Shabnam K, Begum Jasmina
All India Institute of Medical Sciences, Bhubaneswar, India.
Prz Menopauzalny. 2023 Sep;22(3):169-172. doi: 10.5114/pm.2023.131456. Epub 2023 Sep 25.
Malignant transformation of mature cystic teratoma (MCT) is a well-known but uncommon phenomenon seen mostly in postmenopause women. We report a case of a 65-year-old postmenopausal woman with a malignant transformation of MCT and with a low-grade squamous intraepithelial lesion in her cervix. She was treated surgically by total abdominal hysterectomy with bilateral salpingo-oophorectomy with a preoperative diagnosis of right ovarian teratoma. Her postoperative period was uneventful. On follow-up, the histopathology report revealed a right ovarian dermoid cyst with well-differentiated squamous cell carcinoma; there was no evidence of malignancy elsewhere, including the cervix. Ascitic fluid was also free of malignant cells, and the disease was at stage Ia. The patient did not receive any adjuvant chemotherapy and was followed up with clinical examination postoperatively for 1 year, and there was no evidence of any relapse clinically. Preoperative diagnosis of malignant transformation of squamous cell carcinoma (SCC) is difficult, as there is no specific screening marker and no consensus or standard guidelines available regarding the optimum management of this relatively poorly known entity. Here we emphasize the need for a high index of suspicion of malignant transformation with the presence of factors such as elderly age, the huge size of the tumor, and large solid components in the tumor. Considering the scarcity of case reports and studies about SCC arising from MCT, every experience with malignant transformation of MCT should be reported for a better understanding of the disease presentation and management.
成熟性囊性畸胎瘤（MCT）的恶性转化是一种众所周知但并不常见的现象，多见于绝经后女性。我们报告一例65岁绝经后女性，患有MCT恶性转化且宫颈存在低级别鳞状上皮内病变。术前诊断为右侧卵巢畸胎瘤，她接受了全腹子宫切除术及双侧输卵管卵巢切除术的手术治疗。术后恢复顺利。随访时，组织病理学报告显示右侧卵巢皮样囊肿伴高分化鳞状细胞癌；其他部位包括宫颈均无恶性证据。腹水也未发现恶性细胞，疾病处于Ia期。患者未接受任何辅助化疗，术后进行了1年的临床检查随访，临床上未发现任何复发迹象。鳞状细胞癌（SCC）恶性转化的术前诊断困难，因为没有特异性筛查标志物，对于这个相对鲜为人知的实体的最佳管理也没有共识或标准指南。在此我们强调，对于存在老年、肿瘤巨大及肿瘤内大实性成分等因素的情况，需要高度怀疑恶性转化。鉴于关于MCT来源的SCC的病例报告和研究较少，应报告每一例MCT恶性转化的病例，以便更好地了解疾病表现和管理。
