PMC4805138_01
Plain radiograph of the chest (A) and abdomen (B) reveals a large lesion occupying almost the entire abdominal cavity and pelvis with superior displacement of the bowel loops due to mass effect.
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The erect abdominal radiograph revealed a large mass occupying almost the entire abdominal cavity and displacing the bowel loops superiorly (Figure 1).
Ultrasonography revealed a completely anechoeic lesion suggestive of a purely cystic consistency. Note the absence of sepatae or soft tissue component within the lesion.
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There was no obvious evidence of internal echoes or septations within the lesion (Figure 2).
Contrast-enhanced computed tomography of the abdomen and pelvis, in coronal reformatted (A) and axial (B, C) sections reveal a large, unilocular, purely cystic lesion arising from the pelvis and occupying almost the entire abdominal cavity. Note the absence of enhancing soft tissue or septae within the lesion. Also note the urinary bladder (black arrow), uterus (white arrow) and right ovary (white arrowhead). The left ovary could not be visualised separately from the lesion implying left ovarian origin of the cystic lesion.
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Subsequently, a computed tomogram of the abdomen and pelvis was advised which showed a large 85x110x125 cm (APxTRxCC) lesion of fluid consistency arising from the pelvis (Figure 3).
Gross pathological specimen showing cut surface of the ovarian cystic wall. Note the intervening solid areas (black arrows).
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The cyst wall revealed a few intervening solid areas (Figure 4).
Photomicrograph, hematoxylin and eosin stained section (x40) shows the cyst lined by cuboidal to columnar epithelium resting on the thick fibrous wall. At places it shows multi-layering of the lining epithelium.
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Histopathological examination of the solid cell nests showed round to oval cells with moderately pleomorphic nuclei, prominent nucleoli and scanty cytoplasm (Figure 5).
Photomicrograph, hematoxylin and eosin stained section (x100) through the solid nests of the cyst wall shows round to oval cells with moderately pleomorphic nuclei, prominent nucleoli and scanty cytoplasm. Many nuclei show irregular nuclear margins and a few show grooves. Call-Exner bodies are seen.
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Call-Exner bodies were noted (Figure 6).