PMC3272908_01
Transabdomen grayscale US image shows a heterogeneous lesion demonstrating solid and cystic portions arising from the left ovary.
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F1
African American female, gravida 1 para 1; with no significant medical history, who had been on surveillance, for the past 3 years, for a left pelvic mass found incidentally during routine perinatal ultrasound (US). At the time of initial discovery, the left adnexal mass measured 7.1 x 7.4 x 5.1 cm and contained both cystic and solid components [Figure 1].
(a) Transvaginal US image shows a complex mass arising from the left ovary with solid and cystic components (b) Color Doppler examination of the same mass demonstrates high vascularity in the solid portion of the left ovarian mass.
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F2
Transvaginal US [Figure 2] as well as abdominal computed tomography (CT) was obtained.
Axial CT images with IV contrast demonstrate the presence of a heterogeneous mass in the left adnexa (arrows) with macro calcifications and enhancement of the solid components.
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F3
CT demonstrated enhancement of the solid portions of the mass and, in addition, calcifications were noted [Figure 3].
(a) Transvaginal US image shows a complex mass with solid and cystic components and calcifications (arrow). (b) Corresponding color flow Doppler image of the lesion.
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F4
After 1 year of US imaging follow up [Figure 4] and intermittent episodes of left lower quadrant pain, the patient elected to have a laparoscopic operative procedure.
Hematoxylin and eosin-stained tissue (400x) displaying branching papillae with atypical cytologic features including nuclear groves, clearing, overlapping, and enlargement, consistent with papillary thyroid carcinoma arising in a struma ovarii.
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F5
The histopathology report was papillary thyroid carcinoma arising in SO [Figure 5], with no capsular invasion.