The use of serum TA-4 in monitoring patients with malignant transformation of ovarian mature cystic teratoma

The development of cancer in mature cystic teratomas of the ovary is rare and sometimes difficult to detect because of sampling errors. Six cases of squamous cell carcinoma arising in ovarian mature cystic teratomas were studied, five of which showed an elevated level of a squamous cell carcinoma-associated antigen, TA-4, in the sera obtained preoperatively; the preoperative determination was not performed in the sixth case. However, no elevated TA-4 level was detected in the sera of 28 patients with mature cystic teratomas of the ovary. Moreover, serial determination of the serum TA-4 level showed a good correlation between the clinical course and the serum TA-4 level. Interestingly, an abnormal TA-4 level preceded the clinical detection of recurrence by 2 months in two patients. Thus, determination of the serum TA-4 concentration may be useful for diagnosing and monitoring patients with squamous cell carcinoma arising in mature cystic teratomas of the ovary.