Squamous cell carcinoma of the ovary arising in a mature cystic teratoma in a 28-year-old female: a case report and review of literature

Abstract

Malignant transformation of mature cystic teratoma is a rare phenomenon occurring in approximately 0.17–2% of cases. It has frequently been noted in peri- and postmenopausal women, but it is rarely seen in younger women. There are no distinctive clinical features. However, patients present with nonspecific signs and symptoms such as abdominal pain, distension and abdominal mass. Hysterectomy, bilateral salpingo-oophorectomy and comprehensive surgical staging are the cornerstone of surgical management. In advanced disease, optimal cytoreduction is associated with increased overall survival. While there is no consensus as to the optimal adjuvant therapy, chemotherapy with an alkylating drug has been noted to have the greatest impact on survival. Advanced-stage disease has a poor prognosis, worse than that of epithelial ovarian cancers. We report on a case of a 28-year-old female who presented an abdominal swelling of 10 months, having undergone two previous laparotomies. Histopathology of the left ovary showed features suggestive of invasive squamous cell carcinoma and of the right ovary, it showed features suggestive of dermoid cyst. No tumour deposits were noted on the omentum. The left ovary ruptured during the procedure upstaging the tumour. An attempt at cytoreduction was done at our facility. However, tumour was noted to be unresectable. She received two cycles of carboplatin and paclitaxel but died of the disease three months later.