Immunohistological study of ovarian mature cystic teratoma with extremely elevated SCC antigen level
1Department of Obstetrics and Gynecology, National Hospital Organization Kobe Medical Center, 654-0155 Kobe, Japan
2Department of Pathology, School of Medicine, Ehime University, 791-0295 Toon, Japan
3Department of Obstetrics and Gynecology, Kohnan Medical Center, 658-0064 Kobe, Japan
DOI: 10.22514/ejgo.2023.030 Vol.44,Issue 2,April 2023 pp.121-125
Submitted: 05 January 2023 Accepted: 14 February 2023
Published: 15 April 2023
*Corresponding Author(s): Kyousuke Takeuchi E-mail: email@example.com
Squamous cell carcinoma (SCC) antigen is a reliable tumor marker for various cancers, including cervical cancer and lung cancer, and was recently reported to correlate with the severity of inflammatory skin diseases such as atopic dermatitis. Herein, we present a case of a 47-year-old female patient who presented with acute abdomen rupture due to a mature cystic teratoma of the ovary, approximately 11 cm in diameter on imaging examination, prompting emergency laparoscopic surgery. The patient had no symptoms of atopic dermatitis. The operative findings showed no evidence of torsion, but the membrane was partially ruptured, leading to the leakage of the cyst contents. The operation was completed after excising the adnexa and intraperitoneal lavage. The postoperative results revealed a markedly high serum SCC antigen level of 55.3 ng/dL, which was normalized at 2 months postoperatively. Postoperative histopathological examination revealed no squamous cell carcinoma component but a marked lymphocytic infiltrate under the squamous epithelium, suggesting a high degree of inflammation. Additionally, immunostaining demonstrated a cluster of differentiation (CD) 8+ lymphocyte predominance over CD4+ lymphocytes, similar to the histology of atopic dermatitis. Altogether, our findings suggest that the abnormally high SCC antigen levels might be attributed to the presence of severe inflammation in the mature cystic teratoma rather than an underlying malignancy and support the notion that SCC antigen may be a useful marker beyond its established role in cervical and lung cancers.
Mature cystic teratoma; SCC antigen; Atopic dermatitis-like inflammation of the ovary; Immunohistochemistry
Kyousuke Takeuchi,Akari Shirakuni,Ai Yoshida,Makoto Sugimoto,Sohei Kitazawa,Hiroki Morita. Immunohistological study of ovarian mature cystic teratoma with extremely elevated SCC antigen level. European Journal of Gynaecological Oncology. 2023. 44(2);121-125.
 Ustunyurt E, Gungor T, Iskender C, Ustunyurt BO, Bilge U, Mollamah-mutoglu L. Tumor markers in mature cystic teratomas of the ovary. Archives of Gynecology and Obstetrics. 2009; 279: 145–147.
 Dos Santos L, Mok E, Iasonos A, Park K, Soslow RA, Aghajanian C, et al. Squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case series and review of the literature. Gynecologic Oncology. 2007; 105: 321–324.
 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. Obstetrics & Gynecology. 1997; 89: 1017–1022.
 Tseng CJ, Chou HH, Huang KG, Chang TC, Liang CC, Lai CH, Soong YK, Hsueh S, Pao CC. Squamous cell carcinoma arising in mature cystic teratoma of the ovary. Gynecologic Oncology. 1996; 63: 364–370.
 Suzuki M, Kobayashi H, Sekiguchi I, Konnai K, Terao T, Sato I. Clinical evaluation of squamous cell carcinoma antigen in squamous cell carcinoma arising in mature cystic teratoma of the ovary. Oncology. 1995; 52: 287–290.
 Sagi-Dain L, Lavie O, Auslander R, Sagi S. CA 19-9 in Evaluation of adnexal mass: retrospective cohort analysis and review of the literature. The International Journal of Biological Markers. 2015; 30: e333–e340.
 Gadducci A, Tana R, Cosio S, Genazzani AR. The serum assay of tumour markers in the prognostic evaluation, treatment monitoring and follow-up of patients with cervical cancer: a review of the literature. Critical Reviews in Oncology/Hematology. 2008; 66: 10–20.
 Rim SY, Kim SM, Choi HS. Malignant transformation of ovarian mature cystic teratoma. International Journal of Gynecological Cancer. 2006; 16: 140–144
 Chiang AJ, Chen MY, Weng CS, Lin H, Lu CH, Wang PH, et al. Malignant transformation of ovarian mature cystic teratoma into squamous cell carcinoma: a Taiwanese Gynecologic Oncology Group (TGOG) study. Journal of Gynecological Oncology. 2017; 28: e69.
 Izuhara K, Yamaguchi Y, Ohta S, Nunomura S, Nanri Y, Azuma Y, et al. Squamous cell carcinoma antigen 2 (SCCA2, SERPINB4): an emerging biomarker for skin inflammatory diseases. International Journal of Molecular Sciences. 2018; 19: 1102.
 Nograles KE, Zaba LC, Shemer A, Fuentes-Duculan J, Cardinale I, Kikuchi T, et al. IL-22—producing “T22” T cells account for upregulated IL-22 in atopic dermatitis despite reduced IL-17—producing TH17 T cells. The Journal of Allergy and Clinical Immunology. 2009; 123: 1244–1252.e2.
 Simon D, Lindberg RL, Kozlowski E, Braathen LR, Simon HU. Epidermal caspase-3 cleavage associated with interferon-gamma-expressing lymphocytes in acute atopic dermatitis lesions. Experimental Dermatol-ogy. 2006; 15: 441–446.
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