PMC4724162_01
Image analysis. a Gadolinium-enhanced T1-weighted magnetic resonance imaging scan of the left ovary shows a cystic lesion, approximately three-fourths of which is occupied by an irregularly enhanced mass. b An enhanced computed tomography scan shows a large intra-abdominal cystic lesion occupying the pelvic cavity. Focal intracystic irregular enhancement is noted
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Fig1
Five years after initial presentation, the size of the cyst measured 59 x 59 mm (Fig. 1a), and serum levels of SCC antigen and cancer antigen (CA)125 (normal range: < 35 U/mL) were 1.4 ng/mL and 10.8 U/mL, respectively.
Gross findings and microscopic findings of case 1. a The inner surface of the cyst wall is irregularly thickened. A firm nodule is located within the cyst (arrow). b The cut surface of the cyst contains yellowish-gray, firm areas, and a few cystic cavities are embedded within. c A hematoxylin and eosin-stained section shows scattered islands of invasive squamous cell carcinoma (x 200)
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Fig2
After fixation by formaldehyde, the cyst walls were observed to be thickened, with protruding, irregular nodules partially filling the cyst (Fig. 2a). The cut surface of the thickened cyst wall was yellowish and solid (Fig. 2b). Invasive growth of SCC was pronounced in the cyst wall (Fig. 2c).
PMC4724162_02
Gross findings and microscopic findings of case 2. a The wall of the cyst is thickened (arrow). b The cut surface of the cyst shows nodular protrusions. c A hematoxylin and eosin-stained section of the nodular area shows the boundary between the dysplastic keratinocytes lining the cyst internally, and the invasive squamous cell carcinoma (arrow) (x 100)
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Fig3
Focal and irregular thickening of the cyst wall was observed after fixation by formaldehyde (Fig. 3a). The cut surface of the thickened cyst wall appeared yellowish and solid, and was connected directly to the inner surface of the cyst (Fig. 3b). Malignant transformation was identified in the epithelial lining (Fig. 3c).