Anatomic Pathology Case Report
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A case of Ovarian New Growth in a 40 year-old female.
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Anatomic Pathology Case Report
- 2. Disclaimer! No retrieved chart KRISTINE FAITH P. TABLIZO BUCM Junior Intern
- 3. 40/F 1 day hx of Non- radiating abdominal pain accompanied by N/V Patient R.R.
- 5. Hgb: 127 Hct: 38 N: 10 % L: 87 % M: 11% E: 3% Labs
- 6. Cystectomy, Left Ovary Procedure Unilateral Salpingo- oophorectomy, Right
- 7. “Left ovarian cyst” • Cystic structure measuring 9 x 7 x 5cm. • Cyst is multicolulated and gritty • Has smooth, tan brown external surface with visible vascularities. • Filled with sebum material admixed with hair structures • Noted to have 3 teeth-like structures measuring 0.9 x 0.5 x 0.1cm
- 8. “Right adnexa” • PS cystic structure measuring 7 x 7.5 x 3cm • Rough, brown to dark brown external surface • Multiloculated cyst partly filled with sebum and hair • Attached R fallopian tube– 8 x 1 cm and has slit-like lumen • 0.5 cm paratubal cyst
- 10. Skin and Adnexa Adipose Sebaceous glands SSE A B
- 11. Skin and Adnexa Adipose Hair FolliclesSSE C D
- 13. Glandular tissue A B C * Salivary acinus (serous) ** * Edema Fluid Adipose
- 14. Normal Ovarian Tissue A B Ovarian stroma
- 15. * * * Lumen of FT Mucosal folds * RBCs within the mucosal folds HEMATOSALPINX A B
- 16. Cystic space Lining of paratubal cyst Lumen of FT Mucosal folds PARATUBAL CYST Muscular wall of FT CT
- 17. MATURE CYSTIC TERATOMA, BILATERIAL OVARIES. HEMATOSALPINX AND PARATUBAL CYST (RIGHT)
- 18. MATURE CYSTIC TERATOMA IMMATURE TERATOMA Young women (Most Common ovarian tumor in childhood) Age Predilection prepubertal adolescents and young women mean age:18 years • unilocular cysts with hair and • sebaceous material • Section: thin wall lined by an opaque, gray-white, wrinkled epidermis, frequently with protruding hair shafts. • common to find grossly evident tooth structures and areas of calcification Gross • Bulky; have a smooth external surface • tend to be solid on sectioning. • Hair, sebaceous material, cartilage, bone, and calcification may be present, along with areas of necrosis and hemorrhage.
- 19. MATURE CYSTIC TERATOMA IMMATURE TERATOMA • cyst wall-composed of SSE with underlying sebaceous glands, hair shafts, and other skin adnexal tissues • Tissues from other germ layers can be identified: cartilage, bone, thyroid, and neural tissue. Microscopic Findings • varying amounts of immature neuroepithelium, cartilage, bone, muscle, and other elements BENIGN Malignancy MALIGNANT Surgery Management surgery plus multidrug chemotherapy
- 20. Grading for Immature teratoma • Grade I Abundance of mature tissues, intermixed with loose mesenchymal tissue with occasional mitoses; immature cartilage; tooth anlage • Grade II Fewer mature tissues; rare foci of neuroepithelium with common mitoses, not exceeding three low-magnification (×40) fields in any one slide • Grade III Few or no mature tissues; numerous neuroepithelial elements, merging with a cellular stroma occupying four or more low-magnification fields.
- 22. • Arise from a single germ cell • may contain any of the three germ cell layers- ectoderm , mesoderm or endoderm • 3 categories • Mature teratoma- most common • Immature teratoma • Monodermal OVARIAN TERATOMAS
- 24. 1. Mature Cystic Teratoma- develops into a cyst, also called benign cystic teratoma or dermoid cyst 2. Mature Solid teratoma- elements formed into a solid mass 3. Fetiform teratoma- doll shape, as the germ cell layers display considerable normal spatial differentiation 3 Types of Benign Cystic Teratoma
- 25. • almost 20% of all ovarian neoplasms • most common ovarian tumor in childhood • 80-88% of cases are unilateral. • occasionally accompanied with hemolytic anemia or virilization • grossly: always usually multiloculated (Rosai) • cystic content: greasy, largely composed of keratin, sebum and hairs. Mature Cystic Teratoma
- 26. • -teeth are often present and tend to be located in a well-defined nipple-like structure covered with hair (Rokitansky's protuberance)--exhibits the greatest variety of tissue types- should be selected for microscopic examination • Other common tissue types: cartilage respiratory tissue, GI tissue Mature Cystic Teratoma
- 29. CAT IG Th
Hinweis der Redaktion
- Normal Ovarian stroma CT consisting of spindle shaped stroma cells Also contains Reticular fibers and collagen Tissue appears whorled bec of high number of cells
- Grading for Immature teratoma Grade I Abundance of mature tissues, intermixed with loose mesenchymal tissue with occasional mitoses; immature cartilage; tooth anlage Grade II Fewer mature tissues; rare foci of neuroepithelium with common mitoses, not exceeding three low-magnification (×40) fields in any one slide Grade III Few or no mature tissues; numerous neuroepithelial elements, merging with a cellular stroma occupying four or more low-magnification fields.