Metastatic squamous cell carcinoma to the colon arising from a mature cystic ovarian teratoma

Malignant transformation of a mature cystic teratoma is extremely rare, occurring in 0.17-2% of cases.1 The most common malignant degeneration is squamous cell carcinoma (SCC) arising from the ectoderm. Approximately half of all cases of SCC of the ovary are confined to the ovary at time diagnosis.1,2 Secondary to its absolute rarity and the relative infrequency of cases with metastatic spread the optimal treatment of advanced stage disease is unknown. Outcomes for locally advanced and widespread disease have historically been very poor. Ford and Timmons recently reported on a patient with stage IIC SCC arising in a mature cystic teratoma treated with multimodal therapy who has been free of disease for more than five years.3 Herein we report on a woman with stage IIIC SCC arising within a mature cystic teratoma treated with directed chemoradiation who subsequently developed metastatic SCC to the colon.