Chiang An Jen, Chen Min Yu, Weng Chia Sui, Lin Hao, Lu Chien Hsing, Wang Peng Hui, Huang Yu Fang, Chiang Ying Cheng, Yu Mu Hsien, Chang Chih Long
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan.
J Gynecol Oncol. 2017 Sep;28(5):e69. doi: 10.3802/jgo.2017.28.e69. Epub 2017 Jun 13.
The malignant transformation (MT) of ovarian mature cystic teratoma (MCT) to squamous cell carcinoma (SCC) is very rare. This study analyzed cases from multiple medical centers in Taiwan to investigate the clinicopathologic characteristics, treatment, and prognostic factors of this disease and reviewed related literature.
Pathological reports of 16,001 patients with primary ovarian cancer who were treated at Taiwan medical centers from 1990 to 2011 were reviewed. In total, 52 patients with MT of MCT to SCC were identified.
Among all ovarian MCTs, the incidence of MT to SCC is 0.2%. The median age of patients was 52 years (range, 29-89 years), and the mean tumor size was 10.5 cm (range, 1-40 cm). We analyzed the patients in our study and those in the literature and determined that early identification and complete surgical resection of the tumor are essential for long-term survival. In addition, adjuvant chemotherapy or concurrent chemoradiotherapy can be used to treat this malignancy. Old age, large tumor size (≥15.0 cm), and solid components in MCTs are suitable indicators predicting the risk of MT of MCT to SCC.
Similar to general epithelial ovarian cancers, the early detection of MT of MCT to SCC is critical to long-term survival. Therefore, older patients with a large tumor or those with a tumor containing a solid component in a clinically diagnosed MCT should be evaluated to exclude potential MT to SCC.
卵巢成熟囊性畸胎瘤（MCT）恶变（MT）为鳞状细胞癌（SCC）极为罕见。本研究分析台湾多家医疗中心的病例，以探讨该疾病的临床病理特征、治疗方法及预后因素，并复习相关文献。
回顾1990年至2011年在台湾医疗中心接受治疗的16001例原发性卵巢癌患者的病理报告。共识别出52例MCT恶变至SCC的患者。
在所有卵巢MCT中，恶变至SCC的发生率为0.2%。患者的中位年龄为52岁（范围29 - 89岁），平均肿瘤大小为10.5 cm（范围1 - 40 cm）。我们分析了本研究中的患者及文献中的患者，确定早期识别和完整手术切除肿瘤对长期生存至关重要。此外，辅助化疗或同步放化疗可用于治疗这种恶性肿瘤。高龄、肿瘤较大（≥15.0 cm）以及MCT中的实性成分是预测MCT恶变至SCC风险的合适指标。
与一般上皮性卵巢癌相似，MCT恶变至SCC的早期检测对长期生存至关重要。因此，对于年龄较大、肿瘤较大或临床诊断为MCT且肿瘤含有实性成分的患者，应进行评估以排除潜在的恶变至SCC情况。
