title: Squamous carcinoma coexistent with teratoma of ovary: a clinicopathological study of 12 cases diagnosed over a 10-year period at a tertiary cancer referral center.
abstract: BACKGROUND
  Somatic malignancy in an ovarian teratoma including a squamous carcinoma (SCC) is rare. Clinicopathological features of 12 ovarian teratomas with coexistent SCCs are presented.
  
  
  METHODS
  Over a 10-year-period, 12 ovarian teratomas with coexistent SCCs were reviewed and analyzed.
  
  
  RESULTS
  The age range was 31-68 years (median, 49), and the tumor size (nine cases) varied from 10 to 18 cm (mean, 12.4). Stage-wise (10 cases), 7 cases (70%) were in stage I; a single case (10%) in stage II, and two (20%) cases were in stage III. Microscopically, all 12 tumors revealed mature teratoma with SCC, as a discrete tumor (6, 50%), or arising from the epithelium of the teratoma in six (50%) cases. SCC component was commonly moderately differentiated (eight cases) or poorly differentiated (three cases). P63 immunostaining reinforced squamous differentiation in a single poorly differentiated SCC and CK5/6 in another tumor. All patients underwent surgery. Two cases revealed positive lymph nodes and contiguous colonic involvement. Three patients (stages II and III) underwent adjuvant chemotherapy (CT). Outcomes (seven patients) (3-58 months) included five patients who are free-of-disease (all stage I) and two patients who are alive-with-disease (stages I and III).
  
  
  CONCLUSIONS
  SCC and coexistent ovarian teratomas are rare. Most cases present at an early stage, commonly in perimenopausal women. Teratomas occurring in such patients should be optimally sampled for SCC. Teratomas coexistent with SCC are invariably mature-type. P63 is useful in differentiating poorly differentiated SCC from germ cell tumor components. Surgery forms the treatment mainstay. Adjuvant CT may be offered in high-stage that forms as an adverse prognostic parameter.
authors: Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors: Bharat
authors: B
authors: Rekhi
authors: Pinki
authors: P
authors: Parikh
authors: Kedar K
authors: KK
authors: Deodhar
authors: Santosh
authors: S
authors: Menon
authors: Amita
authors: A
authors: Maheshwari
authors: Rajendra
authors: R
authors: Kerkar
authors: Sudeep
authors: S
authors: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D013724:Teratoma / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D016896:Treatment Outcome; D047368:Tumor Burden