Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Apr 20:47:101192.
doi: 10.1016/j.gore.2023.101192. eCollection 2023 Jun.

Use of platinum-based chemotherapy and pembrolizumab to treat squamous cell carcinoma arising in a mature teratoma of the ovary in a pre-menopausal woman with negative response: A case report

Rachel A Martel  1 , Leah Marsh  1 , Tiffany Lai  1 , Valentina M Rodriguez-Triana  1 , Neda A Moatamed  2 , Joshua Cohen  3
Affiliations
Case Reports

Use of platinum-based chemotherapy and pembrolizumab to treat squamous cell carcinoma arising in a mature teratoma of the ovary in a pre-menopausal woman with negative response: A case report

Rachel A Martel et al. Gynecol Oncol Rep. .

Abstract

Squamous cell carcinoma of the ovary (SCC) is a rare and aggressive disease and optimal treatment is unknown. Here we report the case of a 29- year-old woman who presented with abdominal pain and was ultimately found to have a multi-septate, gas containing pelvic mass with mixed fat, soft tissue, and calcified components concerning for a ruptured teratoma with fistulization to the distal ileum and cecum on imaging. Operative findings included a 20 cm pelvic mass arising from the right ovary with frank invasion into the ileum and cecum and dense adhesion to the anterior abdominal wall on surgical exploration. Pathologic specimens were remarkable for stage IIIC SCC of the ovary arising in a mature teratoma, with a tumor proportion score of 40%. She progressed on first line treatment with cisplatin, paclitaxel and pembrolizumab as well as second line treatment with gemcitabine and vinorelbine. She died nine months after her initial diagnosis.

Keywords: Immunotherapy; Mature teratoma; Ovarian squamous cell carcinoma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. There are no funding sources to report.

Figures

Fig. 1
Fig. 1
Ultrasound imaging of the patient at her initial presentation for care demonstrating bilateral adnexal masses consistent with dermoid cysts A) Long view of the left adnexa B) transverse view of the left adnexa C) long view of the right adnexa D) transverse view of the right adnexa.
Fig. 2
Fig. 2
CT Imaging of the patient at her initial presentation to the emergency department, demonstrating a multi-septate, gas containing pelvic mass with mixed fat, soft tissue, and calcified components concerning for a ruptured teratoma with two sites of frank fistulization with the distal ileum and cecum, focal bowel thickening in the transverse colon, and minimal pelvic free fluid. A) Axial view B) Coronal view.
Fig. 3
Fig. 3
Malignant squamous cell carcinoma arising in a background of preexisting teratoma with squamous lined cyst and hair. (A) The photomicrograph shows a portion of the mass with benign squamous cyst lining (arrow). (B) Few hair shafts (arrows) are seen in the cyst contents (10x objective). (C) Invasive squamous cell carcinoma showing infiltrative nests of malignant cells into the stroma (40x objective). (D) P63 immunohistochemical stain showing positive nuclear staining which confirms squamous cell origin of the tumor (40x objective). (E) PD-L1 immunostain shows positive staining of the tumor cells (40x objective).
See this image and copyright information in PMC

References

    1. Burtness B., Harrington K.J., Greil R., Soulières D., Tahara M., de Castro G., et al. Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. Lancet. 2019;394(10212):1915–1928. - PubMed
    1. Chen R.J., Chen K.Y., Chang T.C., Sheu B.C., Chow S.N., Huang S.C. Prognosis and treatment of squamous cell carcinoma from a mature cystic teratoma of the ovary. J. Formosan Med. Assoc. 2008;107(11):857–868. - PubMed
    1. Cooke S.L., Ennis D., Evers L., Dowson S., Chan M.Y., Paul J., et al. The Driver Mutational Landscape of Ovarian Squamous Cell Carcinomas Arising in Mature Cystic TeratomaSquamous Cell Carcinoma Arising in Mature Cystic Teratoma. Clin. Cancer Res. 2017;23(24):7633–7640. - PubMed
    1. Dos Santos L., Mok E., Iasonos A., Park K., Soslow R.A., Aghajanian C., et al. Squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case series and review of the literature. Gynecol. Oncol. 2007;105(2):321–324. - PubMed
    1. Ford T.C., Timmins P.F., III Successful treatment of metastatic squamous cell carcinoma of the ovary arising within a mature cystic teratoma. Clinical Ovarian Cancer. 2011;4(1):44–46.

Publication types