Mature cystic teratomas are common, mostly benign ovarian tumors, which account for about 20% of all ovarian neoplasms; however, it is also known that malignant transformation occurs in approximately 1% to 2% of those cases. It has been reported that elevated squamous cell carcinoma antigen (SCC) is an indicator of the malignant potential of an ovarian mature cystic teratoma, therefore, special attention must be taken during surgery of those cases with an elevated SCC preoperatively.
We reported two cases of mature cystic teratomas with elevated SCC who underwent laparoscopic surgery. Although the SCC levels were >5.0ng/ml in our cases, the preoperative pelvic CT and MRI did not show any malignant characteristics.
Preventative measures were taken to avoid the potential rupture of tumors, and those tumors were resected laparoscopically without leakage of tumor content into the pelvic cavity. Histopathologic studies confirmed a benign teratoma. The SCC levels were normalized 1-2 months after surgery.
In these cases, it is controversial whether laparoscopic surgery is appropriate because of the potential interruption of capsule integrity during surgery of a possible malignant tumor when an endoscopic approach is chosen.
Laparoscopic surgery can be safely performed in cases in which if a malignant possibility is incontrovertible, intensive preoperative efforts to select less probable malignant case have been taken, and securing measures against the possible rupture of tumor is available.
