Primary malignant melanoma in ovarian cystic teratoma

Malignant degeneration of benign cystic teratoma of the ovary is rare. Occurrence of melanoma in an ovarian cystic primary teratoma in the absence of a demonstrable extraovarian primary is even rarer. We describe here one such case.

A 42-year-old nulliparous woman underwent laparotomy for a cyst in the right ovary. Histopathological examination of the specimen revealed malignant cystic teratoma with the presence of a melanoma component. There was no evidence of extraovarian primary melanoma on clinical examination. Two years later, she presented with lung metastasis and underwent left pneumonectomy. Histopathology confirmed metastatic melanoma. Postoperatively, she received combination chemotherapy using cisplatin and dacarbazine. She is on regular follow-up and continues to be disease-free, 18 months after treatment.

Primary malignant melanoma in cystic teratoma of the ovary is extremely rare. We could find only 19 such cases on review of the literature. Clinical presentation is similar to that of primary epithelial ovarian cancer. Surgery remains the mainstay of treatment. Use of cisplatin and dacarbazine may be considered in a patient with metastatic disease.