International journal of surgery case reports · 2026
Disseminated relapse of ovarian mature cystic teratoma with squamous cell carcinoma transformation following intraoperative spillage: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Maccio Antonio, Neri Manuela, Vallerino Valerio, Sole Gabriele, Pusceddu Elisabetta, Ferrari Paolo Albino
Аннотация
INTRODUCTION: Malignant transformation of ovarian mature cystic teratoma is rare, usually presenting as squamous cell carcinoma (SCC). Rupture or spillage may complicate management, although a causal relationship with recurrence cannot be inferred from individual cases.
PRESENTATION OF CASE: A 59-year-old woman developed disseminated relapse after excision of an ovarian dermoid cyst with SCC transformation, complicated by intraoperative rupture and pelvic spillage. She presented with an abdominal-wall mass and multifocal pelvic/peritoneal disease, consistent with at least FIGO stage IIIC-equivalent recurrence. She underwent diagnostic laparoscopy, then a complete open cytoreduction, including abdominal-wall resection/reconstruction, omentectomy, multivisceral bowel resections, type C2 radical hysterectomy, rectal resection, and pelvic/para-aortic lymphadenectomy. Histology confirmed a poorly differentiated SCC in a dermoid cyst, with negative margins and 87 negative lymph nodes. Adjuvant carboplatin-paclitaxel was administered without any CTCAE grade ≥1 toxicity. At 4 years, she remains disease-free.
DISCUSSION: Reports describe implantation/carcinomatosis after rupture/spillage. Complete cytoreduction, adherence to no-spillage principles, and early expert referral are essential.
CONCLUSION: Strict no-spillage principles and early referral to high-expertise centers are essential when malignancy is suspected.
PRESENTATION OF CASE: A 59-year-old woman developed disseminated relapse after excision of an ovarian dermoid cyst with SCC transformation, complicated by intraoperative rupture and pelvic spillage. She presented with an abdominal-wall mass and multifocal pelvic/peritoneal disease, consistent with at least FIGO stage IIIC-equivalent recurrence. She underwent diagnostic laparoscopy, then a complete open cytoreduction, including abdominal-wall resection/reconstruction, omentectomy, multivisceral bowel resections, type C2 radical hysterectomy, rectal resection, and pelvic/para-aortic lymphadenectomy. Histology confirmed a poorly differentiated SCC in a dermoid cyst, with negative margins and 87 negative lymph nodes. Adjuvant carboplatin-paclitaxel was administered without any CTCAE grade ≥1 toxicity. At 4 years, she remains disease-free.
DISCUSSION: Reports describe implantation/carcinomatosis after rupture/spillage. Complete cytoreduction, adherence to no-spillage principles, and early expert referral are essential.
CONCLUSION: Strict no-spillage principles and early referral to high-expertise centers are essential when malignancy is suspected.