Malignant degeneration of a mature ovarian teratoma

Malignant components are present in 1-2% of mature teratomas (dermoid cysts) and historically have been associated with a very poor prognosis. Patients with malignant mature cystic teratomas typically are postmenopausal and may present with a rapidly enlarging tumor or systemic symptoms suggestive of malignancy. However, the diagnosis is rarely made pre-operatively and, if the tumor is not metastatic, may not be made until the tumor is examined microscopically. Squamous cell carcinoma is the most common malignancy found in mature cystic teratomas. We present a 26-year-old woman with this cancer in whom the disease proved fatal. A surgical approach to patients with malignant mature teratomas is suggested. Prognostic factors and adjuvant therapy are discussed.