Squamous Cell Carcinoma Arising in an Ovarian Mature Cystic Teratoma with Anterior Abdominal Wall Incisional-Site Recurrence: A Case Report

Abstract

Background: Mature cystic teratoma (MCT) is the most common ovarian germ cell tumour. Malignant transformation is an uncommon complication, occurring in approximately 1–2% of cases, with squamous cell carcinoma (SCC) accounting for more than 80% of malignant transformations. Early diagnosis and timely management are essential to improve patient outcomes. Case Presentation: A 32-year-old woman presented with acute abdominal pain secondary to ovarian torsion caused by a dermoid cyst. She underwent emergency laparotomy with left ovarian cystectomy. Histopathological examination revealed moderately differentiated squamous cell carcinoma arising in a mature cystic teratoma. Completion staging surgery comprising left salpingo-oophorectomy and omentectomy was subsequently performed. However, the patient was lost to follow-up and re-presented nine months later with a painful anterior abdominal wall swelling. Histopathological examination of the abdominal wall lesion confirmed metastatic squamous cell carcinoma originating from the left ovary. She received five cycles of paclitaxel-carboplatin chemotherapy; however, the abdominal wall mass progressed despite treatment. She subsequently underwent wide local excision of the anterior abdominal wall mass with abdominal wall reconstruction, together with completion surgery comprising total abdominal hysterectomy and right salpingo-oophorectomy. Conclusion: Squamous cell carcinoma arising in an ovarian mature cystic teratoma is a rare but aggressive malignancy. Isolated anterior abdominal wall metastasis is an exceptionally uncommon presentation. This case highlights the importance of early diagnosis, timely definitive treatment, and close postoperative surveillance to reduce the risk of disease recurrence.