Sertoliform Endometrioid Carcinomas of the Right Ovary

Abstract Background: Endometrioid carcinomas of the ovary are a sub-type of epithelial ovarian tumors. The vast majority are malignant and invasive. On imaging, they are usually characterized as complex nonspecific solid-cystic masses and found associated with endometriosis. However, endometrioid carcinoma of ovary resembling sex cord-stromal tumor is a rare variant of endometrioid adenocarcinoma that focally looks like a sex cord-stromal tumor with sertoli, leydig, or granulosa cells. Sertoliform endometrioid carcinoma of the ovary (SEC) is one variant that bears histologic similarity to Sertoli and Sertoli-Leydig cell tumors (SLTs). Clinical Case: A 47 year old, premenopausal female, presented with rapid growing hirsutism, frontal hair loss, abdominal distension and constipation for less than one year. On clinical examination modified Ferriman-Gallwey (mFG) score was 17/36. Abdominal examination showed a palpable mass in lower abdomen, 25cm in size, rounded, and hard in nature. CT abdomen and pelvis revealed large pelvic abdominal mass (21x20.5x17 cm) with cystic and basal soft tissue components related to right ovary. Preoperatively laboratory investigations showed FSH 9.96 mIU/mL, LH 15.4, Estradiol (E2) 94.7 pg/ml, raised total testosterone 4.38 nmol/l, normal SHBG 34 nmol/l and normal DHEA-S 161 microg/dl. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was done, in which the right ovary was seen to be replaced by a solid cystic tumor with ruptured capsule. Grossly, the right ovary was enlarged measuring 9.5 cm × 8 cm × 4.8 cm. Microscopy showed round to solid tubules lined by pseudostratified columnar epithelium with elongated nuclei resembling sertoli tumor-like pattern along with conventional endometrioid tumor. A histopathological diagnosis of SEC of right ovary was made. Immunohistochemistry showed tumor cells strongly immunoreactive for epithelial membrane antigen (EMA), cytokeratin (CK) but negative for inhibin, thus confirming the diagnosis of SEC of right ovary. Conclusion: SEC is extremely rare variant of endometrioid carcinomas and tend to present at an earlier stage as compared with most endometrioid carcinomas of the ovary. Recognition of SEC in virilizing patients is important as it is a well-differentiated, low-grade malignancy that displays a good prognosis when confined to the ovary.

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A Case Presentation of Gastrointestinal Stromal Tumor of Duodenum

Journal of Renal and Hepatic Disorders ◽

10.15586/jrenhep.v5i1.112 ◽

2021 ◽

Vol 5 (1) ◽

pp. 49-53

Author(s):

Aamir Ghazanfar ◽

Afifa Asghar ◽

Farrukh Zaman ◽

Hassan Mumtaz ◽

Shahzeb Habib ◽

...

Keyword(s):

Gastrointestinal Stromal Tumor ◽

Abdominal Distension ◽

Stromal Tumor ◽

Palpable Mass ◽

Case Presentation ◽

Complete Surgical Resection ◽

Abdominal Examination ◽

Duodenal Gists ◽

The Right ◽

Common Mesenchymal Tumor

A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. It is caused by the mutation in KIT and PDGFRα genes. It constitutes <1% of all gastrointestinal tumors. Duodenal GISTs constitute 4.5% of all GISTs. We report a 61-year-old lady, presented with generalized abdominal pain, vomiting, abdominal distension, and nausea for the last 3 years. Physical exam-ination showed a pallor and on abdominal examination, a large palpable mass was extending from the pelvis to the right upper quadrant of the abdomen. The CT scan showed a large heterogeneously echogenic mass in the abdomen and pelvis with no lymphadenopathy and distant metastasis in this region. Laparotomy showed a large globular mass extending from the pelvis to the right upper quadrant of the abdomen adherent to the wall of a third part of the duodenum. Complete surgical resection of tumor done with an intact capsule. Microscopic examination showed neoplastic spindle cells with tumor necrosis. An immunohistochemical study confirmed GIST.

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Ovarian endometrioid carcinoma resembling sex cord-stromal tumor: A case report

World Journal of Clinical Cases ◽

10.12998/wjcc.v8.i12.2623 ◽

2020 ◽

Vol 8 (12) ◽

pp. 2623-2628

Author(s):

Xiao-Xia Wei ◽

Yan-Mei He ◽

Wei Jiang ◽

Lei Li

Keyword(s):

Case Report ◽

Stromal Tumor ◽

Endometrioid Carcinoma ◽

Sex Cord Stromal Tumor

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Sporadic ovarian sex cord-stromal tumor with annular tubules: a rare case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193955 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3591

Author(s):

Krutika Patel ◽

Devang Painter ◽

Vashudha M. Bhagat ◽

Pinkal Shah

Keyword(s):

Granulosa Cell ◽

Stromal Tumor ◽

Tissue Mass ◽

Predominant Component ◽

Rare Case Report ◽

Chief Complaints ◽

Sporadic Cases ◽

Post Menopausal ◽

The Right ◽

Sex Cord Stromal Tumor

Ovarian sex cord stromal tumor with annular tubules (SCTAT) is a distinctive, rare subtype of sex cord stromal tumor of the ovary, predominant component of which has morphological features intermediate between that of granulosa cell and sertoli cell. The majority of ovarian SCTAT are benign. So far, malignant behavior in SCTAT has been reported only in sporadic cases. We have presented a case of SCTAT in a 40 year old lady with no association of Peutz-Jegher (P-J) syndrome. The patient’s chief complaints were post-menopausal bleeding for 1 year on and off along with menorrhagia. MRI abdomen was suggestive of intensely enhancing solid tissue mass lesion in the right adnexa, features suggestive of ovarian mass. Panhysterectomy was done. Grossly uterus and left adnexa appeared to be normal. Right ovary showed mass measuring 17x11x9cm3 in size, on cut section, solid, homogenous lobulated, yellowish areas identified. Microscopic and Immunohistochemistry findings confirmed the diagnosis of sex cord stromal tumor with annular tubules of granulosa cell type. PAS stain supported the diagnosis.

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Low-Grade Appendiceal Mucinous Neoplasm (LAMN) Primarily Diagnosed as an Ovarian Mucinous Tumor

Case Reports in Surgery ◽

10.1155/2021/5523736 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Konstantinos Perivoliotis ◽

Gregory Christodoulidis ◽

Athina A. Samara ◽

Ioanna-Konstantina Sgantzou ◽

Theodoros Floros ◽

...

Keyword(s):

Differential Diagnosis ◽

Transvaginal Ultrasound ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Tertiary Hospital ◽

Right Hemicolectomy ◽

Cystic Tumor ◽

Low Grade ◽

Mucinous Neoplasms ◽

The Right

Background. Low-grade appendiceal mucinous neoplasms (LAMN) are detected in 0.7 to 1.7% of all appendicectomies. The diagnosis can be challenging, particularly in female patients where the differential diagnosis of primary appendiceal and ovarian mucinous neoplasms is unclear. Case Presentation. A 71-year-old female was referred to our tertiary hospital with the working diagnosis of a right ovarian cystic tumor. The lesion was identified through a transvaginal ultrasound performed for vague lower abdominal pain symptoms. CT scan confirmed these findings. Intraoperatively, an appendiceal mucocele was identified and a right hemicolectomy was performed. The histopathology examination revealed a LAMN. Six months later, the patient remains disease-free. A close biannual oncological follow-up has been suggested. Conclusion. This case underlines the difficulty in determining the origin of mucinous neoplasms of the right pelvic area. Mucocele of the appendix should be considered in the differential diagnosis of a mass in the right iliac fossa.

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Imaging Features of Breast Periductal Stromal Tumor: A Case Report

Frontiers in Oncology ◽

10.3389/fonc.2021.577227 ◽

2021 ◽

Vol 11 ◽

Author(s):

Ning Ding ◽

Ying Jiang ◽

Haimin Liu ◽

Fuling Zheng ◽

Shenling Zhu ◽

...

Keyword(s):

Blood Flow ◽

Digital Breast Tomosynthesis ◽

Stromal Tumor ◽

Imaging Features ◽

Breast Tomosynthesis ◽

Palpable Mass ◽

Full Field ◽

Full Field Digital Mammography ◽

The Right ◽

Biphasic Tumor

Breast periductal stromal tumor (PDST) is a rare biphasic tumor, with both benign ductal epithelium and non-phyllodes sarcomatous stroma. Its imaging features were rarely reported due to the rarity. In this study, we describe the case of a 48-year-old female who presented with a palpable mass in the right breast. Presurgery imaging evaluations of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and ultrasonography (US) were performed. The imaging features include the following: 1. multiple solid lobulated lesions comprising nearly the entire right breast; 2. hypoechoic heterogeneous masses with internal separations and abundant blood flow; 3. FFDM and DBT showed multiple irregular high-density masses with lobulated margin, partially integrated. The patient underwent extended mastectomy of the right breast. The surgical pathology confirmed a PDST. After excision of the mass, she was followed up in the outpatient clinic for 25 months without local recurrence or distant metastasis.

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Giant liver hemangioma in patient with ileal gastrointestinal stromal tumor

Medicinski pregled ◽

10.2298/mpns1402055a ◽

2014 ◽

Vol 67 (1-2) ◽

pp. 55-59

Author(s):

Vasilije Antic ◽

Marjan Micev ◽

Danijela Baskic ◽

Violeta Mladenovic

Keyword(s):

Gastrointestinal Tract ◽

Gastrointestinal Stromal Tumor ◽

Gastrointestinal Stromal Tumors ◽

Stromal Tumor ◽

Surgical Removal ◽

Liver Hemangioma ◽

Palpable Mass ◽

Gastrointestinal Malignancies ◽

Stromal Tumors ◽

The Right

Introduction. Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. These tumors represent more than 80% of all mesenchymal tumors found in the gastrointestinal tract, though they account for only approximately 3% of all gastrointestinal malignancies. Literature offers case reports, which describe symptomatic gastrointestinal stromal tumors and they generally represent patients with larger tumors. Case report. We present the case of a small gastrointestinal stromal tumor in a 40-year-old man, with associated giant liver hemangioma and fever, and with history of abdominal discomfort and fever. Clinical examination revealed hepatosplenomegaly, palpable mass in the right lower abdomen, and signs of neurofibromatosis type 1 (Morbus von Recklinghausen). Computed tomography revealed a giant tumor in the right lobe of the liver. Magnetic resonance showed abscess in the hemangioma of the liver. An intestinal tumor was incidentally found and excised during surgical laparotomy. An intestinal gastrointestinal stromal tumor was revealed by histopathology and confirmed by immunohistochemistry. Although a multidisciplinary team proposed surgical removal of the liver tumor mass, the surgeons decided to follow up the patient because of a high risk of new intervention. Conclusion. According to the available data, this is a very rare case of small intestinal gastrointestinal stromal tumor, with symptoms of fever and giant abscess in the liver hemangioma.

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Nasal Septal Hemangiopericytoma-like Tumor: A Case Report with an Immunohistochemical Study

American Journal of Rhinology ◽

10.1177/194589240101500409 ◽

2001 ◽

Vol 15 (4) ◽

pp. 267-270 ◽

Cited By ~ 8

Author(s):

Rie Yasui ◽

Toru Minatogawa ◽

Naoyuki Kanoh ◽

Yasuo Nakata ◽

Akira Kubota

Keyword(s):

Case Report ◽

Immunohistochemical Study ◽

Preoperative Evaluation ◽

Vascular Tumor ◽

Histopathological Diagnosis ◽

Low Grade ◽

Topoisomerase Iiα ◽

Ki 67 ◽

Grade Malignancy ◽

The Right

Nasal hemangiopericytoma-like (HPCL) tumor is a rare vascular tumor and should be differentiated from typical hemangiopericytomas (HPCs). This study reports the case of an HPCL tumor in a 77-year-old man with histological and immunohistochemical features. After preoperative evaluation of the blood supply, the dark-red right intranasal tumor was resected completely via the right maxillary sinus. The final histopathological diagnosis was HPCL tumor based on several stains: vimentin (+), α-SMA (+), etc. Moreover, there were few p53 (+) cells and the Ki-67 and topoisomerase IIα labeling indices were both under 5%. These findings indicated that this tumor was a low-grade malignancy. The immunohistochemical investigations used are useful for making the diagnosis of HPCL tumor and determining the treatment, malignancy, and prognosis. (American Journal of Rhinology 15 267–270, 2001)

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Cystic mass of the right iliac fossa: don't forget about lymphatic malformation

BJR|case reports ◽

10.1259/bjrcr.20200165 ◽

2020 ◽

pp. 20200165

Author(s):

Habib Bellamlih ◽

Ayman El Farouki ◽

Rahal Mssrouri ◽

Sabrine Derqaoui ◽

Ahmed Jahid ◽

...

Keyword(s):

Iliac Fossa ◽

Lymphatic Vessels ◽

Surgical Excision ◽

Cystic Lymphangioma ◽

Lymphatic Malformation ◽

Benign Tumour ◽

Cystic Tumor ◽

Palpable Mass ◽

Complete Surgical Excision ◽

The Right

Lymphatic malformation or cystic lymphangioma is a benign tumour of the lymphatic vessels. It is more commonly reported among children and has polymorphic clinical presentations. The diagnosis is based on imaging but requires histological confirmation. The treatment of choice is surgical excision for the abdominal and symptomatic localization. We report the case of a 30-year-old female who consulted for right iliac fossa pain mimicking an acute appendicitis. The physical examination revealed a slight tenderness in the right iliac fossa without fever or palpable mass. Though the biological screening was normal, the imaging exploration has revealed the presence of a multiloculated cyst located in the right iliac fossa at the ascending colon and measuring 15 cm. The mass matches with lymphatic malformation. Therefore, a laparoscopy was performed, and complete resection of the cystic tumor was accomplished with right hemicolectomy. The histologic exam has confirmed the diagnosis. Colonic lymphatic malformation is a rare and benign tumour, requiring a complete surgical excision to minimise any recidivism. The definitive diagnosis remains histological.

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