PMC6351288_01
Ultrasonography (US).. US showed a well-circumscribed hypoechoic mass, with spotty hyperechoic lesions, 70 mm in diameter.
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Transvaginal ultrasonography revealed a well-circumscribed and globular low echoic mass with punctate rod-shaped high echoic area (Fig. 1).
Magnetic resonance (MR) imaging.. a) The mass showed heterogeneous hyperintensity on T1-weighted MR images (repetition time [TR]/effective echo time [TE], 300/2.4 ms).. b) T2-weighted images demonstrated hypointense mass with hyperintense reticular structures (TR/TE, 4267/91 ms). A unilocular cyst was also present in the mass.. c) Contrast-enhanced MR images with fat-saturation showed slight reticular enhancement (TR/TE, 4.2/2.0 ms).. d) Apparent diffusion coefficient value of the tumor was 1.38 x 10-3 mm2/s (TR/TE, 4800/64 ms, b-value = 800 s/mm2).
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On MRI examinations, the tumor demonstrated heterogeneous slight hyperintensity on T1-weighted images and extremely hypointensity on T2-weighted ones (Fig. 2a, b). Although contrast-enhanced fat-saturated T1-weighted images exhibited slight enhancement at reticulated structures, most of the tumor did not show any enhancement (Fig. 2c). On diffusion-weighted images (DWI), the tumor showed slightly high signal intensity (Fig. 2d).
Unenhanced CT.. On unenhanced CT, the tumor demonstrated heterogeneous hyper-attenuated.
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On unenhanced CT, the tumor showed heterogeneous hyper-attenuated (Fig. 3).
Photograph of cut surface of ovarian tumor.. The cut surface of the mass showed multiple whitish firm gelatinous texture deposition with septa.
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Macroscopically, the ovarian tumor was round and well-encapsulated, and the cut surface of the tumor was composed of multiple yellowish firm gelatinous texture deposition separated by fibrous septa (Fig. 4, Fig. 5a).
Histopathological finding of surgical specimen (Macrograph and magnified image).. a) On Macrograph of resected specimen, the gelatinous portion consisted of degenerated mucin.. b) On the septal structure, papillary cell proliferation, pseudostratified epithelium pattern and nuclear enlargement were observed in some areas.
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On the septal structure, the septal lined cells were simple thin epithelium composed of low papillary column cells with cytoplasmic clear mucin (Fig. 5b).