Diagnosis of squamous cell carcinoma arising from mature cystic teratoma of the ovary

• Published in: Cancer Vol. 82; no. 11; pp. 2249 - 2255
• Main Authors: Kikkawa, Fumitaka, Nawa, Akihiro, Tamakoshi, Koji, Ishikawa, Hisatake, Kuzuya, Kazuo, Suganuma, Nobuhiko, Hattori, Sen‐ei, Furui, Kenji, Kawai, Michiyasu, Arii, Yoshitaro
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.06.1998; Wiley-Liss
• Subjects: Adult; Age Factors; Aged; Antigens, Neoplasm - analysis; Biological and medical sciences; CA-125 Antigen - analysis; CA-19-9 Antigen - analysis; Carcinoembryonic Antigen - analysis; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Diagnosis, Differential; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; malignant transformation; mature cystic teratoma; Medical sciences; Middle Aged; ovarian cancer; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - pathology; Ovary; Serpins; squamous cell carcinoma; squamous cell carcinoma antigen; Teratoma - diagnosis; Teratoma - pathology; Tumors; Human; Squamous cell carcinoma; Teratoma; Tumor associated antigen; Tumoral marker; Malignant tumor; Female genital diseases; Ovarian diseases; Ovary; Malignant transformation; Tumor; CA 125 antigen; Female; Diagnosis
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19980601)82:11<2249::AID-CNCR21>3.0.CO;2-T

BACKGROUND The prognoses of patients with squamous cell carcinoma of the ovary are quite poor. However, preoperative diagnosis is difficult due to the rarity of this tumor and its similarity to mature cystic teratoma (MCT). The objective of this study was to assess the value of tumor markers and clinical characteristics in making a differential diagnosis between MCT and squamous cell carcinoma arising from MCT. METHODS Between September 1979 and June 1996, 37 patients with ovarian squamous cell carcinoma arising from MCT were treated by the Tokai Ovarian Tumor Study Group. The authors evaluated tumor markers, tumor size, and age as parameters for differentiation between MCT and squamous cell carcinoma arising from MCT. Diagnostic efficiency was calculated as the sensitivity multiplied by the specificity. RESULTS There were significant differences (P ≤ 0.0002) in age, tumor size, and levels of squamous cell carcinoma antigen (SCC), CA125, and CEA, as well as a significant difference (P ≤ 0.0396) in the CA19‐9 level between MCT and squamous cell carcinoma arising from MCT. Diagnostic efficiency was highest for SCC (63.0%), followed by CA125 (50.7%). Receiver operating characteristic (ROC) curves demonstrated that CEA was the best screening marker for squamous cell carcinoma arising from MCT, whereas age and tumor size were better markers than CA125 or CA19‐9. The optimal cutoff values for age and tumor size were 45 years and 99 mm, respectively, according to ROC analysis. CONCLUSIONS These findings demonstrate that age and tumor size are important factors in making a differential diagnosis. In addition, SCC and CEA levels should be measured in patients age 45 years or older who have an MCT‐like ovarian tumor larger than 99 mm in greatest dimension. Cancer 1998;82:2249‐2255. © 1998 American Cancer Society. Measurement of carcinoembryonic antigen and squamous cell carcinoma antigen levels is advisable for patients age 45 years or older who have an ovarian tumor larger than 99 mm in greatest dimension with characteristics of mature cystic teratoma.