PMC9152346_01
A large lobulated solid heterogeneously enhancing mass (solid black arrows) arising from the right ovary of size 11.9 cm x 6.5 cm x 9.4 cm with punctuate internal calcification and ascites.
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Contrast enhanced computed tomography revealed a large lobulated solid mass of size 11.9 cm x 6.5 cm x 9.4 cm arising from the right ovary, morphologically normal looking left ovary, and presence of gross ascites (Figure 1). The right ovarian mass was characterized by heterogeneous post-contrast enhancement and punctuate internal calcification along with multiple intratumor tortuous vascular channels (Figure 1).
Resected specimen showing cut opened the right ovary with an attached fallopian tube. The right ovary measures around 15 cm x 10 cm with a bosselated outer surface. The ovary is entirely replaced by a solid mass which greyish-yellow with focal areas of myxoid changes and haemorrhage with an intact capsule. The fallopian tube appears normal.
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The patient underwent right salpingo-oophorectomy, pelvic lymph node dissection, and infracolic omentectomy along with left ovarian biopsy (Figure 2).
Histological findings showing nests of germ cells separated by fibrous septa infiltrated by lymphoid cells. Tumor cells are large, high N : C ratio with prominent nucleoli. (hematoxylin and eosin (H&E), 200x).
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Based on the above characteristic findings, a diagnosis of dysgerminoma associated with burned out gonadoblastoma was made (Figure 3).