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    Squamous Cell Carcinoma in Situ Arising in Mature Cystic Teratoma of The Ovary: A Case Report

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    Squamous Cell Carcinoma in Situ Arising in Mature Cystic Teratoma of The Ovary: A Case Report

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    Squamous Cell Carcinoma in Situ Arising in Mature Cystic Teratoma of The Ovary: A Case Report

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    Zakkouri et al.

    Journal of Ovarian Research 2011, 4:5


    http://www.ovarianresearch.com/content/4/1/5

    CASE REPORT Open Access

    Squamous cell carcinoma in situ arising in mature


    cystic teratoma of the ovary: a case report
    Fatima A Zakkouri1*, Saloua Ouaouch1, Saber Boutayeb1, Mouna Rimani2, Lamiae Gamra2, Hind Mrabti1 and
    Hassan Errihani1

    Abstract
    Introduction: Malignant transformation is a rare complication of mature cystic teratoma with squamous cell
    carcinoma being the most common type. We report a new case of squamous cell carcinoma in situ.
    Case presentation: A 62 year old woman was admitted for an abdomino-pelvic mass and she underwent a left
    salpingo-oophorectomy. The histopathologic analysis revealed a squamous cell carcinoma in situ arising in mature
    cystic teratoma of the ovary. Then, she underwent a total hysterectomy, contralateral salpingo-oophorectomy and
    omentectomy without adjuvant treatment.
    Conclusion: Optimal cytoreduction has been associated with a statistically significant improvement in survival for
    malignant transformation of mature cystic teratoma.

    Introduction revealed a squamous cell carcinoma in situ arising in


    Mature cystic teratoma (MCT) is the most common mature cystic teratoma of the ovary (Figure 2 and 3).
    germ-cell tumor of the ovary. It consists of well-differ- Then she was referred to our institution for treatment.
    entiated derivatives of the three germ-cell layers [1]. Pelvic examination, thoraco-abdominal computed tomo-
    Malignant transformation is a rare complication of this graphy scan and the serum tumour markers (ßHCG,
    pathology; it accounts for 1-2% of MCTs and the prog- AFP, LDH and CA125) were normal. She underwent a
    nosis of this disease is generally poor [2]. In this article, total hysterectomy, contralateral salpingo-oophorectomy
    we report a case of MCT who was admitted to National and omentectomy.
    Institute of Oncology in Rabat (Morocco). The diagnosis The histological examination found a mature cystic
    was proved by histopathologic analysis. teratoma in the contralateral ovary without malignant
    transformation. Adjuvant treatment was not planned.
    Case report
    A 62 year old woman was admitted to a gynecology Discussion
    clinic for adnexal mass which was suspected at first to Ovarian germ-cell tumours account for around 20-25% of
    be a MCT. She had only an abdomino-pelvic pain. ovarian neoplasms and 5% of cancers of the ovary [3].
    Abdominal computed tomography scan revealed a heav- Mature cystic teratoma (MCT) is the most common ovar-
    ily triple tissular mass with greasy and osseous constitu- ian germ cell tumor (10-20% of all ovarian tumors) [1].
    ent (= 10 cm) (Figure 1). The serum tumour markers Malignant transformation of mature cystic teratomas is
    (ßHCG, AFP and LDH) were normal. The patient very rare (1-2%), with squamous cell carcinoma being the
    underwent a laparotomy who revealed a voluminous most common type [4]. Pure squamous cell carcinoma in
    abdomino-pelvic mass. She underwent a left salpingo- situ arising in an ovarian cystic teratoma is extremely rare
    oophorectomy only. The histopathologic analysis [5]. We have only 5 cases from 1976 to 2005 [6].
    In our case, it’s a squamous cell carcinoma in situ
    arising in ovarian mature cystic teratoma. In most of the
    * Correspondence: zora-83@hotmail.com series, the median age at diagnosis of malignant trans-
    1
    Department of Medical Oncology, National Institute of Oncology, Rabat, formation of MCT was 54-61.5 years [7] and the most
    Morocco
    Full list of author information is available at the end of the article
    common symptoms were abdominal pain, palpable mass

    © 2011 Zakkouri et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
    Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
    reproduction in any medium, provided the original work is properly cited.
    Zakkouri et al. Journal of Ovarian Research 2011, 4:5 Page 2 of 3
    http://www.ovarianresearch.com/content/4/1/5

    Figure 3 Squamous cell carcinoma in situ (G × 300): Atypical


    Figure 1 Abdominal computed tomography scan: a heavily triple cells on all the epithelial height with an architectural
    tissular mass with greasy and osseous constituent (= 10 cm). disorganization. The basal membrane is intact and the chorion is
    free.

    and abdominal distension; but some people may be asymp-


    tomatic at diagnosis [8]. MCT with diameter > 10 cm Conclusion
    is associated with increased risk of malignancy in some Squamous-cell carcinoma in situ arising in a mature
    studies [9]. In our case, the tumor size was 10 cm. Most of cystic teratoma is an unusual disorder. Because of the
    studies have found that MCT has a poor prognosis. Early rarity of this disease, there is no therapeutic standard at
    stage and optimal cytoreductive surgery are reported to be the moment. However, the prognosis seems highly
    good prognostic factors [10]. dependent on complete surgical debulking.
    Due to the relative rarity of the squamous cell carci-
    noma in situ arising in MCT, there is no uniform con- Consent statement
    sensus regarding treatment. However, the treatment for written informed consent was obtained from the patient
    many authors consist to a complete tumor excision. for publication of this case report and accompanying
    Adjuvant chemotherapy or radiotherapy is not helpful in images.
    improving survival [4-6].
    In the review of the literature from 1976 through to Abbreviations
    2005, the optimal debulking rate for carcinoma in situ MCT: Mature cystic teratoma; ßHCG: ß-human gonadotropin; AFP: a-
    fetoprotein; LDH: lactate dehydrogenase.
    was 100% and the 5-year survival rate for this disease
    was 100% [6]. Author details
    1
    Department of Medical Oncology, National Institute of Oncology, Rabat,
    Morocco. 2Laboratory of Histopathology “Hassan”, Rabat, Morocco.

    Authors’ contributions
    FAZ: participated in the care of the patient and wrote the article. SO:
    participated in the care of the patient. SB: participated in the writing of
    article. MR and LG: realized the histopathologic analysis. HM: participated in
    the writing of article. HE: Validated content and form of the article. All
    authors read and approved the final manuscript.

    Competing interests
    The authors declare that they have no competing interests.

    Received: 23 December 2010 Accepted: 24 March 2011


    Published: 24 March 2011

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    doi:10.1186/1757-2215-4-5
    Cite this article as: Zakkouri et al.: Squamous cell carcinoma in situ
    arising in mature cystic teratoma of the ovary: a case report. Journal of
    Ovarian Research 2011 4:5.

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