PMC10088404_01
(A) MRI T2 coronal plane fat saturation; solid mass with large necrotic area originating from the left ovary (yellow arrow), fistulation between the mass and the sigmoid (red arrow), uterine (blue arrow). (B) T2 coronal plane fat saturation; dilated right ureter (yellow arrow), dilated left ureter (red arrow). (C) T2 coronal plane fat saturation; dilated right ureter (yellow arrow), infiltration mass to the left ureter (red arrow). (D) T2 axial plane; right ovary (yellow arrow), dilated right ureter (red arrow), uterine (blue arrow), the mass (green arrow), and dilated left ureter with infiltration (orange arrow).
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The mass also infiltrated the left ureter (Figure 1).
(A) Large adhesions between the mass, omentum, and peritoneal tissue after opening the abdominal cavity. (B) The mass originates from the left ovary with a necrotic area (yellow arrow); the uterus is normal (blue arrow). (C) Fistulation between the mass from the left ovary and sigmoid (yellow arrow). (D) The mass (yellow arrow) and left ureter (blue arrow) after separation (E). Normal uterus. (F). Specimen after surgery, right adnexa (blue arrow), uterine (yellow arrow), and mass from the left ovary (red arrow).
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The patient was diagnosed with ovarian carcinoma after the surgery based on the gross pathology result (Figure 2).
(A) Histopathological features (hematoxylin and eosin stain) with clear cytoplasm (yellow arrow). (B) Papillary tumor pattern with tubulocystic and solid appearance, anaplastic cells with prominent, oval nucleoli, pleomorphic, coarse chromatin, and clear cytoplasm suggesting clear cell carcinoma of the left ovary (blue arrow). (C) Hobnail cells (yellow arrow) (D and E) Metastatic clear cell carcinoma within the muscularis propria of the sigmoid (red arrow).
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Although no tumor was found in the right ovary, uterus, or cervix, the tumor had infiltrated the muscularis propria of the sigmoid colon (Figure 3).