PMC8214896_01
Magnetic resonance imaging (T1 weighted) shows a solid cystic ovarian mass with internal septations.
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The abdominal contrast-enhanced computed tomography (CT) and Magnetic Resonance Imaging (MRI) revealed a well-defined abdominopelvic cystic lesion measuring 13x12x10cm with enhancing solid components of ovarian origin (Figure 1), and multiple subcentimetric and ill-defined subpleural and pulmonary nodules in the right upper lobe, right middle lobe and left upper lobe.
A - The cut surface of the right and left ovary shows a solid-cystic lesion with areas of necrosis (Scale bar: 3 cm); B - left ovary; C - thickened gallbladder wall.
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Both ovaries had a solid-cystic cut surface (Figure 2). The gallbladder measured 05 cm in length with an irregularly thickened wall measuring 1.5- 2.5 cm (Figure 2).
A - Photomicrograph of the gallbladder shows infiltrating irregular glands eliciting a desmoplastic response (H&E, 40x); B, C and D - Photomicrograph of right ovarian mass B - shows cystically dilated infiltrative glands (H&E, 40x); (C) shows the glands being lined by cuboidal to columnar cells having large vesicular nuclei, prominent nuclei and moderate amphophilic cytoplasm (H&E, 40x); (D) Cytokeratin 7 (40x magnification).
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The histopathological examination from both ovaries showed an infiltrative tumor arranged in varying sized glands, many of which were cystically dilated, enclosing a pale mucinous material (Figure 3B). These glands were lined by cuboidal to columnar cells having basally placed large, pleomorphic nuclei with open to clumped chromatin, prominent nucleoli, and moderate pale eosinophilic to mucin filled cytoplasm (Figure 3C). The sections from the gallbladder showed a dysplastic mucosa along with underlying infiltrative glands, which are lined by cuboidal to columnar cells having similar morphology to those seen in both ovaries (Figure 3A). Pathnsitu, Ready to use) (intense, cytoplasmic), CK19 (Clone EP-73, Pathnsitu, Ready to use) (intense, cytoplasmic) and CDX2 (Clone EP-25, Pathnsitu, Ready to use) (focal, nuclear); while being negative for WT1 (Clone EP-122, Pathnsitu, Ready to use), ER (Clone EP1, Pathnsitu, Ready to use), PR (Clone EP2, Pathnsitu, Ready to use) and CK20 (Clone EP-23, Pathnsitu, Ready to use) (Figure 3 D, Figure 44B). P53 (Clone BP-53-12, Pathnsitu, Ready to use) showed mutant expression (50% cytoplasmic blush).