Squamous cell carcinoma arising in endometriosis of the ovary.

Abstract

Squamous cell carcinoma arising in ovarian endometriosis is extremely rare, but a case is reported in a 62 year old woman. If such an ovarian tumour is discovered evidence of teratoma, Brenner tumour, or endometriosis should be sought. Extensive sampling is mandatory as the developing tumour often overgrows the foci of endometriosis, thus obliterating evidence of its origin.

Squamous Lesions of the Ovary

“…Young et al 10 have identified epidermoid cysts, some in concert with small Walthard rests, but in the absence of any other teratomatous features. Other case reports and small series [11][12][13][14][15][16][17][18][19] have identified de novo squamous cell carcinoma of the ovary, some associated with endometriosis. By all accounts, these entities are exceedingly rare, and questions remain about their histogenesis.…”

“…The radiologic findings generally show a solid and cystic mass, usually about 10 to 15 cm in maximal dimension. [6][7][8][9][10][11][12][13][14][15][16][17][18] This latter fact may be helpful in sorting out the preliminary differential diagnosis, given that many aggressive ovarian neoplasms are much larger. Areas of necrosis are often visible, and there are often adhesions to surrounding pelvic structures.…”

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19] Other symptoms may relate to the invasion of the tumor into neighboring structures (eg, the urinary system and other gynecologic organs) and to distant sites (eg, liver). [11][12][13][14][15][16] In their case series, Pins et al 9 noted that squamous cell carcinoma (arising in association with a dermoid, with endometriosis or de novo endometriosis) usually presents at 52 years; it would seem, therefore, that nonmetastatic squamous cell carcinoma of the ovary is a disease of perimenopausal women, again in contradistinction to a number of other aggressive ovarian neoplasms. A review of reported cases, [6][7][8][9][10][11][12][13][14][15][16][17][18][19] furthermore, suggests that most cases of primary squamous cell carcinoma of the ovary present at advanced stages.…”

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19] Neither primary squamous cell carcinoma nor squamous cell carcinoma associated with dermoid cysts appears to be associated with significant ascites, in contradistinction to a number of other aggressive gynecologic neoplasms. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Other symptoms may relate to the invasion of the tumor into neighboring structures (eg, the urinary system and other gynecologic organs) and to distant sites (eg, liver). [11][12][13][14][15][16] In their case series, Pins et al 9 noted that squamous cell carcinoma (arising in association with a dermoid, with endometriosis or de novo endometriosis) usually presents at 52 years; it would seem, therefore, that nonmetastatic squamous cell carcinoma of the ovary is a disease of perimenopausal women, again in contradistinction to a number of other aggressive ovarian neoplasms.…”

“…Areas of necrosis are often visible, and there are often adhesions to surrounding pelvic structures. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Frozen sections are often requested at the time of surgery for intraoperative and postoperative planning. In cases of clinically suspicious malignant tumors, a diagnosis of squamous cell carcinoma can be made if all the required histologic features are present.…”