PMC6879666_01
Magnetic resonance imaging revealing solid, cystic, irregular, and space-occupying lesions in the left adnexal area and before the rectum, presenting long T2 signals and equal short T1 signals. The solid part of the diffusion-weighted imaging lesion shows high signal intensity with unclear boundaries, the cystic part shows the liquid level, enhanced scanning of the solid part reveals obvious heterogeneous enhancement, and the boundary between the lesion and adjacent structures is unclear.
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F1
The thickness of rectal wall was increased. The solid part of the diffusion-weighted imaging lesion showed high signal intensity with unclear boundaries, whereas the cystic part showed the fluid level, and enhanced scanning of the solid part revealed obvious heterogeneous enhancement, and the borders between the lesion and adjacent structures were unclear (Figure 1). The patient was diagnosed with ovarian carcinoma on the basis of the ultrasound results and was scheduled for cytoreductive surgery.
(A) High-grade serous carcinoma is contiguous with endometriosis, infiltrating throughout the sub-serosa. H&E, x200. (B) The black arrow area is the endometrial gland, and the red arrow area is the stroma.
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F2
Contiguous with endometriosis, the high-grade serous carcinoma infiltrated throughout the sub-serosa, as shown in Figures 2A,B.
Strong WT-1-positive staining of tumor cells. WT-1 (A). ER-positive staining of the endometrial glands and stromal cells (B). ER, estrogen receptor.
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F3
The immunohistological examination indicated that WT-1 was positively stained and that the rectal tumors near endometrial glands were positive to estrogen receptor (ER) staining (Figures 3A,B).