MEETING No 47 HELD ON NOVEMBER 13th, 2002 AT THE SAN RAFFAELE HOSPITAL - MILAN

Case 1
Case 2
Case 3
Case 4
Case 5
Case 6

Case 4


"OVARIAN MASS"
S. CRIPPA – Desio Hospital
(pict. by dr. Crippa)

Clinical history: an 82y.o. woman undergoes surgery for a large ovarian mass with multiple peritoneal metastases.
Macroscopical description: an 8 cm mass, which on cut section, consists of greyish tissue with necrotic areas. Macroscopically there is no residual ovarian tissue.
Microscopical description: the tumour shows trabecular architecture with central necrosis and pushing margins (pict. 1 - pict. 2).
At high power it consists of medium and small size cells with scanty cytoplasm and small nuclei, sometimes elongated, with irregular and hyperchromatic chromatin, always without nucleoli. The mitotic index is very high (pict. 3 - pict. 4 - pict. 5 - pict. 6).
At the periphery of the lesion residual ovarian parenchyma is recognized (pict. 7 - pict. 8).
With immunohistochemical staining the neoplastic cells are positive for Cytokeratin 7 (pict. 9), CA 125 (pict. 10), Chromogranine (pict. 11), Synaptophysin (pict. 12), focally positive for CEA and negative for CK 20.

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10
pict. 11	pict. 12

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