PMC6854983_01
(a) Contrast CT scan of the abdomen and pelvis showed an enlarged 2.6 x 2.3 x 2.5 cm right ovary (blue arrow). (b) Transabdominal ultrasound showed an enlarged 4.5 x 2.6 x 4.5 cm right ovary five months after CT scan (blue arrow) (c) Transvaginal ultrasound showed a 2.6 x 2.4 x 2.2 cm hyperechoic solid tumor inside the right ovary (blue arrow) (d) FDG PET-CT scan with contrast showed a 2.6 x 2.3 x 2.5 cm mildly FDG-avid mass (SUVmax 2.9 g/ml) in the right ovary (tumor dimensions labelled).
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fig1
Contrast computed tomography (CT) of the abdomen and pelvis showed a 2.6 x 2.3 x 2.5 cm ovoid enhancing soft tissue over the right adnexal region, commented to be likely the right ovary, with a small local surrounding fluid collection (Figure 1(a)). Similar to the CT scan obtained earlier, no obvious mass was found in either ovaries (Figure 1(b)). Transvaginal ultrasound of the pelvis revealed a 2.6 x 2.4 x 2.2 cm hyperechoic solid tumor inside the right ovary with hypervascularity seen on Doppler and multiple follicles at the periphery of the right ovary (Figure 1(c)). There were no hypermetabolic lymph nodes seen in the abdomen and pelvis (Figure 1(d)). Mitotic figures were inconspicuous (<1 per 10 high power fields).
(a) Microscopic appearance of the tumor (20x magnification); (b) Calretinin immunostain (10x magnification): Positive; (c) Inhibin immunostain (10x magnification): Positive; (d) Androgen receptor immunostain (10x magnification): Positive; (e) Melan-A immunostain (10x magnification): Weakly positive; and (f) CD-99 (10x magnification) immunostain: Negative.
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fig2
Immunostaining was positive for inhibin, calretinin, and androgen receptor, weakly positive for Melan-A, and negative for CD99 (Figure 2).