Fukase Mika, Ohta Tsuyoshi, Watanabe Norikazu, Suzuki Yuriko, Seino Manabu, Sudo Takeshi, Nagase Satoru
Department of Obstetrics Gynecology, Faculty of Medicine, Yamagata University, Iida-nishi, 2-2-2, Yamagata 990-9585, Japan.
Gynecol Oncol Rep. 2020 Aug 26;34:100632. doi: 10.1016/j.gore.2020.100632. eCollection 2020 Nov.
Ovarian mature cystic teratomas (MCT) are usually benign. However, squamous cell carcinoma (SCC) develops in 0.17-2% of MCT. Because of its low frequency, the optimal treatment for this disease is unclear. We present a case of SCC arising from MCT. Our patient was a 30-year-old nulliparous woman complaining of right lower abdominal pain, who was referred to our hospital for a pelvic solid mass with suspected malignant ovarian tumor. A diagnosis of SCC arising from MCT was suspected based on the elevation in SCC antigen and the imaging. After surgery to remove the tumor, the diagnosis was confirmed based on the pathology. Although the surgery by radical cytoreduction was optimal, the tumor showed early recurrence. Therefore, we administrated combination chemotherapy, consisting of carboplatin, paclitaxel, and bevacizumab, followed by maintenance therapy with bevacizumab. Response to the chemotherapy regimen was complete and the patient was alive with no evidence of recurrence for 45 months after starting the initial surgery. We discuss the clinical characteristics of the malignant transformation of MCT and the treatment of SCC arising from MCT.
卵巢成熟囊性畸胎瘤(MCT)通常为良性。然而,MCT中0.17% - 2%会发生鳞状细胞癌(SCC)。由于其发病率低,该病的最佳治疗方法尚不清楚。我们报告一例由MCT引发的SCC病例。我们的患者是一名30岁未生育的女性,主诉右下腹痛,因盆腔实性肿块伴疑似恶性卵巢肿瘤被转诊至我院。基于SCC抗原升高及影像学检查怀疑为MCT引发的SCC。手术切除肿瘤后,根据病理确诊。尽管根治性细胞减灭术是最佳手术方式,但肿瘤出现早期复发。因此,我们给予了由卡铂、紫杉醇和贝伐单抗组成的联合化疗,随后用贝伐单抗进行维持治疗。化疗方案反应完全,患者自初次手术开始后存活45个月,无复发迹象。我们讨论了MCT恶变的临床特征以及MCT引发的SCC的治疗。