Secondary malignancies in ovarian dermoid cyst

OBJECTIVE: To review our local experience with mature cystic ovarian teratoma, and describe our treatment modality regarding this uncommon condition.

METHODS: The databases of the Sydney Gynecologic Oncology Group at Royal Prince Alfred and Liverpool Hospital, Sydney, Australia, were reviewed from 1987 to 2007. A retrospective chart review, and analysis of patient's data were conducted.

RESULTS: Eleven cases of ovarian dermoid cyst with secondary malignancy were identified. Six out of eleven (54.5%) of the cases were carcinoid tumor, 4/11 (36%) squamous cell cancer, and one case (9%) transitional cell carcinoma. The median age of cases was 47 years (range of 28-74). Stage I-II was recorded in 8/11 (73%) of the cases, while stage III-IV was found in 3/11 (27%). The initial treatment ranged from unilateral cystectomy to hysterectomy, and bilateral salpingo-oophrectomy, and debulking surgery. All patients with stage I disease showed more than 5 years survival (100%). The survival for late staged disease (III-IV) ranged from 2.5 months to 18 months with an average of 8 months.

CONCLUSION: Carcinoid tumor is the most common malignancy noticed. Survival is related mainly to tumor stage, and optimal debulking procedure. However, further studies are needed to study the effect of other factors on survival.