PMC10213384_01
Ultrasound scan of abdomen of the 12-year-old patient. The red arrowheads indicate an area of increased echogenicity suggestive of a space-occupying lesion. The other organs appear normal.
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Ultrasound of the abdomen revealed a large midline space-occupying lesion measuring 13 cm x 12 cm in the umbilical region, separate from the urinary bladder, having a heterogeneous echotexture and scattered echogenic specks (Figure 1).
H&E stain of the resected specimen of the right ovary (40x). The periphery is occupied by viable cells with distinct features (green arrows). The central infarcted part of the specimen demonstrates ghost outlines of cells arranged in sheets and cords.
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At the periphery, the viable tumour cells had round to oval vesicular nuclei, prominent nucleoli and amphophilic cytoplasm (Figure 2).
H&E stain of the resected specimen of the right ovary (100x). The pale pink fibrous stroma is densely infiltrated with hyperchromatic inflammatory cells (red arrows).
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The nests of the tumour were surrounded by a delicate fibrous stroma infiltrated by inflammatory cells (Figure 3).
Sagittal cuts of MRI scan of the pelvis of the patient at the age of 16 years. The body of the uterus posterior to the bladder is hypoplastic with a slit-like uterine cavity (red arrow). The length of the vagina is normal (yellow arrow).
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Magnetic resonance imaging (MRI) scan of the abdomen and pelvis revealed a small, hypoplastic uterus (Figure 4).
H&E stain of the left ovary (100x) obtained after total abdominal hysterectomy with left-sided salpingo-oophorectomy. Dense inflammatory infiltrates and atretic ovarian follicles containing colloid-like secretions dominate the field (red arrowheads). Normal ovarian structures are replaced by a pale, fibrous stroma and narrow trabeculae. Dysplastic and anaplastic changes suggestive of malignancy are absent.
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Histopathological examination of the resected left-sided adnexa revealed a streak gonad (Figure 5) with no evidence of malignancy.