PMC7344131_01
(a) Chest X-ray showed bilateral mild pleural effusion on admission. (b) Pelvic ultrasonography revealed a mass of 2.5x2 cm size on the posterior of right ovary (white arrow). (c1, c2) Preoperative magnetic resonance imaging showing bilateral hydrothrax (c1) and massive ascites in axial images (c2) (white arrows). (d) Coronal fat-suppressed T1-weighted image showing the hyperintense right and left ovarian mass contained solid and cystic components (arrows) and ascites in the pelvis (arrow) (right ovary 32x45 mm, left ovary 14x12 mm). (e) Axial view revealed masses on the both ovaries contained solid and cystic components (white arrows); F: T2-weighted sequence of coronal image showing masses on the both ovaries contained solid and cystic components (black arrows)
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F1
Magnetic resonance imaging (MRI) performed on day 8 post onset of her symptoms showed bilateral pleural effusion, massive ascites, and masses with solid cystic components on both ovaries, 32x45 cm on the right, and 14x12 cm on the left, which were primarily thought to be malignant (Fig. 1), and also paraaortic-paracaval lymphadenopathies and implantation masses compatible with peritonitis carcinomatosa were observed.
(a) Tumor infiltration in Ovary (Normal ovary is seen on the right side, white arrow). This ovary shows the alveolar pattern of spindle cells on the left (H&E 100x). (b) Tumor cells that have lost cellular cohesion between fibrovascular septations and septations surrounded by single row cells (H&E 100x) (Omentum). (c) Solid areas (H&E 200x) produced by round narrow cytoplasmic tumor cells (Omentum). (d) Multinuclear tumor giant cells (marked with arrow) (H & E 400x) (Omentum). (e) Characteristic alveolar growth pattern. Discohepatic neoplastic cells in alveolar like spaces (H&E 100x) (Omentum). (f1) Cytoplasmic desmin positivity (200x) in tumor cells in the immunohistochemical examination (Omentum). (f2) Nuclear myogenin positivity (200x) in tumor cells in the immunohistochemical examination (Omentum)
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F2
Pathologic evaluation of the ovarian tumor revealed an alveolar pattern (>50 percent alveolar component, predominantly) (Fig. 2).