title: Carcinosarcoma arising in a dermoid cyst of the ovary.
abstract: A case of carcinosarcoma arising within an otherwise benign cystic teratoma is reported. The patient, a 78 year old nulliparous woman, presented with right sided abdominal pain of short duration and subsequently underwent a bilateral salphingo-oophorectomy. Slicing of the left ovary revealed a unilocular cyst containing hair admixed with soft yellow material with a thin wall apart from a solid area at one pole. Extensive areas of necrosis and cystic degeneration were present within this mass. Histologically, the large cyst was a typical mature cystic teratoma, containing carcinomatous and sarcomatous elements. Mature cystic teratomas have been reported in association with a variety of malignant ovarian tumours such as mucinous cystadenocarcinoma and malignant germ cell neoplasms. Secondary malignant transformation within a dermoid cyst is a much rarer occurrence, estimated as less than 2% of all such lesions. Adenocarcinomas are the second most common malignancies arising within dermoid cysts. Sarcomas alone or in combination with squamous carcinoma have been described arising in a mature cystic teratoma. To the best of our knowledge, no case of sarcoma arising in association with adenocarcinoma has been described before.
authors.affiliation: Department of Histopathology, Royal Devon and Exeter Healthcare NHS Trust.
authors.forename: D S
authors.initials: DS
authors.lastname: Arora
authors.forename: S
authors.initials: S
authors.lastname: Haldane
mesh_terms: D000199:Actins / Q000032:analysis; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002296:Carcinosarcoma / Q000737:chemistry / Q000473:pathology*; D003884:Dermoid Cyst / Q000737:chemistry / Q000473:pathology*; D003893:Desmin / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009378:Neoplasms, Multiple Primary / Q000737:chemistry / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000737:chemistry / Q000473:pathology*; D014746:Vimentin / Q000032:analysis
chemical_list: D000199:Actins; D002272:Carcinoembryonic Antigen; D003893:Desmin; D014746:Vimentin