PMC6885789_01
Preoperative CT images of the right adnexal mass.
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fig1
A CT of the abdomen and pelvis demonstrated the complex mass containing internal calcification, fluid, fat and soft tissue (Figure 1).
(a) Low power view of teratoma showing skin, glandular epithelium, and cartilage. There is infiltration of malignant glands within the cyst wall (H&E x40). (b) Transition of benign squamous epithelium to dysplastic surface glandular epithelium and underlying invasive atypical glands with intraluminal dirty necrosis. (c) Invasive glands lined by intestinal-type epithelium and containing intraluminal necrosis. (d) Perineural invasion of infiltrating glands.
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fig2
The atypical glands were lined by pleomorphic cells with hyperchromatic enlarged nuclei and luminal dirty necrosis (Figures 2(a)-2(d)).
(a) CK20 is strongly positive in tumour. (b) CDX2 in strongly positive in tumour cell nuclei. (c) CK7 is patchy variable positive. (d) MUC-2 is strongly positive.
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fig3
Immunohistochemical staining showed the tumour cells were strongly positive for CK20, CDX2, focally positive for CK7 and negative for CD30, PAX-8, Vimentin, ER, PR, and CD10 (Figures 3(a)-3(c)). MUC-2 staining was also performed and showed cytoplasmic positivity in tumoural cells consistent with intestinal differentiation (Figure 3(d)).