PMC5894037_01
(A, B) Ultrasound images show bilateral adnexal mass lesions with hemorrhagic changes in the right mass (arrow)
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However, iso-to-hyperechoic bulky solid mass lesions were noted in bilateral adnexa (Figure 1A, 1B).
(A, B) Color Doppler images of same lesions show a vascular nature of the masses.
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On color Doppler, both lesions showed significant vascularity (Figure 2A, 2B).
Plain axial CT image of the pelvis shows bilateral ovarian masses (arrows).
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Few hyperdense areas were noted in the right ovarian lesion (Figures 3, 4), suggestive of hemorrhage.
Plain axial CT image at a slightly higher level shows hemorrhage in the right lesion (arrow).
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Few hyperdense areas were noted in the right ovarian lesion (Figures 3, 4), suggestive of hemorrhage.
Contrast-enhanced CT image at same level as in Figure 3 shows heterogeneous enhancement of the solid portions of the lesions.
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Both masses showed moderate heterogeneous enhancement (Figure 5).
Axial T1W image of the pelvis shows slightly hyperdense bilateral ovarian masses with few areas of hemorrhage.
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Plain and contrast-enhanced magnetic resonance imaging (MRI) showed these lesions as iso- to slightly hyperintense on T1W images, and heterogeneously hyperintense on T2W and short tau inversion recovery (STIR) sequences (Figures 6-8).
Axial T2W image at same level as in Figure 6 shows hyperintense signal of the masses with central hemorrhage.
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Plain and contrast-enhanced magnetic resonance imaging (MRI) showed these lesions as iso- to slightly hyperintense on T1W images, and heterogeneously hyperintense on T2W and short tau inversion recovery (STIR) sequences (Figures 6-8).
Axial STIR image at same level as in Figure 7 shows lesions to have peripheral high-signal intensity with central low signal.
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Plain and contrast-enhanced magnetic resonance imaging (MRI) showed these lesions as iso- to slightly hyperintense on T1W images, and heterogeneously hyperintense on T2W and short tau inversion recovery (STIR) sequences (Figures 6-8).
Sagittal oblique GRE image shows central area of blooming within the ovarian mass.
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Areas of hyperintensity were seen in both ovarian masses on T1W images that showed blooming on the gradient echo (GRE) sequence due to hemorrhage (Figure 9).
Axial fat-saturated post-contrast T1W images show avid enhancement of both ovarian lesions.
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Avid peripheral enhancement of both lesions was seen on post-gadolinium enhanced images (Figure 10).
Gross surgical specimen shows bulky ovaries with cystic and hemorrhagic spaces (arrow).
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On gross examination, both ovaries appeared bulky with few hemorrhagic cystic spaces (Figure 11).
High-power microscopic histopathological specimen shows syncytiotrophoblast and cytotrophoblast cells with nuclear pleomorphism and increased mitoses.
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Also, abnormal mitoses with nuclear pleomorphism and hyperchromasia were noted within the cells due to malignancy (Figure 12).