Preoperative prediction of malignant transformation arising in a mature cystic teratoma of the ovary

Background: Preoperative factors were retrospectively analyzed to distinguish malignant transformation (MT) in mature cystic teratoma (MCT) of the ovary.Methods: Subjects were 73 patients with MCT and 4 patients with MT who underwent surgery from January 2010 to March 2013.Results: Patients with MT had a median age of 68.5 years, significantly older than patients with MCT who had a median age of 34.0 years. All of the patients with MT (100%) had a tumor 10 cm across or larger while 12 (16%) patients with MCT did. Most patients with MT (75.0%) had an squamous cell carcinoma（SCC） antigen level of 2.5 ng/mL or higher while few (6.7%) patients with MCT did. Most patients with MT (75.0%) had a Carcinoembryonic antigen (CEA) level at or above the cutoff (5.0 mg/mL) significantly higher than the few (3.2%) patients with MCT. In a pelvic MRI, most patients with MT (75%) had a tumor with contrast-enhanced solid portions significantly more than the few (9.5%) patients with MCT.had a tumor with contrast-enhanced solid part.Discussion: Most patients with MT were 60 years of age or older and had a tumor 10 cm or larger, a serum SCC antigen level of 2.5 ng/mL or greater, a serum CEA level of 5.0 mg/mL or greater, and a tumor with solid portions that were contrast-enhanced. Laparoscopyic findings should be considered in cases where the aforementioned factors are not present.