PMC3296578_01
Computerized Tomography findings before and during the course of treatment. (A1) showing huge heterogeneous mass filling the upper pelviabdominal cavity (arrows), (A2) showing unremarkable pelvis after chemotherapy, (B) showing the appearance of a new mass situated between right liver lobe, right kidney, and adrenal gland (arrows).
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F1
Computerized tomography (CT) scan showed a huge, heterogeneously enhancing pelviabdominal mass with multiple cystic and necrotic areas, originating from the right ovary (Figure 1A). Imaging studies revealed a new complex multiloculated mass in the right suprarenal area (Figure 1B).
Histological features of the primary ovarian mass and the recurrent new mass. (A) low power magnification of the mature teratoma component, in which mature glands and stroma are seen (H&E X4), (B): higher power magnification of rhabdomyoblasts seen with abundant acidophilic cytoplasm and eccentric nuclei (H&E X 40) (inset show desmin positive staining of the rhabdomyoblasts), (C): mature glandular tissue is seen in the recurrent new mass, no immature tissue was identified (H&E X 40).
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F2
Histopathology revealed non-germinomatous mixed germ cell composed of a mixture of yolk sac tumor (20%), mature teratoma (30%) (Figure 2A), embryonal carcinoma (40%), and choriocarcinoma (5%). In addition, an embryonal rhabdomyosarcomatous component (5%) (Figure 2B) was identified in the form of spindle and globoid rhabdomyoblasts staining positively with desmin and focally for myogenin. Histopathology confirmed the presence of mature cystic teratoma (Figure 2C).