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.

摘要 尽管成熟囊性畸胎瘤（Mature Cystic Teratoma, MCT）属于良性病变，但约1%~2%的病例会发生恶性转化（Malignant Transformation, MT），其中约80%的恶性转化病例表现为鳞状细胞癌（Squamous Cell Carcinoma, SCC）。梭形细胞（肉瘤样）癌（Spindle-Cell (Sarcomatoid) Carcinoma, SCSC）是一种少见的SCC亚型，占所有相关病例的比例最高可达3%。由于此类肿瘤缺乏特征性临床症状与特异性影像学表现，术前易出现误诊。此外，鉴于这类肿瘤较为罕见，尤其是在育龄女性群体中，其临床病理特征、治疗方案、预后影响因素及恶性转化的潜在机制尚未得到充分阐明。本文报告1例34岁妊娠14周的患者，术前被诊断为疑似卵巢畸胎瘤的附件肿块。患者于分娩6个月后接受了腹腔镜下输卵管卵巢切除术，术后组织病理学检查显示其MCT病灶伴发肉瘤样SCC。