Monday, May 20, 2013

Sunny Side Up

An 18 year old previously healthy woman has several months of an enlarging abdomen; one day, she presents with acute onset severe abdominal pain. She is found to have an ovarian mass which is removed. This is the histopathology:


The gross pathology is shown below. The tan, fleshy portion (green arrow) makes the diagnosis.

Challenge: What is it?

First image shown under GNU Free Documentation License; second image shown under Fair Use.

3 comments:

sibogox said...

dysgerminoma?

Alex said...

i have no idea how to interpret histo.. thinking its a brenner tumor or maybe fibrothecoma.. since no cystic elements.

Craig Chen said...

yes - funny how we spend so much of the first two year of medical school looking at histo and rarely use it
-
Sunny Side Up

This is a dysgerminoma, an uncommon but malignant ovarian neoplasm. The histopathology with undifferentiated germ cells, large vesicular cells with clear cytoplasm, well-defined boundaries, and centrally placed regular nuclei are often described as “fried eggs.” On pathology, the yellow arrow shows the bisected Fallopian tube; the green arrow shows the neoplasm, and the white arrow shows a hemorrhagic component (unusual).

Sources: UpToDate; Wikipedia; radiology.uchc.edu.