Gynecologic Cancer InterGroup (GCIG) Consensus Review for Squamous Cell Carcinoma of the Ovary

Abstract

Squamous cell carcinoma of the ovary is a rare complication of mature cystic teratoma. The epidemiology, pathology, diagnosis, and management of this rare tumor are reviewed. Clinical characteristics, preoperative imaging, and tumor markers may help to predict malignancy preoperatively. Complete cytoreduction should be the aim of surgery. The prognosis for stage 1A disease is good, but for women with advanced or recurrent disease, it is very poor and has not improved in recent years. At present, there are insufficient data to provide clear guidance on the optimal management strategy for advanced disease, and there is a need to gain an understanding of the biology and to develop novel effective therapies. This will require coordinated international collaboration.

Malignant transformation from mature cystic teratoma of the ovary

“…reported that SCC antigen, CEA and CA125 were most frequently raised serum markers. SCC antigen was elevated in 81% of ovarian SCC cases, while CEA was elevated in 65% and CA125 was elevated in 60% . Hypercalcemia is also reported in patients with SCC, and was detected in our case of ovarian SCC using zoledronic acid.…”

“…We report here a case of malignant change from an ovarian mature cystic teratoma. The estimated incidence of SCC arising from ovarian mature cystic teratomas is 0.2–0.8% . From September 2013 to September 2017, only two cases of malignant change from ovarian mature cystic teratoma were diagnosed at our institution.…”

“…The number of patients with malignant transformation of mature cystic teratomas is small and there are insufficient data for clear guidance on optimal management strategies. Total abdominal hysterectomy, bilateral salpingo‐oophorectomy and omentectomy are generally accepted treatment approaches in SCC patients . Pelvic lymphadenectomy is also accepted in surgery for malignant melanoma in accordance with ovarian cancer treatment.…”

“…Pelvic lymphadenectomy is also accepted in surgery for malignant melanoma in accordance with ovarian cancer treatment. In the Gynecologic Cancer InterGroup consensus analysis of patients with ovarian SCC, optimal debulking surgery is supported . No phase III studies have reported chemotherapy effectiveness because the number of patients with ovarian SCC is small.…”

The driver mutational landscape of ovarian squamous cell carcinomas arising in mature cystic teratoma

“…Due to their rarity, there are few large published series and no prospective clinical trials in MCT-derived SCC, and the recent Gynecologic Cancer Intergroup (GCIG) consensus review concluded that there were insufficient data to provide clear guidance on optimal treatment (7). However, the prognosis for these SCC is poor, especially for stage II -IV disease [summarised in (6)].…”