成熟嚢胞性奇形腫の腹腔鏡下腫瘍核出術の途中で悪性転化を疑い術式変更した33歳症例―診断上のpitfall―

抄録

  The preoperative diagnosis of malignant transformation of a mature cystic teratoma is difficult. A 33-year-old woman received laparoscopic cystectomy under the diagnosis of a mature cystic teratoma, and the frozen biopsy result indicated squamous cell carcinoma arising from the mature cystic teratoma. On the same day as the biopsy, we performed right adnectomy, followed by total hysterectomy, left adnectomy, low anterior resection of the rectum, and omentectomy, 1 month after the first surgery. At the second surgery, the tumor had spread to the intra-pelvic cavity, omentum, and biopsy wound scar. Even in patients aged less than 40 years with a tumor size less than 10 cm, we need to check for the presence of squamous cell carcinoma and examine the findings on magnetic resonance imaging thoroughly.