PMC6135157_01
Magnetic resonance imaging studies of the pelvis in the present case. (a), (b), (c), and (d) Magnetic resonance imaging performed at 12 weeks of gestation. (e), (f), (g), and (h) magnetic resonance imaging performed at 2 months after delivery. (a) Axial T1-weighted image showing an enlarged right ovary (arrow) with iso intensity to low intensity. (b) Axial T2-weighted image showing an enlarged right ovary (arrow) with relatively high intensity. (c) Axial diffusion-weighted imaging showing an enlarged right ovary (arrow) with increased signal intensity. (d) Axial apparent diffusion coefficient showing an enlarged right ovary (arrow) with low-signal intensity. (e) Axial T1-weighted image showing an enlarged right ovary (arrow) with iso intensity to low intensity. (f) Axial T2-weighted image showing an enlarged right ovary (arrow) with somewhat lower intensity than the image presented in (b). (g) Axial diffusion-weighted imaging showing an enlarged right ovary (arrow) with high-signal intensity. (h) Axial apparent diffusion coefficient showing an enlarged right ovary (arrow) with low-signal intensity
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F1
T1-weighted images, heterogeneous relatively high intensity on T2-weighted images, high-intensity signals on diffusion-weighted imaging (DWI), and a low apparent diffusion coefficient (ADC) value [Figure 1a-d]. The laboratory values were within normal limits, including those of tumor markers (e.g., carbohydrate antigen 125, carbohydrate antigen 19-9, and carcinoembryonic antigen). DWI and a low ADC value [Figure 1e-h].
Laparoscopic view and pathological findings of the right ovarian cyst. (a) Uterus and ovaries. The right ovary being enlarged to egg size. (b) Incision to the surface of the right ovarian cyst revealing a cream-colored irregular mass. (c) Pathological findings of the right ovarian cyst with h and e staining. Wall of the cyst is lined by mature stratified squamous epithelium without skin adnexae and other tissues. Original magnification, x4
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F2
DISC  (Hakko) and EZ Access  (Hakko). During surgery, a soft, egg-sized ovarian tumor with a smooth surface was identified in the right ovary [Figure 2a]. The tumor ruptured and could easily be separated from the normal ovarian tissue by forceps intraperitoneally and was carried out from the incision; therefore, total laparoscopic cystectomy was performed, and tumor dissection revealed a cream-colored irregular mass [Figure 2b]. Histopathological examination revealed that the cyst wall was lined by mature stratified squamous epithelium without skin adnexae and other tissues, and histopathological diagnosis revealed an epidermoid cyst with no malignant findings [Figure 2c].