6 months following first treatment of the last enrolled pt in each cohort. Pharmacodynamics (PD), including analysis of CD38, PD-L1 and tumor-infiltrating lymphocytes in the tumor microenvironment (TME), were also evaluated. Results: In Phase 1, Isa+Atezo had acceptable safety and tolerability, with no new safety signals, in pts with EOC, GBM, HCC, or SCCHN. No DLTs were observed and RP2D were confirmed. Overall, 99% of pts experienced TEAEs, with >40% being Grade ≥3. The most frequently reported TEAE of any grade for all cohorts was infusion-related reactions (EOC, 83.3%; GBM, 54.5%; HCC, 63.0%; SCCHN, 31.0%). In the GBM Phase 2 cohort, the PFS-6 was 3.1%; no patients responded in Stage 1. In the EOC, HCC, and SCCHN Phase 2 cohorts, ORR was 5.6%, 7.4%, and 13.8%, respectively; therefore, the study did not continue to Stage 2. Tumor-infiltrating CD38+ immune cells were reduced by ~20% after treatment. Isa+Atezo did not lead to significant modulation of Tregs or PD-L1 in the TME. Conclusions: Isa+Atezo had acceptable safety and tolerability. Clinical PD evaluation suggested the efficient target engagement effect of Isa by demonstrating treatment-mediated reduction of CD38+ immune cells in the TME. However, significant reduction of CD38+ Tregs and restoration of T-cell proliferation was not observed. Based on clinical data, CD38 inhibition does not seem to influence response to anti-PD-L1 agents in these pts. Although no new safety signals were observed, efficacy did not fulfil criteria to expand enrollment despite the evidence of target engagement of Isa. Citation Format: Maria Vieito Villar, Matteo Simonelli, Ferry A.L.M. Eskens, Marta Gil-Martin, Chia-Jui Yen, Radka Obermannova, Yee Chao, Vittorina Zagonel, Bohuslav Melichar, Victor Moreno, Ming-Lung Yu, Alberto Bongiovanni, Emiliano Calvo, Sylvie Rottey, Jean-Pascal Machiels, Antonio González-Martín, Luis Paz-Ares, Chih-Long Chang, Warren Mason, Chia-Chi Lin, David Reardon, Elena Garralda, Armando Santoro, Robin Meng, Giovanni Abbadessa, Fatima Menas, Helen Lee, Qianying Liu, Cécile Combeau, Nils Ternes, Christophe Massard. Isatuximab (Isa) plus atezolizumab (Atezo) in patients (pts) with advanced malignancies: Results from a Phase 1/2 open-label multicenter study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT154.

A Rare Case of Synchronous Ovarian Adenocarcinoma and Squamous Cell Carcinoma of Cervix

Synchronous tumours of gynaecological malignancies occur rarely and most of these cases are represented by synchronous ovarian and endometrial cancer. Synchronous malignancies of cervix and ovary are rare with poor prognosis. Only few cases of synchronous cancer of cervix and ovary are found in the literature as case reports. Here, we report a case of a 63 year old patient who was diagnosed with synchronous squamous cell carcinoma of cervix and high grade serous carcinoma of ovary in which her clinical presentation, investigation and intraoperative findings were atypical. Patient presented with postmenopausal bleeding and mass per abdomen. Pipelle sampling revealed squamous cell carcinoma of cervix. Examination under anaesthesia noted endocervical growth measuring 3×4 cm with endoluminal extension into the whole endometrial cavity. Computerized tomography (CT) imaging showed left ovarian mass measuring 10.0×11.7 cm. Uterine corpus involvement in this case mislead us to the initial diagnosis of ovarian metastasis in cervical cancer. The distinct histopathological features of the ovary, cervix and endometrial lesion post operatively helped in establishing the diagnosis of two separate primaries which was synchronous cervical and ovarian cancer rather than metastatic spread of one primary malignancy.

A Mature Cyst Teratoma with Malignant Transformation in Squamous Cell Carcinoma Presenting Like a Sigmoid Fistula: A Case Report of a Rare Differential Diagnosis of a Giant Colonic Diverticulum

Mature cystic teratoma is the most common form of ovarian germ cell tumor. Mature cystic teratoma is a benign tumor, mainly diagnosed in young women, with non-specific symptoms. However, the risk of malignant transformation exists (1-2%). Squamous cell carcinoma is the most frequently encountered histological form. Giant colonic diverticulum is a rare complication of diverticular disease, characterized by a diverticulum larger than 4 cm which can sometimes be confused with other digestive pathologies (appendicitis, small bowel perforation ...). We report a case of an ovarian squamous cell carcinoma arising from a mature cystic teratoma, presenting like a sigmoid fistula, with an initial doubt with the diagnosis of a giant colonic diverticulum. A 68-year-old woman was admitted for chronic hypogastric abdominal pain with a doubt concerning the diagnosis between a mature cystic teratoma and a giant colonic diverticulum. A computed tomography scan was performed revealing a perisigmoid cyst with hydro-aeric level in favor of a giant colonic diverticulum. The pelvic MRI rather suggested a left ovarian cyst, fistulated in the sigmoid colon. Finally, the colonoscopy confirmed this hypothesis with the visualization of a sigmoid fistula located 15cm from the anal margin in connection with a cavity containing hairs. Biopsies revealed a squamous cell carcinoma. After a negative extension assessment, a posterior pelvectomy was performed with pelvic and lumbo-aortic lymph node dissection. The pathological diagnosis was an ovarian pT4N1R0 squamous cell carcinoma. An adjuvant chemotherapy is still in progress.

A Mature Cyst Teratoma with Malignant Transformation in Squamous Cell Carcinoma Presenting Like a Sigmoid Fistula: A Case Report of a Rare Differential Diagnosis of a Giant Colonic Diverticulum

Mature cystic teratoma is the most common form of ovarian germ cell tumor. Mature cystic teratoma is a benign tumor, mainly diagnosed in young women, with non-specific symptoms. However, the risk of malignant transformation exists (1-2%). Squamous cell carcinoma is the most frequently encountered histological form. Giant colonic diverticulum is a rare complication of diverticular disease, characterized by a diverticulum larger than 4 cm which can sometimes be confused with other digestive pathologies (appendicitis, small bowel perforation ...). We report a case of an ovarian squamous cell carcinoma arising from a mature cystic teratoma, presenting like a sigmoid fistula, with an initial doubt with the diagnosis of a giant colonic diverticulum. A 68-year-old woman was admitted for chronic hypogastric abdominal pain with a doubt concerning the diagnosis between a mature cystic teratoma and a giant colonic diverticulum. A computed tomography scan was performed revealing a perisigmoid cyst with hydro-aeric level in favor of a giant colonic diverticulum. The pelvic MRI rather suggested a left ovarian cyst, fistulated in the sigmoid colon. Finally, the colonoscopy confirmed this hypothesis with the visualization of a sigmoid fistula located 15cm from the anal margin in connection with a cavity containing hairs. Biopsies revealed a squamous cell carcinoma. After a negative extension assessment, a posterior pelvectomy was performed with pelvic and lumbo-aortic lymph node dissection. The pathological diagnosis was an ovarian pT4N1R0 squamous cell carcinoma. An adjuvant chemotherapy is still in progress.

Poorer prognosis of ovarian squamous cell carcinoma than serous carcinoma: a propensity score matching analysis based on the SEER database

BackgroundOvarian squamous cell carcinoma (SCC) is a rare cancer with possible poor survival, however no direct evidence supports this viewpoint and the independent prognostic factors are controversial. Patients with ovarian SCC and serous carcinoma (SC) who were diagnosed between 2004 and 2016 were selected using the recent released SEER database. Propensity score matching was used to balance the characteristics of the two groups. The difference of survival between patients with ovarian SCC and SC was explored using Kaplan-Meier method. Cox regression analyses were performed to further identify the independent prognostic factors among patients with ovarian SCC.ResultsOf 15,286 patients (15,106 SC cases and 180 SCC cases), 304 were identified in the matched cohort (200 SC cases and 104 SCC cases). The overall survival and cause-specific survival for patients with SCC were significantly poorer (Plog-rank < 0.001). The median survival time was 21 months for SCC and 95 months for SC. Patients who underwent bilateral salpingo-oophorectomy with hysterectomy and omentectomy seemed to have a better outcome. In multivariate analysis, older age at diagnosis, larger tumor size, bilateral and FIGO stage IV malignancy were the independent risk factors for poor disease outcome.ConclusionsThe prognosis of ovarian SCC is worse than ovarian SC. Older age at diagnosis, advanced disease stage, larger tumor size and bilateral malignancy are the independent risk factors for poor survival.

Recurrence of ovarian squamous cell carcinoma with MET gene copy number variation: a case report and review of literature

BackgroundMalignant transformation such as ovarian squamous cell carcinoma (SCC) in ovarian mature cystic teratoma (OMCT) is a rare tumor. The gene mutation of ovarian SCC remains unclear. We herein report a recurrent case of ovarian squamous cell carcinoma with MET gene copy number variation.Case presentationA 60-year-old woman presented with recurrence of ovarian SCC 8 months after primary surgery. Adhesiolysis, right abdominal wall mass excision, prosthetics, enterectomy, enterostomy and partial cystectomy were performed by laparoscope. Pathologic examination demonstrated metastatic squamous cell carcinoma in ileocecus, rectum and abdominal wall muscle. MET gene copy number was elevated with copy number of six in this case. Postoperatively, the patient was treated with four cycles of combination chemotherapy with docetaxel and carboplatin. The patient was free of disease at 20 months’ follow-up.ConclusionsOptimal cytoreductive surgery combined with platinum-based chemotherapy is recommended currently for not only primary tumor but also recurrence. For patients with malignant transformation in OMCT, prompt diagnosis and individualized treatment are crucial for better prognosis. Increased copy number of MET may be correlated with her poor PFS and can be a potential therapeutic target for this case.

Diagnostically challenging human papillomavirus-associated primary squamous cell carcinoma of the rectum with metastasis in both ovaries: a case report

IntroductionSquamous cell carcinomas of the rectum are extremely rare and their pathogenesis is still under debate. Their proper diagnosis and treatment may thus be challenging.Case presentationA 52-year-old Caucasian woman was transferred to our department with a history of pelvic pain. Colonoscopy revealed a small tumorous lesion of the upper rectum and an endoscopic biopsy showed infiltration of the rectal mucosa by a squamous cell carcinoma. Afterward, tumorous lesions were found on imaging in both her ovaries. A laparoscopy with adnexectomy and anal mapping was performed and revealed tumor masses of squamous cell carcinoma in both ovaries. Based on the large size of the ovarian tumors and the concurrence of extensive, partly ciliated, macrocystic epithelium in one of the ovaries, a diagnosis of ovarian squamous cell carcinoma arising from a mature teratoma was rendered. However, human papillomavirus genotyping analyses were positive for human papillomavirus-16 in both the rectal tumor and ovarian tumors leading to a final diagnosis of a human papillomavirus-associated rectal squamous cell carcinoma metastatic to both ovaries. Neoadjuvant chemoradiation therapy of her rectum, total mesorectal excision, and hysterectomy were performed followed by adjuvant chemotherapy.ConclusionColorectal squamous cell carcinoma is a rare disease. In cases of colorectal squamous cell carcinoma, metastatic disease at any other location has to be excluded. Human papillomavirus genotyping is essential in this context. Discussion of the treatment strategies should be interdisciplinary and include chemoradiation therapy and radical surgery.

A Case Report of Primary Ovarian Squamous Cell Carcinoma: Pathways (And Pitfalls) To A Difficult Diagnosis

A Case Report of Primary Ovarian Squamous Cell Carcinoma: Pathways (And Pitfalls) To A Difficult Diagnosis

Ovarian Endometrioid Borderline Tumor With Massive Squamous Differentiation: A Case Report

Abstract Introduction Ovarian endometrioid borderline tumor is uncommon and constitutes only 0.2% of all epithelial ovarian tumors. Many patients have associated endometriosis, and coexisting endometrial hyperplasia and/or carcinoma is commonly present. Methods Here we report an ovarian endometrioid borderline tumor with massive squamous differentiation. The peculiar histologic features made the diagnosis of this uncommon entity even more challenging. The patient was a 43-year-old female with a history of chronic pelvic pain. A pelvic ultrasound showed a 7.9-cm complex solid and cystic right ovarian mass and a hypoechoic left ovarian mass. Patient underwent a hysterectomy with bilateral salpingo-oophorectomy. Grossly, the right ovary showed a 2.5-cm solid and cystic lesion with focal papillary inner surface. Microscopic examination showed uterine adenomyosis with serosal endometriosis. The left ovary showed endometriosis with atypical hyperplasia. Initial representative sections from the right ovary demonstrated extensive squamous cell proliferation with papillary architecture. The squamous cells had pink or clear cytoplasm, intracellular bridging, irregular nuclei, and prominent nucleoli. Immunostains confirmed the squamous differentiation. Based on the histologic features and immunophenotype, a well-differentiated squamous cell carcinoma was considered one of the differential diagnoses. However, further examination of additional sections from entirely submitted lesion showed some areas with classic morphologic features of endometriosis with atypical hyperplasia. With the consideration of clinical-pathological correlations, a diagnosis of endometrioid papillary cystic borderline tumor with massive squamous differentiation was rendered and close follow-up was recommended. The patient was doing well at 4-month postoperative follow-up. Conclusion We present this case to emphasize (1) extensive squamous metaplasia arising in endometriosis can make the rendering of a definitive diagnosis challenging. (2) Primary squamous cell carcinoma of ovary is very rare. (3) Careful sampling is very important for achieving a precise pathologic diagnosis.

Overexpression of CASC11 in ovarian squamous cell carcinoma mediates the development of cancer cell resistance to chemotherapy

LncRNA CASC11 promotes gastric cancer and colon cancer. Our study analyzed the role of CASC11 in ovarian squamous cell carcinoma (OSCC). In the present study we showed that plasma CASC11 was upregulated in OSCC, and the upregulation of CASC11 distinguished OSCC patients from control group. Plasma levels of CASC11 were further increased after chemotherapy. Treatment with oxaliplatin, tetraplatin, cisplatin, and carboplatin mediated the upregulation of CASC11 in cells of OSCC cell line. In addition, overexpression of CASC11 led to increased cancer cell viability under oxaliplatin, tetraplatin, cisplatin, and carboplatin treatment, while CASC11 siRNA silencing played an opposite role. Therefore, overexpression of CASC11 in OSCC mediated the development of cancer cell resistance to chemotherapy.