PMC7273584_01
Brain MRI images, in axial section, showing (a) hyperintense foci (white arrows) are
seen at the right temporal lobe on the FLAIR sequence and (b) T2-weighted image, at the
same slice, showing hyperintense foci (white arrows).
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The brain MRI showed areas of T2/FLAIR hyperintensity of the right temporal lobe, concerning for herpes simplex virus (HSV) encephalitis (Figure 1).
Pelvic MRI images, in axial section, showing the right ovary lesion (left ovarian
lesion not demonstrated at this level) (a) and (b) - (a) T1- and (b) T2-weighted images
showing focal hyperintensity within the right ovary, which is suspicious for a fat
density lesion, possibly a teratoma. (c) T1 fat-suppressed sequence image of the right
ovary, showing suppression of the right ovarian lesion signal intensity, confirming a
fat density lesion. Surgical resection and pathological examination confirmed a
teratoma.
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A pelvic MRI was then pursued, revealing fat signal intensity within both ovaries, suspicious of teratoma (Figure 2).
(a) Mature cystic teratoma lined by keratinised stratified squamous epithelium with
underlying mature skin adnexal structures, adipose tissue, and glial tissue (H&E,
x20). (b) Mature glial tissue (arrow) with mature skin adnexal structures (arrowheads)
and mature adipose tissue (fat). No immature neuroepithelial tissue is seen (H&E,
x100). (c) GFAP (glial fibrillary acidic protein) stain highlights the glial tissue
(arrow) (GFAP, x100).
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Bilateral cystectomy was performed, and the histopathological examination confirmed the diagnosis of bilateral mature ovarian teratoma (Figure 3).