Management options for a patient with squamous cell carcinoma arising in a mature cystic teratoma of the ovary

Mature cystic teratomas, also referred to as dermoid cysts, are one of the commonly occurring ovarian germ cell tumors. Malignant transformation of a germ cell tumor occurs approximately 1-2% of the time. Treatment options vary by stage and are not well outlined in the literature. Here we report a case of a perimenopausal female who presented with increasing abdominal girth and an elevated CA-125. Final pathology revealed an invasive squamous cell carcinoma, moderately to poorly differentiated, multifocal, arising in a cyst on the left ovary, possibly a teratoma. At the time of diagnosis, the patient was FIGO stage IA. The decision was made against adjuvant treatment. Squamous cell carcinoma arising in a mature cystic teratoma of the ovary is rare. Treatment options are not well outlined in the literature, especially for disease less than stage II. Further research is needed to better inform the clinician on management recommendations.