Mucinous tumors are a common ovarian cystic tumor, having a characteristic finding in MR imaging, the so-called stained glass appearance. consistency wholly, that was hypointense on T2-weighted pictures, mimicking ovarian fibrous tumor such as for example thecoma-fibroma band of ovarian stromal tumors. 2.?Case record A 46-year-old Asian feminine was described our medical center for the study of a pelvic mass detected by ultrasonography on a schedule medical check-up. Physical evaluation revealed small tenderness in the proper lower abdomen. Bloodstream ensure that you tumor markers which includes alpha-fetoprotein, carcinoembryonic antigen, -individual chorionic gonadotropin, and carbohydrate antigen 125 were regular, and different hormonal tests which includes estradiol, progesterone, and testosterone had been also regular. Transvaginal ultrasonography revealed a well-circumscribed and globular low echoic mass with punctate rod-shaped high echoic area (Fig. 1). The maximum diameter of the tumor PD98059 small molecule kinase inhibitor was 7?cm. On MRI examinations, the tumor demonstrated heterogeneous slight hyperintensity on T1-weighted images and extremely hypointensity on T2-weighted ones (Fig. 2a, b). A reticulated structure was observed within the mass, showing PD98059 small molecule kinase inhibitor relative hyperintensity on T2-weighted images. Although contrast-enhanced fat-saturated T1-weighted images exhibited slight enhancement at reticulated structures, most of the tumor did not show any enhancement (Fig. 2c). A unilocular well-demarcated cyst PD98059 small molecule kinase inhibitor was observed in the mass. On diffusion-weighted images (DWI), the tumor showed slightly high signal intensity (Fig. 2d). There was no fat component in the tumor. 18F-FDG-PET did not show definite uptake in the tumor. On unenhanced CT, the tumor showed heterogeneous hyper-attenuated (Fig. 3). The tumor was suspected to belong to sex cord-stromal tumors including the fibroma and thecoma, stroma ovarii, or Brenner tumor of right ovary based on the characteristic hypointensity on T2-weighted images. Open in a separate window Fig. 1 Ultrasonography (US). US showed a well-circumscribed hypoechoic mass, with spotty hyperechoic lesions, 70?mm in diameter. Open in a separate window Fig. 2 Magnetic resonance (MR) imaging. a) The mass showed heterogeneous hyperintensity on T1-weighted MR images (repetition time [TR]/effective echo time [TE], 300/2.4?ms). b) T2-weighted images demonstrated hypointense mass with hyperintense reticular structures (TR/TE, 4267/91?ms). A unilocular SHH cyst was also present in the mass. c) Contrast-enhanced MR images with fat-saturation showed slight reticular enhancement (TR/TE, 4.2/2.0?ms). d) Apparent diffusion coefficient value of the tumor was 1.38??10?3?mm2/s (TR/TE, 4800/64?ms, b-value?=?800?s/mm2). Open PD98059 small molecule kinase inhibitor in a separate window Fig. 3 Unenhanced CT. On unenhanced CT, the tumor demonstrated heterogeneous hyper-attenuated. Because the tumor was large, surgical resection was performed. Macroscopically, the ovarian tumor was round and well-encapsulated, and the cut surface of the tumor was composed of multiple yellowish firm gelatinous texture deposition separated by fibrous septa (Fig. 4, Fig. PD98059 small molecule kinase inhibitor 5a). Microscopically, the gelatinous component stained positive for Alcian Blue and periodic acid-Schiff-diastase staining, suggesting the presence of degenerated mucin. No septal thickenings or mural nodules were noted. On the septal structure, the septal lined cells were simple thin epithelium composed of low papillary column cells with cytoplasmic obvious mucin (Fig. 5b). Although there were no stromal invasions in the septum or capsule, papillary cell proliferation, pseudostratified epithelium pattern and nuclear enlargement were observed, and led to the pathological diagnosis of mucinous borderline tumor/atypical proliferative tumor. Open in a separate window Fig. 4 Photograph of cut surface of ovarian tumor. The cut surface of the mass showed multiple whitish firm gelatinous texture deposition with septa. Open in a separate window Fig. 5 Histopathological obtaining of surgical specimen (Macrograph and magnified image). a) On Macrograph of resected specimen, the gelatinous portion consisted of degenerated mucin. b) On the septal structure, papillary cell proliferation, pseudostratified epithelium pattern and nuclear enlargement were observed in some areas. 3.?Conversation MTs of the ovary are the second most common ovarian neoplasm composed of gastrointestinal-type epithelial cells, accounting for approximately 20%. MTs of the ovary are classified as cystadenoma, borderline tumor/atypical proliferative tumor, and carcinoma. Borderline tumor and malignant tumors comprise 10% and 5% of all MTs, respectively [1]. The classification is determined pathologically on the basis of the cytological, structural findings and stromal invasion, sometimes presenting a diagnostic dilemma [2]. On MRI, main mucinous cystic tumors appear as huge multi-cystic masses and the loculi of the tumor often show various signal intensities on both T1- and T2-weighted images, resulting in the so-called.
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