Intraoperative intraperitoneal chemotherapy with cisplatin in epithelial ovarian cancer / 부인종양

OBJECTIVE: To assess retrospectively the feasibility of intraoperative intraperitoneal (IP) chemotherapy with cisplatin in epithelial ovarian cancer. METHODS: IP chemotherapy during optimal staging surgery was performed in 10 patients who were diagnosed with primary epithelial ovarian cancers between April 2008 and February 2011. Cisplatin (70 mg/m2 in 1 L normal saline solution) was administered in the abdominal cavity for 24 hours postoperatively and then adjuvant chemotherapy was started 2-4 weeks after surgery. Perioperative toxicity of the combined treatment was evaluated until the initiation of postoperative adjuvant chemotherapy. RESULTS: A total of 23 adverse events were observed in 9 of 10 patients (grade 1, 7; grade 2, 13; grade 3, 3; grade 4, 0). In descending order of frequency, adverse events affected the gastrointestinal system (n=14), hematologic system (n=6), pulmonary system (n=2), and genito-urinary system (n=1). The adverse events did not affect adjuvant systemic chemotherapy schedules. One patient experienced disease recurrence in the liver 16 months after surgery. The remaining 9 patients have been well controlled by chemotherapy and/or observation during the follow-up period of 4 to 39 months after surgery. CONCLUSION: Intraoperative IP chemotherapy with cisplatin during surgical procedures is considered feasible for the treatment of primary epithelial ovarian cancer. Further studies, including long-term, prospective and comparative trials, are needed to validate the efficacy of this combined therapy.

Clinical experiences of the levonorgestrel-releasing intrauterine system in Korean women with adenomyosis / 대한산부인과내시경학회지

OBJECTIVE: To analyze the clinical experiences of patients who treated with levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis associated with dysmenorrhea and/or menorrhagia. METHODS: The LNG-IUS was inserted into 103 patients who were diagnosed with adenomyosis on ultrasound examination and suffered from dysmenorrhea or menorrhagia at CHA Gangnam Medical Center between January 2009 and December 2009. Symptomatic changes of dysmenorrhea and menorrhagia, side effects, and failure rates were evaluated, retrospectively. RESULTS: During the follow-up periods, dysmenorrhea was improved in 91.4% and menorrhagia was improved in 90.4% of patients. Most common side effects were prolonged vaginal spotting in 41 (39.8%), and expulsion of LNG-IUS in 32 (31.1%) patients. Six (5.7%) patients were premature removal of LNG-IUS and 9 (8.5%) patients were underwent hysterectomy. Overall 77 (74.8%) patients continued to use of LNG-IUS. CONCLUSION: The LNG-IUS is effective treatment option for management of dysmenorrhea and menorrhagia for patients with clinical diagnosis of adenomyosis. It seemed to be an alternative treatment method before hysterectomy.

Single-port access total laparoscopic hysterectomy in women with history of previous abdominal surgery / 대한산부인과내시경학회지

OBJECTIVE: The aim of the present study was to evaluate the impact of previous abdominal surgery on surgical outcomes of single-port access (SPA) total laparoscopic hysterectomy (TLH). METHODS: We reviewed the medical records of 111 women who underwent SPA-TLH at the Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University between January 2010 and December 2010. Women were classified according to their history of previous abdominal surgery. RESULTS: Of 111 women undergoing SPA-TLH, 74 women (66.7%) without history of previous abdominal surgery and 37 women (33.3%) with history of previous abdominal surgery were classified. There was no significant difference in surgical outcomes including operative time, estimated blood loss, change in hemoglobin, uterine weight, perioperative complications, transfusion, and additional port insertion between two groups. CONCLUSION: In our experience, previous abdominal surgery has no significant impact on SPA-TLH.

A Case of Ovarian Microinvasive Mucinous Carcinoma and Co-existent Angiosarcoma

Primary ovarian angiosarcoma is very rare with only 27 cases reported so far in the medical literature. We report here on a rare case of ovarian microinvasive mucinous carcinoma that was coexistent with angiosarcoma in a 54-year-old woman. The tumor was a 26x19x10 cm-sized multilocular cystic mass with a 4x3 cm-sized solid hematoma-like nodule in the center. Microscopically, it was composed mostly of mucinous tumor of various grades from borderline to microinvasive carcinoma. The hematoma-like area turned out to be an angiosarcoma, composed of pleomorphic cells that formed slit-like spaces, spindle cells that formed short fascicles and anastomosing vascular channels with atypical endothelial cells. All these cells were positive for CD31, CD34 and factor VIII-related antigen. The patient developed peritoneal and pleural metastases, which were angiosarcoma and mucinous carcinoma, respectively. We believe this case is only the fourth example of an ovarian collision tumor of angiosarcoma and surface epithelial tumor.

The effectiveness of a single preoperative dose of misoprostol during laparoscopic myomectomy / 대한산부인과내시경학회지

OBJECTIVE: To evaluate the effectiveness of single preoperative dose of misoprostol to reduce intraoperative hemorrhage during laparoscopic myomectomy. METHODS: We reviewed retrospectively the medical records of 148 patients who underwent laparoscopic myomectomy in Gangnam CHA Medical Center between January 2007 and December 2009 by single surgeon. Among them, 46 patients used preoperative transrectal misoprostol. One hundred two patients underwent laparoscopic myomectomy in conventional method without any preoperative agents. RESULTS: The two groups were similar in baseline characteristics. There was no significant difference in mean blood loss (misoprostol group: 203.3+/-181.8 mL vs. no agent group: 207.7+/-144.5 mL), operation time (misoprostol group: 113.3+/-28.2 min vs. no agent group: 113.4+/-31.5 min), and hemoglobin change (misoprostol group: 2.0+/-1.0 g/dL vs. no agent group: 1.9+/-1.0 g/dL). Two patients needed transfusion in misoprostol group whereas none in control group, but there was no statistical significance. CONCLUSION: A single preoperative dose of transrectal misoprostol cannot reduce bleeding during laparoscopic myomectomy.

The effectiveness of levonorgestrel releasing intrauterine system in the treatment of endometrial hyperplasia in Korean women / 부인종양

OBJECTIVE: Levonorgestrel releasing intrauterine system (LNG-IUS) has been shown to treat patients with non-atypical & atypical endometrial hyperplasia (EH) successfully in many western studies. Our purpose was to examine the effectiveness of LNG-IUS in the treatment of Korean women with EH. METHODS: We conducted a prospective observational study of 12 women diagnosed with EH and treated with LNG-IUS insertion between February 2007 and August 2009 at the Department of Gynecology of Gangnam CHA Hospital, CHA University School of Medicine. Baseline endometrial biopsies were done before insertion of LNG-IUS, and outpatient follow-up endometrial biopsies were undertaken at 3-month intervals after insertion of LNG-IUS. We investigated the regression rate and the time to regression. RESULTS: Four patients had simple hyperplasia without atypia, 7 patients complex hyperplasia without atypia, and just 1 patient complex atypical hyperplasia. Complete regression of EH was achieved in all cases (100%, 12/12), with the significant proportion (66%, 8/12) achieving it within 3 months. The mean duration to regression was 4.5 months. All cases had regression within 9 months. In the case of complex atypical hyperplasia, the regression was attained at the 9th month after insertion of LNG-IUS. The mean follow-up duration was 12 months (range, 3 to 27 months). As long as LNG-IUS was maintained, the EH did not recur. CONCLUSION: LNG-IUS appears to be as highly effective in treating Korean women with EH.

Cellular fibroma of the ovary containing Leydig cell hyperplasia: a case report / 부인종양

Ovarian stromal tumors containing Leydig cell components are rare. Only a few cases of ovarian stromal Leydig cell tumors characterized by clusters of Leydig cells have been reported to date. Here, we present the first case report of a 65-year-old woman with a cellular fibroma of the ovary containing Leydig cell hyperplasia. Microscopic examination revealed the proliferation of spindle cells arranged in intersecting bundles with mild nuclear atypia and an average of 2-3 mitotic figures per ten high-power fields. Multifocal nests of polygonal cells with abundant eosinophilic cytoplasm and round nuclei were seen within the spindle cells. Final pathology of the tumor revealed a cellular fibroma including Leydig cell hyperplasia.

Clinical Significance of Microsatellite Instability in Sporadic Epithelial Ovarian Tumors

PURPOSE: We evaluated the expression of microsatellite instability (MSI) in sporadic ovarian tumors using 5 standard and 9 new MSI markers to determine the clinical significance of MSI in sporadic epithelial ovarian tumors. MATERIALS AND METHODS: MSI was examined in 21 borderline and 25 malignant ovarian tumors. Polymerase chain reaction (PCR) was performed using the 5 markers recommended by the National Cancer Institute (NCI) for colon cancer and 9 additional markers. MSI was determined using fractional analysis by mixing the PCR products and size markers. RESULTS: Using the 5 conventional MSI markers, MSI was found in 4 of 46 (8.6%) ovarian tumors, including 2 of 21 (9.5%) borderline ovarian tumors and 2 of 25 (8%) malignant ovarian tumors. Using the 9 additional MSI markers, MSI was observed in 7 of 46 (15.2%) ovarian tumors, including 3 of 21 (14.3%) borderline ovarian tumors and 4 of 25 (16%) malignant ovarian tumors. There was no statistically significant difference between MSI and clinicopathological factors, including histology and stage, although there was a trend toward an increased incidence of MSI in the serous type. CONCLUSION: MSI was infrequent in ovarian tumors, including both borderline and malignant tumors. MSI was found to be uncommon in sporadic ovarian tumors, even by using additional MSI markers. The clinical significance of MSI is not strong in patients with sporadic ovarian tumors.

Comparison of surgical outcomes after laparoscopy-assisted vaginal hysterectomy and total laparoscopic hysterectomy / 대한산부인과학회지

OBJECTIVE: To compare the surgical outcomes between laparoscopy-assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH). METHODS: The data were collected retrospectively from hospital records. Between September 2006 and August 2007, Patients undergone with LAVH (93 cases) and TLH (142 cases) with pathologic reports of leiomyoma or adenomyosis were enrolled. The characteristics and surgical results were compared according to the operation type. The correlations among the variables were analyzed with multiple linear regression. RESULTS: Between two groups, the characteristics of patients were similar such as age, body mass index, surgical history, and pathologic findings. In the univariate analysis, the differences of operation duration and blood loss between LAVH (129.0+/-34.5 min, 385.5+/-296.1 mL) and TLH (123.6+/-40.8 min, 294.7+/-285.4 mL) were significant (P0.050). In multivariate analysis, blood loss was correlated with operation duration and specimen weight (P=0.000) but not with operation type (P=0.213). CONCLUSIONS: LAVH tends to be selected in larger uteri and results in more blood loss and longer operation duration. Operation type (LAVH or TLH) does not affect blood loss which is related with operation duration and uterine weight.

Tumor volume measured by 3-D magnetic resonance imaging in the prediction of prognosis for cervical carcinoma / 대한산부인과학회지

OBJECTIVE: Clinical evaluation of tumor size in cervical cancer is often difficult. Digital imaging technique using computer has shown an eye opening progress. Quantitative analysis of tumor size or tumor volume using magnetic resonance imaging (MRI) has been reported as useful in the prediction of prognosis in patients with cervical cancer. The purpose of this study was to evaluate whether quantitative analysis can further improve the efficacy of using MR imaging to predict the prognosis of cervical cancer. METHODS: MRI on 0.5- or 1.5-T scanners was performed in 93 consecutive women with invasive carcinoma of the uterine cervix. Initial tumor diameter and volume were determined on T2-weighted images; volume was calculated by the standard technique of multiplying the sum of the areas by the slice thickness. Patients were treated by radical surgery, radiotherapy, or a concurrent chemoradiotherapy based on clinical International Federation of Gynecology and Obstetrics (FIGO) stage and individual patient criteria. Clinical data (patient age and FIGO stage), MRI-derived tumor dimensions (diameter and volume), and histological findings (tumor invasion depth and histological type) were associated and linked to patient outcome. RESULTS: Tumor volume on MRI was significantly associated with recurrence of cervical cancer (P=0.018). Univariate analysis demonstrated graphically that MRI-derived tumor volume and clinical stage were associated with progression-free survival. CONCLUSION: Our preliminary results suggest that tumor volume, determined by pretreatment MRI, predict progression-free survival for patients with invasive cervical carcinoma. This study reveals the value of MRI as an adjunctive tool to clinical evaluation of invasive cervical cancer.

Predicting parameters of survival in patients with vulva carcinoma: its relationship with human papillomavirus infection / 대한산부인과학회지

OBJECTIVES: This study was conducted to evaluate the relationship between HPV infection status and clinicopathologic parameters and to define the predictive parameters including treatment modality affecting survival in patients with vulva cancer. MATERIALS AND METHODS: Data were collected from 30 patients who were diagnosed for vulva carcinoma from Jan 1991 to June 2005. The cancer-related variables including age, stage, cell type, lesion size, multifocality, lymph node involvement, treatment modality and HPV infection were evaluated by reviewing medical records. Statistical analysis was performed by chi-square, log rank test and Cox proportional hazards analysis using SPSS program. RESULTS: Among all 30 patients of vulva carcinoma, HPV infection status was tested in 17 patients. And of these patients, 11 (64.7%) had positive HPV infection. Although there was no survival difference according to HPV infection status, patients with positive HPV infection had significantly more positive lymph nodes (p=0.04). Among all the cancer-related variables, radiation therapy was significantly more associated with poor overall survival than surgery (p=0.007). And squamous cell type was related with decreased overall survival although not statistically significant (p=0.06). However, on the basis of multivariate analysis, there was no significant independent prognostic factor affecting overall survival for vulva carcinoma. CONCLUSIONS: Although this study didn't show any direct relationship between HPV infection and prognosis, HPV infected patients were significantly associated with lymph node metastasis. And the surgery might be an important treatment modality affecting overall survival in patients with vulva carcinoma.

An Ovarian Steroid Cell Tumor Causing Virilization and Massive Ascites

Steroid cell tumors, not otherwise specified (NOS), are rare ovarian sex cord-stromal tumors with malignant potential. The majority of these tumors produce several steroids, particularly testosterone. Various virilizing symptoms such as hirsutism, temporal balding, and amenorrhea are common in these patients; however massive ascites is an infrequent symptom. A 52-year-old woman with the sudden onset of virilization and massive ascites presented for treatment at Severance Hospital. After clinical evaluation, the patient underwent an exploratory laparotomy and a complete surgical staging procedure. She recovered from the surgery uneventfully and was discharged from the hospital five days after surgery. We present here an unusual case of an ovarian steroid cell tumor, NOS, and a brief review of the literature regarding these types of tumors.

The expression and interaction of HLA-G and IL-10 in cervical cancer / 대한산부인과학회지

OBJECTIVES: To determine the expression of HLA-G and IL-10 and their correlation in tissue of cervical cancer, and to investigate the relationship between their expression and clinicopathologic factors in patients with cervical cancer. METHODS: Tissue samples were obtained from 40 patients diagnosed with cervical cancer and 15 patients with normal cervix for control from Oct. 2004 to Oct. 2005. Quantitative real-time RT-PCR for HLA-G mRNA and semi-quantitative RT-PCR for IL-10 mRNA were used. And proteins of HLA-G and IL-10 were detected by Western blot analysis. RESULTS: Both HLA-G and IL-10 mRNA expression in cervical cancer tissue were higher than normal control, which was statistically significant (P<0.001, P<0.001). The proteins levels of HLA-G and IL-10 in cancer group were also significantly higher than control (P<0.001, P=0.041). The mRNA expression of HLA-G tended to be correlated with IL-10 expression (P=0.061), although it was not statistically significant. Among clinicopathologic factors of cervical cancer, there was inverse relationship between FIGO stage and mRNA value of HLA-G (P=0.045). CONCLUSIONS: The mRNA and protein expression of HLA-G and IL-10 in cervical cancer were much higher than in controls. These results showed that HLA-G and IL-10 might have an important role of tumorigenesis in patients with cervical cancer. The levels of HLA-G and IL-10 seem to be correlated although it was not statistically significant. High HLA-G mRNA expression could be related in early tumorigenesis since it was associated with early stage cervical cancer.

Expression of Cdc25A, Cdc25B and Cdc25C in cervical carcinoma / 대한산부인과학회지

OBJECTIVE: This study was undertaken to quantitatively detect Cdc25A, Cdc25B and Cdc25C in cervical carcinoma and determine the relationship between the expression of mRNA and protein of cell division cycle (Cdc)25 phosphatase and various clinicopathologic prognostic factors of cervical carcinoma. METHODS: 39 patients diagnosed with cervical carcinoma between February 2000 to March 2005 and 10 patients with benign gynecologic disease were enrolled in this study. A reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot analysis were used to analyze the expression of Cdc25 phosphatase mRNA and protein in fresh invasive cervical cancer tissue and normal cervix tissue. RESULTS: The mRNA expressions of Cdc25A, Cdc25B and Cdc25C in the cancer tissues were significantly greater than in the control (p=0.02, 0.01, 0.02), respectively. A Western blot analysis yielded same results (p=0.01, 0.02, 0.01). There were also significant relationships between the age and the Cdc25B mRNA expression (p=0.03), between the cell type and the Cdc25C mRNA expression (p=0.04). However, other clinicopathologic prognostic factors including stage, subtype, SCC Ag level, DNA flow cytometry, lymph node metastasis, lymphovascular space invasion and HPV positivity were not statistically significant. CONCLUSION: Our results show that Cdc25A, Cdc25B and Cdc25C expression levels were significantly greater in cervical cancer patient group than in those of control group. Thus Cdc25 phosphatase might play an important role in carcinogenesis of cervical carcinoma. Further studies based on the correlation between Cdc25 phosphatase and survival rate would be need to support Cdc25 phosphatase as a prognostic factor of cervical carcinoma.

Robot-assisted total laparoscopic hysterectomy: initial experience in Korea / 대한산부인과학회지

Hysterectomy is one of the most common non-pregnancy-associated surgical techniques in the field of gynecology. Over the years, this laparoscopic approach has evolved to include both subtotal and total laparoscopic hysterectomy. Robot-assisted technology may attenuate the learning curve for complex laparoscopic procedures, leveling the playing field between conventional laparotomy practitioners and laparoscopists. The advantages of robotics, such as motion scaling, three-dimensional visualization, and articulated instrumentation, enables complex surgical procedures to be performed with greater dexterity, more quickly, and more easily by many surgeons. We have experienced a case of patient with carcinoma in situ of the uterine cervix treated by robotic surgery. We report the first case treated by robotic total laparoscopic hysterectomy with a brief review of literature.

Primary ovarian hepatoid carcinoma: Case report with review of the literature / 부인종양

Hepatoid carcinoma is histologically similar to hepatocelluar carcinoma and produce alfa-fetoprotein. Ovarian hepatoid carcinoma is extremely rare whether primary or metastatic. We experienced one case of primary ovarian hepatoid carcinoma. In this case report, we present histologic findings, therapeutic modalities of primary hepatoid carcinoma with review of literatures.

A case of ovarian fibrosarcoma with pregnancy / 대한산부인과학회지

Ovarian fibromas originating primarily from the ovarian stroma are rare, accounting for approximately 4% of all ovarian neoplasm. The ovarian fibromas are mostly benign tumors, but infrequently they have histologically malignant appearances such as hypercellularity, high mitotic rate, marked nuclear pleomorphism. Malignant fibromatous tumor can be categorized on the basis of prognosis into two separate types of tumors, one of which is cellular fibroma (one to three miotic counts per 10 high power fields) and the other of which is fibrosarcoma (over four miotic counts per 10 high power fields) that has extremely poor prognosis. We report a case of large ovarian fibrosarcoma accompanied with pregnancy and have a brief review of literatures.

Relationship between Flow Cytometric Nuclear DNA Quantification and Clinicopathologic Parameters in Endometrial Cancer / 대한산부인과학회지

OBJECTIVE: The aim of this study was to investigate the relationship of the DNA ploidy, S-phase fraction to other clinicopathologic factors including age, stage, architecture grade, nuclear grade, lymph node involvement, myometrial invasion in patients with endometrial cancer. METHODS: A prospective analysis was performed on 66 endometrial cancer cases treated at our hospital from Jan. 2000 to Nov. 2004. Of these 66 cases, 41 cases were analyzed by flow cytometry. Fresh tissues for analysis were obtained by dilatation and curettage or surgery as hysterectomy. All specimens for histopathologic grading and stage were classified according to WHO criteria and FIGO stage. DNA ploidy groups were divided into two groups, diploidy and aneuploidy. Fraction more than 6% was classified as high percentage S-phase fraction (SPF). DNA ploidy and SPF were analyzed by flow cytometry in fresh surgical specimens from endometrial cancer. RESULTS: Of the 41 cases, 5cases were aneuploidy, and 16 cases were high percentage SPF. With regard to DNA ploidy and clinicopathologic prognostic factors, aneuploidy was significantly increased as stage, histological type, nuclear grade, architecture grade, and myometrial invasion increased. With regard to DNA ploidy and clinical prognostic factors, aneuploidy was not increased as age, lymph node involvement increased. With regard to SPF and clinicopathologic prognostic factors, high percentage SPF (>6%) was significantly increased as stage, histological type, and nuclear grade increased. With regard to SPF and clinicopathologic prognostic factors, high percentage SPF (>6%) was not increased as age, lymph node involvement, architecture grade, and myometrial invasion increased. CONCLUSION: The DNA ploidy by flow cytometry has shown to have a close relationship to stage, histological type, myometrial invasion, and nuclear and architecture grade. Also, the SPF has shown to have a close relationship to stage, histological type, and nuclear grade. Our results were consistent with the concept that aneuploidy or high percentage SPF could predict the poor prognosis of disease course. The flow cytometric DNA quantification in endometrial cancer may provide major information about tumor prognosis.

Relationship between p16(INK4a), pRb and high risk HPV infection and recurrence / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to identify the abnormal expressions of p16(INK4a) and pRb in cervical intraepithelial neoplasia (CIN), and then to determine the relationship between the levels of p16(INK4a) and pRb and high risk HPV infection and recurrence. METHODS: The study group was composed of 265 formalin-fixed, paraffin-embedded tissue array sections of the uterine cervix collected from women who had underwent biopsy, conization or hysterectomy at our hospital from January 2001 to December 2003. Immunohistochemical stainings for p16(INK4a) and pRb were performed and the association of pRb and p16(INK4a) expressions with clinical features was analyzed retrospectively. RESULTS: There was positive correlation between p16(INK4a) expression rate and grade of cervical lesion. Meanwhile, there was reverse correlation between pRb expression rate and grade of cervical lesion. The expression rate of p16(INK4a) was higher (33%) in CIN I with high risk HPV infection, than in CIN I without high risk HPV infection (19%). In all CIN lesions, the mean expression rate of p16(INK4a) was lower in recurred group than in those which did not recur. In CIN II and CIN III, the mean expression rate of pRb was higher in recurred group than in those which did not recur. CONCLUSION: With increasing CIN grade, abnormal expression of p16(INK4a) was increased, but pRb expression was decreased. Relatively decreased p16(INK4a) expressions and increased pRb expressions significantly cooperate to predict a recurrence of the CIN lesions.

Squamous cell carcinoma arising from mature cystic teratoma of the ovary: A clinicopathologic analysis / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate clinicopathologic characteristics of squamous cell carcinoma arising from ovarian mature cystic teratoma and to determine whether SCC Ag and CA 125 are useful serum markers for diagnosing this tumor. METHODS: From January 1990 to December 2005, 1266 patients diagnosed with ovarian mature cystic teratoma were reviewed. Of the 1266 patients, 8 patients which had squamous cell carcinoma arising from mature cystic teratoma were evaluated in this study. A retrospective analysis of clinicopathologic characteristics and disease-free survival rate was performed. RESULTS: The incidence of squamous cell carcinoma arising from ovarian mature cystic teratoma was 0.7% (8/1266). The mean age of the patients was 47.3 years (range, 32-72 years). Five patients (62.5%) had clinical FIGO stage I disease and three patients (37.5%) had stage III disease. The mean tumor diameter was 13.3 cm. The mean SCC Ag level was 0.3 ng/mL which was normal and the mean CA 125 was slightly increased to 68.5 U/mL. The mean disease free survival was 58.4 months and 2-year disease-free survival was 62.5% (5/8). Out of 8 patients, one patient died and one out of 7 patients who survived had recurrence. Age, clinical FIGO stage, grade, residual tumor, postoperative treatment were not significant prognostic factor for disease-free survival. CONCLUSION: The incidence of squamous cell carcinoma arising from ovarian mature cystic teratoma in our institute was lower and survival rate was relatively higher compared to previous studies. SCC Ag and CA 125 were not helpful tumor markers in diagnosing squamous cell carcinoma arising from ovarian mature cystic teratoma. Age, grade, residual tumor, postoperative treatment were not significant prognostic factor for disease-free survival.