Rare Case of Sarcomatoid Squamous Cell Carcinoma Arising in an Ovarian Mature Teratoma

Abstract

Although mature cystic teratoma (MCT) is benign, malignant transformation (MT) occurs in ∼ 1% to 2% of all cases, and usually consists of squamous cell carcinoma (SCC), which accounts for ∼ 80% of the cases. Spindle-cell (sarcomatoid) carcinoma (SCSC) is an uncommon type of SCC, comprising up to 3% of all cases. The lack of characteristic symptoms and specific imaging findings may lead to preoperative misdiagnosis. Moreover, the clinicopathologic characteristics, the treatment, the prognostic factors and the mechanism of MT have not yet been well understood due to the rarity of such tumors, especially in women of reproductive age. The authors present a case of a 34-year-old patient with 14 weeks of gestation who was diagnosed with an adnexal mass suggestive of ovarian teratoma. A laparoscopy salpingo-oophorectomy was performed after 6 months of delivery, and the histological exam revealed a sarcomatoid SCC in the MCT.

Ovarian Sarcomatoid Carcinoma Presenting with Paraneoplastic Leukemoid Reaction: Case Report

“…The presence of this tumor is typically associated with aggressive behavior and a poor prognosis (1,7). Prompt, accurate diagnosis is of extreme importance, to ensure patients receive timely treatment (1,2,14).…”

Malignant transformation of mature cystic teratoma of the ovary

“…10, Carcinomas can arise from any mature epithelial tissue. Adenosquamous carcinoma 13,14 Anaplastic Carcinoma 15 Angiosarcoma 16,17 Atypical compound nevus 18 BRAF-wild type PTEN mutant uveal malignant melanoma 19 Carcinoid tumor [20][21][22] Carcinosarcoma 23 Chordoma 24 Dedifferentiated chondrosarcoma 25 Fibrosarcoma 26 Follicular lymphoma 27 Follicular variant of papillary thyroid carcinoma 28 Ganglioneuroblastoma 29 Glioblastoma multiforme 30 Granular cell tumor 31 High-grade B-cell non-Hodgkin lymphoma 32 Large cell neuroendocrine carcinoma 33 Leiomyosarcoma 34 Low-grade astrocytoma 35 Malignant melanoma 10,36 Mucoepidermoid carcinoma 37,38 Multifocal carcinoma arising in struma ovarii 21 Oligodendroglioma/oligodendroglial cell proliferation 20,39 Ovarian clear cell adenocarcinoma 40 Ovarian mucinous cystadenocarcinoma 41 Papillary thyroid carcinoma 20,42 Poorly differentiated adenocarcinoma 43 Primary apocrine adenocarcinoma 44 Primary primitive neuroectodermal tumor 45 Prostate-type adenocarcinoma 46 Rhabdomyosarcoma 47 Sarcomatoid squamous cell carcinoma 48 Sebaceous carcinoma 21,49,…”

“…Less frequent histologic types include adenocarcinoma, sarcomas, thyroid carcinoma, malignant melanoma, and neuroectodermal tumors, among others (Table 1). 10,13–56 Carcinomas can arise from any mature epithelial tissue. Squamous cell carcinoma in mature cystic teratoma arises from the epidermal component via a carcinoma in situ pathway, or from the respiratory epithelium via squamous metaplasia/dysplasia/carcinoma in situ pathway 2,7,11 .…”