Article Data

  • Views 581
  • Dowloads 150

Case Reports

Open Access

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

  • Keisuke Ogimoto1
  • Miho Kitai1,*,
  • Takehito Ota2
  • Takaaki Nakanishi3
  • Yukihiro Imai3
  • Toshiko Sakuma4
  • Tamotsu Sudo5
  • Satoshi Yamaguchi1

1Department of Gynecologic Oncology, Hyogo Cancer Center, 673-8558 Akashi, Japan

2Department of Obstetrics and Gynecology, Kakogawa City Hospital, 675-8611 Kakogawa, Japan

3Department of Pathology, Kakogawa City Hospital, 675-8611 Kakogawa, Japan

4Department of Pathology, Hyogo Cancer Center, 673-8558 Akashi, Japan

5Department of Gynecologic Oncology and Section of Translational Research Hyogo Cancer Center, 673-8558 Akashi, Japan

DOI: 10.22514/ejgo.2024.038 Vol.45,Issue 2,April 2024 pp.158-162

Submitted: 17 October 2023 Accepted: 13 November 2023

Published: 15 April 2024

*Corresponding Author(s): Miho Kitai E-mail: *Correspondence


Pure primary ovarian squamous cell carcinoma (SCC) is a rare histological type with a poor prognosis. Herein, we present the first reported case of advanced pure primary ovarian SCC with homologous recombination deficiency (HRD). A 65-year-old woman who underwent emergency surgery because of acute abdominal pain was diagnosed with SCC of the ovary and was referred to our department for further treatment. Thorough investigations revealed no signs of other primary sites of SCC except for the left ovary. Postoperative positron emission tomography-computed tomography showed residual tumor. Since pure primary ovarian SCC typically shows a poor response to chemotherapy, we decided to perform debulking surgery. Total abdominal hysterectomy, right salpingo-oophorectomy, pelvic lymphadenectomy, para-aortic lymphadenectomy, bowel resection and left partial ureterectomy were performed. Postoperatively, there was no residual tumor larger than 1 cm. Postoperatively, she developed pelvic infection that prolonged her hospital stay due to the need for antibiotics. However, there were no other perioperative complications and she was discharged. SCC with keratinization was observed on histopathological examination of metastatic lymph nodes. An HRD companion diagnostic test performed on the resected specimen was positive for HRD (score 57) and negative for BRCA 1/2 mutations. She received six courses of paclitaxel and carboplatin followed by maintenance therapy with niraparib, which is continuing. There are no signs of recurrence as of the one-year follow-up after surgery. We presented a rare case of advanced pure primary ovarian SCC with HRD. Complete surgical removal of HRD-positive pure primary ovarian SCC may lead to long-term survival with subsequent chemotherapy followed by maintenance therapy with poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors.


Primary ovarian squamous cell carcinoma; Homologous recombination deficiency; Debulking surgery; Chemotherapy; Poly (adenosine diphosphate-ribose) polymerase inhibitor

Cite and Share

Keisuke Ogimoto,Miho Kitai,Takehito Ota,Takaaki Nakanishi,Yukihiro Imai,Toshiko Sakuma,Tamotsu Sudo,Satoshi Yamaguchi. Pure primary ovarian squamous cell carcinoma with homologous recombination deficiency: a case report. European Journal of Gynaecological Oncology. 2024. 45(2);158-162.


[1] Black WC, Benitez RE. Nonteratomatous squamous cell carcinoma in situ of the ovary. Obstetrics & Gynecology. 1964; 24: 865–868.

[2] Koufopoulos N, Nasi D, Goudeli C, Antoniadou F, Kokkali S, Pigadioti E, et al. Primary squamous cell carcinoma of the ovary. Review of the literature. Journal of Balkan Union of Oncology. 2019; 24: 1776–1784.

[3] Atwi D, Kamal M, Quinton M, Hassell LA. Malignant transformation of mature cystic teratoma of the ovary. Journal of Obstetrics and Gynaecology Research. 2022; 48: 3068–3076.

[4] 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 Gynecologic Oncology. 2017; 28: e69.

[5] Cai Z, Yang GL, Li Q, Zeng L, Li LX, Song YP, et al. Squamous cell carcinoma associated with endometriosis in the uterus and ovaries: a case report. World Journal of Clinical Cases. 2023; 11: 6240–6245.

[6] Shi Z, Yang L, Bian C. Squamous cell carcinoma in mature cystic teratoma of the ovary induced by human papillomavirus 16 infection: a case report and literature review. Medicine. 2022; 101: e30667.

[7] Zhang C, Ma T. Poorer prognosis of ovarian squamous cell carcinoma than serous carcinoma: a propensity score matching analysis based on the SEER database. Journal of Ovarian Research. 2020; 13: 75.

[8] Hackethal A, Brueggmann D, Bohlmann MK, Franke FE, Tinneberg H, Münstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. The Lancet Oncology. 2008; 9: 1173–1180.

[9] Luo Y, Bian C. Primary squamous cell carcinoma of the ovary. Review of the literature. Frontiers in Oncology. 2022; 12: 962613.

[10] Park JW, Bae JW. Pure primary ovarian squamous cell carcinoma: a case report and review of the literature. Oncology Letters. 2015; 9: 321–323.

[11] Li C, Zhang Q, Zhang S, Dong R, Sun C, Qiu C, et al. Squamous cell carcinoma transformation in mature cystic teratoma of the ovary: a systematic review. BMC Cancer. 2019; 19: 217.

[12] Ji W, Weng X, Xu D, Cai S, Lou H, Ding L. Non-small cell lung cancer cells with deficiencies in homologous recombination genes are sensitive to PARP inhibitors. Biochemical and Biophysical Research Communications. 2020; 522: 121–126.

[13] Akinjiyan FA, Morecroft R, Phillipps J, Adeyelu T, Elliott A, Park SJ, et al. Homologous recombination deficiency (HRD) in cutaneous oncology. International Journal of Molecular Sciences 2023; 24: 10771.

[14] Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. New England Journal of Medicine. 2011; 365: 2473–2483.

[15] Moore K, Colombo N, Scambia G, Kim B, Oaknin A, Friedlander M, et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. New England Journal of Medicine. 2018; 379: 2495–2505.

[16] González-Martín A, Pothuri B, Vergote I, DePont Christensen R, Graybill W, Mirza MR, et al. Niraparib in patients with newly diagnosed advanced ovarian cancer. New England Journal of Medicine. 2019; 381: 2391–2402.

[17] Ray-Coquard I, Pautier P, Pignata S, Pérol D, González-Martín A, Berger R, et al. Olaparib plus bevacizumab as first-line maintenance in ovarian cancer. New England Journal of Medicine. 2019; 381: 2416–2428.

[18] Harter P, Mouret-Reynier MA, Pignata S, Cropet C, González-Martín A, Bogner G, et al. Efficacy of maintenance olaparib plus bevacizumab according to clinical risk in patients with newly diagnosed, advanced ovarian cancer in the phase III PAOLA-1/ENGOT-ov25 trial. Gynecologic Oncology. 2022; 164: 254–264.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time