Saori Kondo, Takashi Suzuki, Kanato Yoshiike, Sakura Yamanaka, Kenta Sonehara, Hiroshi Nabeshima, Osamu Oguchi, Department of Obstetrics and Gynecology, Saku Central Hospital Advanced Care Center, Saku City 385-0051, Nagano, Japan
Co-corresponding authors: Saori Kondo and Takashi Suzuki.
Author contributions: Kondo S and Suzuki T contribute equally to this study as co-corresponding authors. Kondo S and Suzuki T contributed to manuscript writing, editing, and data collection; Yamanaka S and Yoshiike K contributed to data analysis; Sonehara K, Nabeshima H, and Oguchi O contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Saori Kondo, MD, Chief, Doctor, Department of Obstetrics and Gynecology, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku City 385-0051, Nagano, Japan. kondorabass@hotmail.co.jp
Received: August 3, 2024 Revised: September 18, 2024 Accepted: October 25, 2024 Published online: January 6, 2025 Processing time: 95 Days and 22.3 Hours
Abstract
BACKGROUND
Malignant transformation (MT) of mature cystic teratoma (MCT) has a poor prognosis, especially in advanced cases. Concurrent chemoradiotherapy (CCRT) has an inhibitory effect on MT.
CASE SUMMARY
Herein, we present a case in which CCRT had a reduction effect preoperatively. A 73-year-old woman with pyelonephritis was referred to our hospital. Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass. Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) revealed squamous cell carcinoma. The patient was diagnosed with MT of MCT. Due to her poor general condition and renal malfunction, we selected CCRT, expecting fewer adverse effects. After CCRT, her performance status improved, and the tumor size was reduced; surgery was performed. Five months postoperatively, the patient developed dissemination and lymph node metastases. Palliative chemotherapy was ineffective. She died 18 months after treatment initiation.
CONCLUSION
EUS-FNB was useful in the diagnosis of MT of MCT; CCRT suppressed the disease and improved quality of life.
Core Tip: Malignant transformation (MT) of mature cystic teratoma (MCT) is uncommon and has a poor prognosis, especially in advanced cases. Surgery and chemotherapy are selected in accordance with ovarian cancer, but the prognosis is typically poor due to the high degree of malignancy, making treatment often challenging. We present a case of stage IV MT of MCT in which concurrent chemoradiotherapy (CCRT) had a reduction effect preoperatively. Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) was used for diagnosis due to the patient’s poor general condition. EUS-FNB was useful in diagnosing MT of MCT; CCRT suppressed the disease and improved the patient’s quality of life.
