Squamous cell carcinoma arising in a mature cystic ovarian teratoma with bladder invasion: a case report.

BACKGROUND: Malignant transformation in a mature cystic ovarian teratoma is rare. Except in cases with high index of suspicion or overt metastasis, oophorectomy is the mainstay of treatment for ovarian teratoma. METHOD: A 46-year-old perimenopausal woman who had salpingo-oophorectomy following a clinical diagnosis of benign ovarian tumour that was subsequently reported histologically as mature cystic ovarian teratoma with malignant transformation is presented. RESULTS: She was referred to our facility based on the histopathology report and haematuria two weeks after surgery. Cystoscopic biopsy done was reported as metastatic squamous cell carcinoma most probably from the ovary. Patient was thereafter referred for radiotherapy but was lost to follow-up after the first course. CONCLUSION: Adequate evaluation prior to surgery in suspected ovarian teratoma with malignant transformation is critical to determine extent of surgery and adjuvant therapy. Prognosis in advanced disease condition such as the case presented is generally poor although radical pelvic surgery with resection of the adjacent involved bladder before radiotherapy would probably have improved her prognosis.

Typhoid intestinal disease: 32 perforations in 1 patient.

Typhoid intestinal perforation is a common complication of typhoid fever in our environment. The occurrence of multiple intestinal perforations that involves both small and large bowel is increasingly being seen in our practice. We report a case of 32 intestinal perforations in a child. This is the highest number of perforations seen in any 1 patient in our search of the English literature. This article details our approach to management of this type of patient.