PMC7285408_01
Sagittal view of right ovary on transvaginal ultrasound. The right ovary measures 5.24 cm x 5.52 cm x 3.22 cm. Within the right ovary is a solid heterogenous mass measuring 3.4 cm x 3.3 cm x 3.8 cm.
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Pelvic ultrasound showed an enlarged right ovary measuring 5.24 cm x 5.52 cm x 3.22 cm with a solid heterogenous mass measuring 3.4 cm x 3.3 cm x 3.8 cm (Figure 1).
Rapid frozen section of right ovarian mass. There are many tumor cells with appearance mimicking macrophages containing abundant intracellular hemosiderin, suggestive of a hemorrhagic cyst (magnification x100).
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On initial rapid frozen section, the ovarian mass grossly appeared very hemorrhagic with multiple hemosiderin deposits microscopically, suggestive of a benign hemorrhagic cyst (Figure 2).
(a) Pseudopapillary growth pattern characteristic of solid pseudopapillary tumors (magnification x100, H&E). (b) Another view of pseudopapillary growth pattern characteristic of solid pseudopapillary tumors (magnification x100, H&E). (c) Tumor cells with characteristic eccentric nuclei and extracellular eosinophilic hyaline globules (magnification x200, H&E). (d) beta-catenin immunohistochemical staining shows nuclear and cytoplasmic positive staining (magnification x100, beta-catenin).
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Upon further sampling of permanent sections of the specimen, a diffuse pseudopapillary growth pattern and prominent hyaline globules were noted (Figures 3(a)-3(c)). IHC of tumor cells showed positivity for nuclear and cytoplasmic beta-catenin and negativity for membranous E-cadherin (Figure 3(d)), consistent with a solid pseudopapillary tumor.