Malignant Transformation in Mature Cystic Dermoid: A Case Series of 8 Cases

ABSTRACT

Introduction: One of the most common types of ovarian germ neoplasm is Mature cystic teratoma(MCT) which accounts for almost 20% of all ovarian neoplasm. Objective: Analyze patients with Malignant Transformation (Mt) arising from Mature Cystic Teratoma of the ovary to evaluate Clinico-pathological features and treatment modalities. Methods: This is an observational study of 8 patients of Mt in MCT, who had taken complete treatment at GCRI between the period from September 2016 to September 2021. During this observation period, a total of two thousand one hundred and seventy seven ovarian tumors were diagnosed. Out of these patients, 9.32% (203) were MCTs. Of the consecutive cases of 203 ovarian MCTs diagnosed, 3.9% (8) had Mt of MCT, which was our study group. Results: The mean age of patients with Mt in MCT was 47.1 years (27- 65 yrs), while mean age of the patients with MCT was 42 years (35-55 years). Among the 21 postmenopausal, MCT's 28.5% (6) cases developed Mt and only 1% i.e., two cases from premenopausal showed Mt. Abdominal pain as main symptom was seen in 87.5% (7/8) patients. The duration of symptoms ranged from 3 to 6 months. CA125 was elevated in 75% patients. Germ cell markers including beta HCG, AFP, LDH were found to be normal. Conclusion: Diagnosis of malignant transformation of MCT is very difficult. There should be high index of suspicion of malignant transformation if the MCT has been present for a long time; the patient is postmenopausal, age>45 yrs; the tumor diameter is greater than 9.5 cm; or there is thickening of the cyst wall or papillary growth occurs, increased tumor markers