Use of platinum-based chemotherapy and pembrolizumab to treat squamous cell carcinoma arising in a mature teratoma of the ovary in a pre-menopausal woman with negative response: A case report

• Published in: Gynecologic oncology reports Vol. 47; p. 101192
• Main Authors: Martel, Rachel A., Marsh, Leah, Lai, Tiffany, Rodriguez-Triana, Valentina M., Moatamed, Neda A., Cohen, Joshua
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-06-2023; Elsevier
• Subjects: Case Report; Immunotherapy; Mature teratoma; Ovarian squamous cell carcinoma; Ovarian squamous cell carcinoma; Mature teratoma; Immunotherapy
• ISSN: 2352-5789; 2352-5789
• DOI: 10.1016/j.gore.2023.101192

•Squamous cell carcinoma of the ovary is a disease with poor prognosis and limited consensus regarding effective treatment.•Many patients experience disease progression while receiving adjuvant platinum-based chemotherapy.•Our patient progressed on platinum-based therapy and pembrolizumab despite evidence of tumor PD-L1 expression.•Additional investigation into whether immunotherapy may be effective in the treatment of this disease is needed.
Squamous cell carcinoma of the ovary (SCC) is a rare and aggressive disease and optimal treatment is unknown. Here we report the case of a 29- year-old woman who presented with abdominal pain and was ultimately found to have a multi-septate, gas containing pelvic mass with mixed fat, soft tissue, and calcified components concerning for a ruptured teratoma with fistulization to the distal ileum and cecum on imaging. Operative findings included a 20 cm pelvic mass arising from the right ovary with frank invasion into the ileum and cecum and dense adhesion to the anterior abdominal wall on surgical exploration. Pathologic specimens were remarkable for stage IIIC SCC of the ovary arising in a mature teratoma, with a tumor proportion score of 40%. She progressed on first line treatment with cisplatin, paclitaxel and pembrolizumab as well as second line treatment with gemcitabine and vinorelbine. She died nine months after her initial diagnosis.