Squamous Cell Carcinoma in the Shadow of the Mature Cystic Teratoma of the Ovary: A Case Report

Mature cystic teratomas, also named dermoid cysts, are the most benign ovarian germ cell tumors and can occur in any age group. Transformation of the mature elements within the dermoid cyst to the malignancy termed mature cystic teratomas (MCTs) with malignant transformation occurs in only 1-2 % of cases. Of these, squamous cell carcinoma (SCC) with 80% prevalence is the most common type. A 54-year-old peri-menopausal woman -gravida 5, para 4, live 4, and abortion 1- presented to Omid Clinic of Ayatollah Rouhani Hospital in Babol, Iran, with a complaint of abdominal pain for about five months. Transvaginal ultrasonography revealed a mass with a diameter of 125-millimeter in the left adnexa with a complex appearance containing fine-echo liquid, solid internal component, and thickened wall. Spiral CT scan of abdomen & pelvis showed 147×121-millimeter bilocular lesion consistent with an ovarian dermoid cyst. Left salpingo-oophorectomy was performed, and a frozen section was requested during the surgery, which showed a malignant epithelial tumor consistent with squamous cell carcinoma arising in teratoma. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and partial omentectomy were done successfully. The patient was discharged from the hospital after two days without any complaints or adverse events. Regarding the rarity of MCT with malignant transformation, it is recommended to consider patient characteristics, preoperative imaging, laboratory evaluations, and the results of the frozen section during surgery since they can significantly change the treatment plan and the prognosis of the patient.