Malignant Transformation in Ovarian Teratomas

Ovarian teratomas are germ‐cell tumours characterised by tissue elements from multiple embryonic layers. While most mature cystic teratomas are benign, a small proportion undergo malignant transformation, most commonly into squamous cell carcinoma but also less frequently into adenocarcinoma, carcinoid tumours or sarcomas. The risk of transformation increases with patient age and lesion size, and it carries a markedly worse prognosis compared with benign counterparts. Clinical presentation is often non-specific, with abdominal pain, mass effect or incidental imaging findings. Definitive diagnosis relies on histopathological examination following surgical excision. Key prognostic factors include histological subtype, International Federation of Gynecology and Obstetrics (FIGO) stage and completeness of cytoreduction. Multimodal management typically involves radical or fertility-sparing surgery tailored to individual risk, followed by platinum-based adjuvant chemotherapy in advanced stages. Emerging studies are elucidating molecular signatures, immunological features and imaging correlates that promise earlier detection and more personalised treatment pathways for this rare malignancy.

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Malignant Transformation in Ovarian Teratomas publication trend

The graph below shows the total number of articles in malignant transformation in ovarian teratomas across all publications each year (not limited to Nature Index journals).

Technical terms

Mature cystic teratoma: A benign ovarian germ-cell tumour composed of well-differentiated derivatives of two or three embryonic germ layers, often containing hair, fat and cartilage.

Malignant transformation: The process by which a previously benign lesion acquires invasive and atypical cellular features indicative of cancer, driven by genetic and microenvironmental alterations.

Cytoreductive surgery: A surgical procedure aimed at removing as much visible tumour tissue as possible to optimise the efficacy of subsequent therapies and improve survival outcomes.

Adjuvant chemotherapy: Systemic drug treatment administered after primary surgery to eradicate microscopic residual disease and reduce the likelihood of recurrence.

Tumour microenvironment: The local cellular and molecular milieu surrounding cancer cells, including immune cells, stromal elements and signaling molecules that influence tumour growth and therapeutic response.

References

1. Mature Cystic Teratoma: An Integrated Review. International Journal of Molecular Sciences (2023).
2. MRI findings of malignant transformation arising from mature cystic teratoma of the ovary: comparison with benign mature cystic teratoma. Japanese Journal of Radiology (2023).
3. 30-Year Experience With 22 Cases of Malignant Transformation Arising From Ovarian Mature Cystic Teratoma: A Rare Disease. Frontiers in Oncology (2022).
4. XCL1 expression correlates with CD8-positive T cells infiltration and PD-L1 expression in squamous cell carcinoma arising from mature cystic teratoma of the ovary. Oncogene (2020).