PMC4485684_01
MRI of the abdomen reveals the liver masses invading the diaphragm.
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On magnetic resonance imaging (MRI), the liver masses were found to have extended superiorly and invaded the diaphragm (Fig. 1).
Angiography shows the encasement of the artery branches and neovasculatity (arrows). (A) The common hepatic artery. (B) The right inferior phrenic artery.
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Angiography demonstrated the encasement of the right hepatic artery and the inferior phrenic artery branches and tumor neovascularity (Fig. 2A and B).
The microscopic features of the original ovarian tumor. (A) The tumor cell is growing with a multiple distributive pattern, including macrofollicular and microfollicular patterns (H and E staining, x100). (B) The original tumor also shows mitotic figures (circle) and grooves nuclei (arrow). (H and E staining, x400).
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Biopsies of the liver, the right ovarian cyst and the areas of peritoneal dissemination revealed a GCT that resembled the previous pathology of the left ovary (Fig. 3).
The microscopic features of the liver. (A) A granulosa cell tumor shows macrofollicular and microfollicular patterns. (H and E staining, x100). (B) A microfollicular pattern with Call-Exner bodies. The nuclei show mitotic figures (circle) and grooves resulting in the characteristic "coffee-bean-like" appearance (arrow). (H and E staining, x400). (C) A microfollicular pattern of growth with Call-Exner bodies surrounded by granulosa cells (H and E staining, x400). (D) An immunohistological staining was positive for inhibin (x400).
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A microscopic examination revealed a mostly microfollicular pattern of growth with Call-Exner bodies and occasional macrofollicular pattern areas (Fig. 4A). An immunohistochemical staining was performed and was positive for inhibin (Fig. 4C and D).