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一名年轻女性成熟畸胎瘤继发鳞状细胞癌:病例报告及文献复习

Squamous cell carcinoma arising from a mature teratoma in a young woman: A case report and review of the literature.

作者信息

Sarra Ben Ltaief, Ghalleb Montassar, Jaouadi Souha, Khemir Aya, Ayadi Mohamed Ali, Dhiab Tarek Ben

机构信息

Surgical Oncology Department, Salah Azaiez Institute of Oncology, Tunis, Tunisia; Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Surgical Oncology Department, Salah Azaiez Institute of Oncology, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.

出版信息

Int J Surg Case Rep. 2025 Jul 10;134:111616. doi: 10.1016/j.ijscr.2025.111616.

Abstract

INTRODUCTION

Mature teratomas (MT), also known as dermoid cysts, are benign ovarian tumors frequently diagnosed in women of reproductive age. Malignant transformation, though rare, occurs in 0.2 % to 3 % of cases, with squamous cell carcinoma (SCC) being the most prevalent form. This report presents an unusual case of SCC arising from a mature teratoma in a 29-year-old woman, adding to the limited literature on this subject.

CASE PRESENTATION

A 29-year-old woman underwent fertility-sparing surgery for a presumed MT at an outside institution. Pathology revealed SCC (FIGO Pt1C2N0M0), and adjuvant chemotherapy was recommended but delayed due to socioeconomic barriers. She later presented with sub-occlusive symptoms, and imaging identified a mesenteric mass. Urgent ileocecal resection confirmed metastatic SCC. The patient was treated with four cycles of carboplatin and paclitaxel and remains disease-free at the latest follow-up.

CLINICAL DISCUSSION

Malignant transformation in MTs is rare but clinically significant due to its aggressive nature. This case highlights the potential for SCC transformation even in young patients, emphasizing the need for vigilant postoperative monitoring. Fertility-sparing surgery is appropriate for early-stage disease; however, delayed adjuvant therapy due to socioeconomic constraints can adversely affect outcomes. Platinum-based chemotherapy remains the standard for metastatic SCC and demonstrated efficacy in this case. Multidisciplinary care addressing both oncologic and reproductive goals is essential for younger patients.

CONCLUSION

This case underscores that malignant transformation in MTs can occur in young patients and may exhibit aggressive behavior. Timely management, addressing socioeconomic barriers, and fertility preservation strategies are crucial for optimizing outcomes.

摘要

引言

成熟畸胎瘤(MT),也称为皮样囊肿,是常见于育龄女性的良性卵巢肿瘤。恶性转化虽罕见,但发生率为0.2%至3%,其中鳞状细胞癌(SCC)最为常见。本文报告一例罕见的29岁女性由成熟畸胎瘤引发的SCC病例,为该领域有限的文献增添了新内容。

病例介绍

一名29岁女性在外地机构因疑似MT接受了保留生育功能的手术。病理检查显示为SCC(国际妇产科联盟分期Pt1C2N0M0),建议进行辅助化疗,但因社会经济障碍而推迟。她后来出现亚闭塞症状,影像学检查发现肠系膜肿块。紧急回盲部切除术证实为转移性SCC。患者接受了四个周期的卡铂和紫杉醇治疗,最新随访时仍无疾病迹象。

临床讨论

MT中的恶性转化虽罕见,但因其侵袭性而具有临床意义。该病例突出了即使在年轻患者中SCC转化的可能性,强调了术后密切监测的必要性。保留生育功能的手术适用于早期疾病;然而,由于社会经济限制导致辅助治疗延迟可能会对治疗结果产生不利影响。铂类化疗仍然是转移性SCC的标准治疗方法,且在本病例中显示出疗效。针对年轻患者,兼顾肿瘤学和生殖目标的多学科护理至关重要。

结论

本病例强调MT的恶性转化可发生在年轻患者中,且可能表现出侵袭性。及时处理、克服社会经济障碍以及采取生育保留策略对于优化治疗结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76a3/12305314/2f44ed3bda4e/gr1.jpg

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