Squamous cell carcinoma developing in a huge dermoid cyst of the ovary in an 80-year-old woman - case report

A case of an 80-year-old patient with squamous cell carcinoma originating from a huge septated dermoid cyst of the right ovary is reported. There were bilateral dermoids in the patient. The tumor sizes were 30 x 40 x 20 cm and 4 x 3 x 5 cm in the right and left ovary, respectively, confirmed by ultrasound and computed tomography. Squamous cell carcinoma arose in the solid part of a huge dermoid cyst of the left ovary. Total abdominal hysterectomy and bilateral salpingo-oophorectomy, omentectomy and appendectomy were performed. The tumor was confined to the right ovary. The patient was categorized as FIGO Stage IA. She recovered uneventfully and there was no evidence of recurrence in the early-stage case during one year of follow-up. The clinical and pathological features, treatment modalities and prognosis of squamous cell carcinoma are described.

Dermoid cyst; Squamous cell carcinoma; Prognosis

[1] Tangjitgamol S., Manusirivithaya S., Sheanakul C., Leelahakorn S., Thawaramara T., Jesadapatarakul S.: "Squamous cell carci­noma arising from dermoid cyst: Case reports and review of liter­ature". Int. J. Gynecol. Cancer, 2003, 13, 558.

[2] Stamp G.W.H., McConnell E.M.: "Malignancy arising in cystic ovarian teratomas. A report of 24 cases". Br .J .Obstet. Gynaecol.,1983, 90, 671.

[3] Kikkawa F., Ishikawa H., Tamakoshi K., Nawa A., Suganuma N., Tomoda Y.: "Squamous cell carcinoma arising from mature cystic teratoma of the ovary: a clinicopathologic analysis". Obstet. Gynecol., 1997, 89, 1017.

[4] Ayhan A., Tuncer Z.S., Bilgin F., Kucukali T.: "Squamous cell car­cinoma arising in dermoid cyst". Eur. J. Gynaecol. Oneal., 1996, 17, 144.

[5] Kashimura M., Shinohara M., Hirakawa T., Kamura T., Mat­sukuma K.: "Clinicopathologic study of squamous cell carcinoma of the ovary". Gynecol. Oneal., 1989, 34, 75.

[6] Pins M.R., Young R.H., Daly W.J., Scully R.E.: "Primary squa­mous cell carcinoma of the ovary. A report of 37 cases". Am. J. Surg. Pathol., 1996, 20, 823.

[7] Krumerman M.S., Chung A.: "Squamous carcinoma arising in benign cystic teratoma of the ovary". Cancer, 1977, 39, 1237.

[8] Powell J.L., Stinson J.A., Connor G.P., Shiro B.S., Mattison M.: "Squamous cell carcinoma arising in a dermoid cyst of the ovary". Gynecol. Onco/., 2003, 89, 526.

[9] Linder D., McCaw B.K., Hecht F.: "Parthenogenic origin of benign ovarian teratomas". N. Engl. J. Med., 1975, 9, 63.

[10] Tobon H., Surti U., Naus G.J., Hoffner L., Hemphill R.W.: "Squa­mous cell carcinoma in situ arising in an ovarian mature cystic ter­atoma. Report of one case with histopathologic, cytogenetic, and flow cytometric DNA content analysis". Arch. Pathol. Lab. Med., 1991, l15, 172.

[11] Christopherson W.A., Councell R.B.: "Malignant degeneration of a mature ovarian teratoma". Int. J. Gynaecol. Obstet., 1989, 30, 379.

[12] Hirakawa T., Tsuneyoshi M., Enjoji M.: "Squamous cell carc1- noma arising in mature cystic teratoma of the ovary. Clinico­pathologic and topographic analysis". Am. J. Surg. Path., 1989, 13, 397.

[13] Peuchmaur M., Reynes M.: "Squamous cell carcinoma in situ developing in dermoid cyst of the ovary. Report of a case with laminin immunohistochemical staining demonstrating basement membrane integrity". Pathol. Res. Pract., 1989, 185, 251.

[14] Zorlu C.G., Kuscu E., Soysal M.E., Caglar T., Aydogdu T., Cobanoglu 0. et al.: "Malignant degeneration of mature cystic ter­atomas". Aust. NZ. J. Obstet. Gynaecol., 1996, 36, 221.

[15] Lee Y.C., Abulafia 0., Montalto N., Holcomb K., Matthews R., Golub R.W.: "Malignant transformation of an ovarian mature cystic teratoma presenting as a rectal mass". Gyneco/. Oncol., 1999, 75,499.

[16] Kido A., Togashi K., Konishi I., Kataoka M.L., Koyama T., Ueda H. et al.: "Dermoid cysts of the ovary with malignant transforma­tion". Am. J. Roentgenol., 1999, 172, 445.

[17] Emoto M., Obama H., Horiuchi S., Miyakawa T., Kawarabayashi T.: Transvaginal color D。ppler ultrasonic characterization of benign and malignant ovarian cystic _ teratomas and comparison with serum squamous cell carcinoma antigen". Cancer, 2000, 88, 2298.

[18] Kimura T., Inoue M., Miyake A., Tanizawa 0., Oka Y., Amemiya K. et al.: "The use of serum TA-4 in monitoring patients with malignant transformation of ovarian mature cystic teratoma". Cancer, 1989, 64, 480.

[19] Ribeiro G., Hughesdon P., Wiltshaw E.: "Squamous carcinoma arising in dermoid cysts and associated with hypercalcemia: a clin­icopathologic study of six cases". Gynecol. Oneal., 1988, 29, 222.

[20] Tseng C.J., Chou HH., Huang K.G., Chang T.C., Liang C.C., Lai C.H. et al.: "Squamous cell carcinoma arising in mature cystic ter­atoma of the ovary". Gynecol. Oneal., 1996, 63, 364.

[21] Peterson W.F.: "Malignant degeneration of benign cystic teratomas of the ovary: a collective review of the literature". Obstet. Gynecol., 1957, 12, 793.

[22] Seltzer V., Vogl S.: "Stage II benign cystic teratoma with malig­nant squamous degeneration". NY State J. Med., 1985, 85, 224.

[23] Yakushiji M., Nishida T., Sugiyama T., Mitamura T., Natsuaki Y., Nagano H. et al.: "Malignant degeneration of benign cystic ter­atomas of the ovary". Acta Obstet. Gynaecol. Jpn., 1981, 33, 1095.

[24] Rose P.G., Tak W.K., Reale F.R.: "Squamous cell carcinoma arising in a mature cystic teratoma with metastasis to the paraaor­tic nodes". Gynecol. Oncol., 1993, 50, 131.

[25] Mayer C., Miller D.M., Ehlen T.G.: "Peritoneal Implantation of squamous cell carcinoma following rupture of a dermoid cystduring laparoscopic removal". Gynecol. Oncol., 2002, 84, 180.

[26] Okada S., Ohaki Y., Inoue K., Nakajo H., Kawamata H., Kumazaki T.: "A case of dermoid cyst of the ovary with malignant transfor­mation complicated with small intestinal fistula formation". Radiat. Med., 2005, 23, 443.