Malignant transformation in mature cystic teratoma: A case series

Background:Mature cystic teratoma is the most common ovarian neoplasm of adolescent and reproductive age group. Squamous cell carcinomas account for most common type of somatic transformation followed by adenocarcinoma. Case Summary: We present a case series of 4 patients with 4 different types of malignant transformation in dermoid and their management at our Institute. The types include Mucinous Adenocarcinoma, Anaplastic Ependymoma, and Rhabdomyosarcoma besides Squamous Cell Carcinoma. Conclusion Malignant degeneration is rare and continues to be evasive in literature, posing detection and management difficulties. A large dermoid of >10cm in a post-menopausal lady, with a solid enhancing component should arouse suspicion of MT-MCT, especially with deranged serum markers. Overall, treatment must be dictated by the transformed malignant histology. Metastatic tumors must be differentiated from MT-MCTs. It can be safely said that there are no standard rules for these entities in terms of clinico-pathological behaviour, management or prognosis. What needs to be done is to keep a high index of suspicion, as to avoid violation of oncological principles.