Squamous cell carcinoma arising in a dermoid cyst of the ovary: A case series

Abstract

Background: Malignant transformation in a dermoid cyst of the ovary is a rare complication, occurring in only 1-2% of cases, with squamous cell carcinoma being the most common type. Preoperative diagnosis is difficult because of the lack of specific symptoms and signs to suggest malignancy. The prognosis is generally poor when disease has spread beyond the ovary.  

Objective: This study was conducted to review experience with this disease and describe the current treatment modality.

Methods: It was identified 4 women with this diagnosis during 2013-2018. This is a descriptive study, looking at the patient’s characteristics, mode of presentation, the role of tumor markers and radiological imaging in diagnosis. It was also examined the stage and pathological features of the presentation and subsequent course of the disease.

Result: The median age was 45 (range: 32-63 yrs). Three cases were stage I and one case was stage III. The average tumor diameter was 14.1cm. All patients were under surgery. Two patients not received any adjuvant therapy and two patients received adjuvant chemotherapy. One patient had recurrent disease in the pelvis during adjuvant chemotherapy and died at 8 month of her diagnosis. Other three patients were disease free for last 3 years. The overall 2 yrs survival was 70%.

Conclusion: Squamous carcinomas arising in mature cystic teratomas are commonly large ovarian tumors that occur in perimenopausal women often present as an incidental finding. There are no reliable diagnostic tools or prognostic indicators. The behaviour of these tumors is unpredictable. Conservative surgery may be considered in women wishing to preserve fertility. The role of chemotherapy and radiotherapy remains unclear in the adjuvant or metastatic setting.