Squamous cell carcinoma arising in a mature cystic ovarian teratoma with bladder invasion: a case report

Background

Malignant transformation in a mature cystic ovarian teratoma is rare. Except in cases with high index of suspicion or overt metastasis, oophorectomy is the mainstay of treatment for ovarian teratoma.

Method

A 46-year-old perimenopausal woman who had salpingo-oophorectomy following a clinical diagnosis of benign ovarian tumour that was subsequently reported histologically as mature cystic ovarian teratoma with malignant transformation is presented.

Results

She was referred to our facility based on the histopathology report and haematuria two weeks after surgery. Cystoscopic biopsy done was reported as metastatic squamous cell carcinoma most probably from the ovary. Patient was thereafter referred for radiotherapy but was lost to follow-up after the first course.

Conclusion

Adequate evaluation prior to surgery in suspected ovarian teratoma with malignant transformation is critical to determine extent of surgery and adjuvant therapy. Prognosis in advanced disease condition such as the case presented is generally poor although radical pelvic surgery with resection of the adjacent involved bladder before radiotherapy would probably have improved her prognosis.     

Intestinal metastases in a squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case report

Metastatic spread to the intestines by squamous cell carcinoma (SCC) arising in mature cystic teratoma (MCT) or dermoid cyst is a very rare event. A case of a 40-year-old cachectic woman is presented with an MCT of the left ovary found at autopsy. Focal mural thickening of the cyst wall harbored a moderately differentiated SCC with single cell keratinization. Intramural metastases were noted in the jejunum, ileum, colon transversum, and left colonic flexure. In addition, liver metastases were detected. The tumor was staged as FIGO IV. The peritoneum was covered diffusely by fibrinous and suppurative exudate. In this unusual case, metastasizing SCC of the ovary arising in an MCT led to suppurative peritonitis and consequently to death of the patient. Follow-up procedures regarding intestinal spread could be useful in patients with SCC in MCT.     

Massive ovarian edema with contralateral mature cystic teratoma--a case report of an uncommon combination

A case with massive ovarian edema (MOE) of left ovary--a rare pseudotumour and mature cystic teratoma of right ovary is described in a young unmarried girl of 16 years. The etiopathological concepts, morphological changes and differential diagnosis are described. Knowledge about the entity and its existence are important for correct treatment. This is the first reported case from Nepal.     

Squamous cell carcinoma in situ arising in ovarian mature cystic teratoma

Mature cystic teratoma is a benign neoplasm, but malignant transformation of one component may occur in 2% of cases. Although very different types of carcinomas may be arise from mature cystic teratoma, invasive squamous cell carcinoma is the most frequent type of malignancy found, comprising about 80% of all malignancies arising from dermoid tumours. Although invasive squamous cell carcinoma is relatively frequent, it is surprising that so few cases of squamous cell carcinoma in situ in mature cystic teratoma have been reported. We describe a case of squamous cell carcinoma in mature cystic teratoma without an invasive component.     

Pigmented oral squamous cell carcinoma: a case report and brief review of the literature

Melanin impregnation in squamous cell carcinoma (SCC) is an uncommon histological finding. Rare nonmelanocytic entities were previously described as having melanocyte colonization. A 57-year-old Brazilian woman was referred with a pigmented lesion in the lower lip and alveolar ridge with a prior clinical diagnosis of melanoma. The incisional biopsy of the tumor revealed an SCC with strong colonization of melanocytes in the stroma. The authors report a case of an unusual SCC variant and a brief review of the literature.     

Mature ovarian cystic teratoma with combined squamous cell carcinoma and malignant melanoma

 In a mature ovarian cystic teratoma (MOCT) in a 67-year-old woman we found associated invasive squamous cell carcinoma and nodular amelanotic malignant melanoma. The finding of foci of typical and atypical melanocytic proliferation at the junctional level of the dermal component together with the absence of other possible sources supports an ovarian origin of the melanoma. A comparative analysis of the reported MOCT-associated malignant melanomas emphasizes the singularity of our case in the amelanotic character of the melanoma, its lymphotropism and the coexistence of invasive squamous cell carcinoma. Received: 23 October 1997 / Accepted: 30 December 1997     

Primary squamous cell carcinoma of the thyroid--a case report

A rare case of primary squamous cell carcinoma of the thyroid is reported herein. A 64-year-old Malay lady presented with a gradually enlarging thyroid nodule for the past 6 months and underwent total thyroidectomy. Histopathology revealed a squamous cell carcinoma of the thyroid with complete resection. Possible primary tumour elsewhere was excluded. Postoperative irradiation was given and patient is still alive after 2 years of follow-up.     

Combined hepatocellular and cholangiocarcinoma with marked squamous cell carcinoma components arising in non-cirrhotic liver

We report a surgical case of liver tumor, 40 x 35 mm in size, with squamous cell carcinoma (SCC) and hepatocellular carcinoma (HCC) components in a 60-year-old Japanese man with steatohepatitis. Most of the SCC component showed typical intercellular bridge and keratinization, while most of the HCC components showed a thick trabecular pattern with mild to moderate nuclear atypia. Both components transit each other without undifferentiated foci; however, a small foci showing glandular structure was intermediated. No cyst formation was found in the liver. The primary site of the squamous cell carcinoma was not detected in general clinical and radiological examination. Immunohistochemical analysis revealed that part of the HCC components neighboring the SCC showed patchy and weak expression of cytokeratin 7. There are several possibilities for the origin of squamous cell carcinoma in this case: marked squamous metaplastic change of cholangiocarcinoma and/or HCC, and carcinoma originating from pleuripotential stem cells. Irregular fatty changes, scattered giant mitochondria and acellular fibrosis with bridging were seen in the liver; however, this patient had no episode of hepatitis-associated viral infection. This is an interesting case of combined hepatocellular and cholangiocarcinoma with marked SCC components arising in a non-cirrhotic fibrotic liver.     

In-situ neoplasia in squamous cell carcinoma of the parotid. A case report

This case report demonstrates the origin of a primary squamous cell carcinoma of the parotid gland in squamous metaplasia of the parotid ducts. Comparison is made between parotid ductal intraepithelial neoplasia and cervical intraepithelial neoplasia. The clinical importance of establishing the primary origin of these tumours and the need for extensive tissue sampling is emphasized.     

Large cell variant ovarian small cell carcinoma: case report

Ultrastructural data about large cell variant ovarian small cell carcinoma (LCV-SCC) are scarce and contradictory and the role of transmission electronmicroscopy (TEM) is not clear in the assessment of such tumors. The authors present a case of LCV-SCC without hypercalcemia in a 30-year-old woman. The diagnosis was confirmed by histopathological and immunohistochemical studies. Cytopathological examination of peritoneal washing showed a population of large neoplastic cells. TEM demonstrated that the neoplasia comprised two types of cells: one type showed many coarse secretory granules without dense core, and the other type was without granules and showed dilated endoplasmic reticulum and sometimes indented nuclei. The present case indicates that different underlying ultrastructural patterns, not yet well known, exist in connection with the pathological and clinical behaviour of LCV-SCC. TEM might play a role in the identification of subtypes of LCV-SCC with different prognostic and therapeutic impact.     

A case of small cell carcinoma arising in a mature cystic teratoma of the ovary

Malignant transformation of ovarian mature cystic teratomas is reported to occur in about 1% of cases. The most common malignant evolution is that of squamous cell carcinoma and one of the least common is that of small cell carcinoma. We report a case of distant metastasis from a small cell carcinoma arising in a mature cystic teratoma. A 28-year-old nulliparous female presented with signs of supraclavicutar lymph node metastasis. This Is the first known case report of lymph node metastasis as an Initial sign of cancer developing in a pre-existing mature cystic teratoma. Histologically, the tumor cells had microscopic features similar to those of pulmonary small cell carcinoma. This report gives a literature review, and the histological, Immunohistochemical, flow cytometric and ultrastructural features are described.     

Dermal adnexal differentiation in a squamous cell carcinoma of the uterine cervix

The first case of a keratinizing squamous cell carcinoma of the uterine cervix with differentiation toward dermal adnexal structures is reported. A review of skin-associated structures in the non-neoplastic uterine cervix is given and the histogenesis discussed. Recent literature dealing with extracutaneous neoplasms with sebaceous differentiation is cited.     

Primary squamous cell carcinoma of the liver: a case report

Primary squamous cell carcinoma (SCC) of the liver is very rare, and few cases have been reported in Korea. Primary SCC of the liver is known to be associated with hepatic cysts and intrahepatic stones. A 71-year-old male was admitted to our hospital, and a abdominal computed tomography scan revealed a 10 × 6 cm mass in the liver. Analysis of a biopsy sample suggested SCC, and so our team performed a thorough workup to find the primary lesion, which was revealed hepatoma as a pure primary SCC of the liver with multiple distant metastases. The patient was treated with one cycle of radiotherapy, transferred to another hospital for hospice care, and then died 1 month after discharge.     

Primary squamous cell carcinoma of the endometrium: a case report

Squamous cell carcinoma of the endometrium is extremely rare female genital malignancy. Only 64 cases have been reported in the literature. A case of primary squamous cell carcinoma of endometrium in a 55-year old-woman is reported. Examination revealed pyometra and cervical stenosis. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology confirmed the diagnosis.     

Primary squamous cell carcinoma of the breast: a case report

INTRODUCTION: Primary squamous cell carcinoma (SCC) of the breast is an extremely rare entity and it has a low incidence in comparison with all other mammary cancers. MATERIAL AND METHODS: We describe a case of SCC of the breast in a 55 year old woman who presented with a painless mass located in the external quadrant of the left breast. The neoformation, once removed, was tamponate formalin fixed and routinely processed for inclusion in paraffin. Sections were stained with haematoxilin-eosin and immunohistochemical and electron microscopy investigations were performed. RESULTS: Histologically, the neoplasia was characterized by cystic cavities covered by nests and sheaths of poorly differentiated squamous cells with keratinized areas. Mitotic activity was high, as well as cellular proliferative index, evaluated by Mib-1 (ki 67) antibody. At immunohistochemistry, the tumor cells were diffusely positive for high molecular weight cytokeratins and c-erbB-2, negative for vimentin, estrogen and progesterone. CD68 and LCA were positive only in the inflammatory cells. Electron microscopy confirmed the epithelial nature of the neoplastic cells. A diagnosis of SCC of the breast was made, and a radical mastectomy was performed. CONCLUSIONS: We make a brief review of the literature and discuss the main histologic criteria for the differential diagnosis with adenocarcinoma of the breast with squamous metaplasia.     

Choriocarcinoma arising in transitional cell carcinoma of bladder: a case report

Trophoblastic metaplasia can occasionally occur in transitional cell carcinomas of the bladder and the resultant choriocarcinoma is likely to behave differently from typical epithelial bladder tumours.     

Anaplastic spindle cell carcinoma, arising in a background of an ovarian mucinous cystic tumor: a case report with clinical follow up, review of the literature

Anaplastic carcinoma (AC) of spindle cell type is an exceedingly rare ovarian malignant neoplasm. The histo-genesis of these tumors is still controversial. Although it was first thought to carry an invariably unfavorable prognosis, recent data indicates that this does not apply to stage Ia tumors. To date, there have been less than ten cases of anaplastic spindle cell carcinoma reported in the medical literature. Furthermore, our case is the first time this tumor has been described in a 40-year-old female with malignant spindle cells merging with conventional high grade adeno-carcinoma. The differential diagnosis of spindle cell proliferation in the ovary will be discussed and their distinction using a panel of immunohistochemical stains. This report demonstrated that the findings of malignant spindle cell proliferation does not imply this entity to be carcinosarcoma. The distinction of AC from true sarcomas is important because of the poorer prognosis of the later compared with the quite favorable behavior of AC. However, such existence necessitates a careful tissue sampling for the logical distinction between AC and carcinosarcoma, which is critical for planning further management and ultimately the predictor of prognosis.     

Clear cell carcinoma arising in a Cesarean section scar endometriosis: a case report.

Endometriosis of a surgical scar is rare and occurs mainly when a hysterectomy or Cesarean section was performed. We describe a 54-year-old woman with a large suprapubic mass as a definite case of a endomerioid carcinoma developing within the scar endometriosis following Cesarean section. Scar endometriosis, as well as endometriosis at other sites, can turn malignant. Endometrioid carcinoma is the most common histological pattern of malignant tumor arising in endometriosis. But clear cell carcinoma is very unusual. A case of primary clear cell carcinoma in endometriosis of a Cesarean section scar is described. To the best of our knowledge, this is the first documented case of endomerioid carcinoma developing within the scar endometriosis in Korea.