Squamous cell carcinoma arising from a mature teratoma in a young woman: A case report and review of the literature

Introduction: Mature teratomas (MT), also known as dermoid cysts, are benign ovarian tumors frequently diagnosed in women of reproductive age. Malignant transformation, though rare, occurs in 0.2 % to 3 % of cases, with squamous cell carcinoma (SCC) being the most prevalent form. This report presents an unusual case of SCC arising from a mature teratoma in a 29-year-old woman, adding to the limited literature on this subject. Case presentation: A 29-year-old woman underwent fertility-sparing surgery for a presumed MT at an outside institution. Pathology revealed SCC (FIGO Pt1C2N0M0), and adjuvant chemotherapy was recommended but delayed due to socioeconomic barriers. She later presented with sub-occlusive symptoms, and imaging identified a mesenteric mass. Urgent ileocecal resection confirmed metastatic SCC. The patient was treated with four cycles of carboplatin and paclitaxel and remains disease-free at the latest follow-up. Clinical discussion: Malignant transformation in MTs is rare but clinically significant due to its aggressive nature. This case highlights the potential for SCC transformation even in young patients, emphasizing the need for vigilant postoperative monitoring. Fertility-sparing surgery is appropriate for early-stage disease; however, delayed adjuvant therapy due to socioeconomic constraints can adversely affect outcomes. Platinum-based chemotherapy remains the standard for metastatic SCC and demonstrated efficacy in this case. Multidisciplinary care addressing both oncologic and reproductive goals is essential for younger patients. Conclusion: This case underscores that malignant transformation in MTs can occur in young patients and may exhibit aggressive behavior. Timely management, addressing socioeconomic barriers, and fertility preservation strategies are crucial for optimizing outcomes.