IMR Press / EJGO / Volume 38 / Issue 6 / DOI: 10.12892/ejgo3507.2017
Open Access Case Report
Prolonged overall survival in Stage IV patient with malignant transformation from ovarian mature cystic teratoma by combination therapy including radiotherapy: a case report and the review of literature
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1 Departments of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Japan
2 Departments of Clinical Oncology, National Defense Medical College, Tokorozawa, Japan
Eur. J. Gynaecol. Oncol. 2017 , 38(6), 951–953; https://doi.org/10.12892/ejgo3507.2017
Published: 10 December 2017
Abstract

Background: The prognosis of Stage IV disease of malignant transformation from mature cystic teratoma (MT-MCT) of the ovary in is extremely poor, and there has been no standard therapy established for MT-MCT. A case with Stage IV tumor that achieved diseasefree survival of 19 months treated with radiotherapy, in addition to surgery and chemotherapy is reported, with a review of the literature. Clinical case: A 57-year-old Japanese woman, gravida 3, para 2, received total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymph nodes biopsy, and Hartmann's operation. Although tumors in the pelvis were completely resected, residual tumor was present in liver. The pathological findings revealed squamous cell carcinoma (SCC) arising from MCT, and her diseases were diagnosed as Stage IV MT-MCT. Postoperatively she received one cycle of combination chemotherapy of paclitaxel and carboplatin (TC). Then stereotactic radiation therapy (SRT, 48 Gy/four fractions) for liver metastasis and additional five cycles of TC was conducted, and the liver metastasis achieved complete response. After 19 months of disease-free interval, relapsed tumors in para-aortic nodes were observed, and radiation therapy (50 Gy/27 fractions) was administered. Although the lesions achieved partial response, recurrence was observed after eight months, and the patient died of disease after achieving overall survival of 30 months. Conclusion: Radiotherapy could be an effective procedure for advanced SCC from MCT, even when the tumors are metastatic or recurrent.
Keywords
Ovary
Malignant transformation
Mature cystic teratoma
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