PMC9375555_01
Ultrasound scan showing 18/11 cm well-delimited giant cystic lesion.
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The abdomen ultrasound scan revealed an 18/11 cm big well-delimited giant cystic lesion, with septa inside, with an upper wall 18.2 mm thick and without Doppler signals (Figure 1); the tumor extends from the hypogastrium to the epigastrium and gives compression on the right ureter, resulting in right grade II hydronephrosis.
IRM examination of the pelvis, sagittal section showing a big well-delimited liquid cyst, located mid-abdominal, with a caudal wall of increased size.
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The described lesion shows contrast in the septum and caudal portion, and appears to develop from the right ovary (Figures 2 and 3).
IRM examination of the pelvis, transversal section.
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The described lesion shows contrast in the septum and caudal portion, and appears to develop from the right ovary (Figures 2 and 3).
Intraoperative laparoscopic appearance: the uterine horn is twisted, and on the right side you can see a part of the giant tumor.
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It has no adherence to the neighboring organs, it belongs to the right ovary and the right horn is twisted 180 degrees (Figure 4).
Intraoperative laparoscopic appearance: on the left side you can see the ovarian stroma preserved, and on the right side you can see the enucleated cyst.
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A puncture was performed for tumor reduction and better operative vision, and 300 mL sero-citrin liquid was extracted; then, cyst enucleation and excision were performed (Figures 5 and 6).
Macroscopic appearance of the excised cystic teratoma, where you can see deposits of sebum and hair.
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A puncture was performed for tumor reduction and better operative vision, and 300 mL sero-citrin liquid was extracted; then, cyst enucleation and excision were performed (Figures 5 and 6).
Intraoperative laparoscopic appearance: the left ovary with follicular cysts and the right ovarian stroma preserved.
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Considering the normally looking pelvis and absence of adenopathy, as well as the patient's age and wish to have children, both ovaries were preserved (Figure 7).
Keratinized squamous epithelium and adnexal glands (HE staining, x40).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).
Pseudostratified epithelium and adnexal glands (HE staining, x40).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).
Mature nerve tissue (HE staining, x 100).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).
Intestinal wall type structure (HE staining, x 40).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).
Microcystic structure with mucosecretory epithelium (HE staining, x 100).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).
Siderophages (HE staining, x 200).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).
Smooth muscle fibers (HE staining, x 40).
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The microscopic examination performed after tissue staining with usual Hematoxylin- Eosin (HE) stain revealed the following types of mature tissues: connective-vascular tissue, smooth muscle fibers, microcystic structures with uni-, bi- and multilayered epithelium, nerve tissue, glandular structures, intestinal epithelium, areas with old hemorrhage and numerous siderophages, skin with appendages, stasis (Figures 8-14).