MEETING No. 31, MANTUA HOSPITAL, MAY 19th, 2001

Case 1
Case 2
Case 3
Case 4

Case 3

"OVARIAN MASS"
C. GALLI - Niguarda Hospital
(pict. by dr. Faravelli)

Clinical history: a 70y.o. woman has a routine abdominal ultrasound before undergoing cardio-surgery for mitral valve pathology. The ultrasound shows a 10cm ovarian mass, which is removed.
Macroscopically the lesion is yellowish and smooth, with dishomogeneous and necrotic appearance, cut section.
During the surgical operation no other abdominal or extra-abdominal masses are seen.
Microscopic description: the tumor consists of nests and cords of epithelioid cells, which tend to form pseudo-lumen ( pict. 1 - pict. 2 - pict. 3).
The cells have large cytoplasm and atypical nuclei ( pict. 4 - pict. 5).
There are numerous atypical mitoses.
The immunohistochemical staining show a strong positivity for Cytokeratin 7 ( pict. 6), Ca125 ( pict. 7) and Inhibin ( pict. 8) and a weak positivity for Alfa 1 anti-trypsin ( pict. 9); Cytokeratin 20 and AFP are negative.
Differential diagnosis:
- poorly differentiated carcinoma
- poorly differentiated granulosa cell tumor
- poorly differentiated carcinoma
- meta-mesonephric carcinoma (Am. J. Surg. Pathol. 2001)

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9

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