Ohira Satoshi, Kitano Reika, Yokoi Yuriko, Kitamura Fumiaki, Hayashi Akiko
Obstetrics and Gynecology, Marunouchi Hospital, Matsumoto, JPN.
Cureus. 2024 Dec 27;16(12):e76470. doi: 10.7759/cureus.76470. eCollection 2024 Dec.
Malignant transformation is a rare complication of ovarian mature cystic teratoma that occurs in 1-3% of cases. We herein report a case of squamous cell carcinoma originating from mature cystic teratoma of the ovary diagnosed 10 years after initial tumor detection. A 69-year-old woman presented to the Department of Internal Medicine with a seven-month history of abdominal fullness. Magnetic resonance imaging performed at another Department of Internal Medicine 10 years ago revealed a left ovarian teratoma measuring 8 cm; however, she refused referral to the Department of Gynecology. The current plane magnetic resonance imaging showed a large pelvic-abdominal cystic tumor measuring 17 cm, consisting of fat, fluid-fluid level, and a hair ball. Although the anterior wall of the cyst was slightly thick, the tumor had no solid projection into the cyst. She was referred to our Department of Gynecology. Contrast-enhanced abdominal computed tomography showed the lack of an enhanced solid component in the tumor. Laparotomy presented a large cystic tumor originating from the left ovary. A left salpingo-oophorectomy was performed without the intraperitoneal spillage of cyst fluid. Macroscopically, the left ovary was a unilocular cyst containing hair and sebaceous yellow fluid. A histological examination revealed that part of the thickened cyst wall was lined by squamous cell carcinoma . Although the area of carcinoma was dominant, nests of squamous cell carcinoma partially invaded the stroma. We diagnosed this tumor as squamous cell carcinoma originating from mature cystic teratoma of the left ovary. We speculate that the reason for the lack of enhancing solid components in the present case may be the abundance of squamous cell carcinoma . The time required for mature cystic teratoma to become malignant remains unclear; therefore, the further accumulation of cases is needed to elucidate the mechanisms underlying the malignant transformation of mature cystic teratoma of the ovary.
恶性转化是卵巢成熟囊性畸胎瘤的一种罕见并发症，发生率为1%-3%。我们在此报告一例起源于卵巢成熟囊性畸胎瘤的鳞状细胞癌病例，该病例在最初发现肿瘤10年后被诊断出来。一名69岁女性因腹部胀满7个月就诊于内科。10年前在另一家内科进行的磁共振成像显示左侧卵巢畸胎瘤，大小为8厘米；然而，她拒绝转诊至妇科。目前的平面磁共振成像显示盆腔-腹部有一个17厘米的大囊性肿瘤，由脂肪、液-液平面和一个毛球组成。尽管囊肿前壁稍厚，但肿瘤没有向囊肿内的实性突出。她被转诊至我们的妇科。增强腹部计算机断层扫描显示肿瘤内无增强的实性成分。剖腹探查发现一个起源于左侧卵巢的大囊性肿瘤。进行了左侧输卵管卵巢切除术，囊肿液未发生腹腔内溢出。大体上，左侧卵巢是一个单房囊肿，内含毛发和皮脂样黄色液体。组织学检查显示增厚的囊肿壁部分内衬鳞状细胞癌。尽管癌灶占主导，但鳞状细胞癌巢部分侵犯了间质。我们将此肿瘤诊断为起源于左侧卵巢成熟囊性畸胎瘤的鳞状细胞癌。我们推测本病例中缺乏增强实性成分的原因可能是鳞状细胞癌含量丰富。成熟囊性畸胎瘤恶变所需时间尚不清楚；因此，需要进一步积累病例以阐明卵巢成熟囊性畸胎瘤恶性转化的潜在机制。
