Presentation
Lower abdominal distension, irregular menstrual cycles and intermittent pelvic pain since 6 months.
Patient Data
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There is a solid-cystic mass in the lower abdominal-pelvic region is not seen separately from the left ovary. It is of variable signal intensity with multiple solid areas noted within it. Central areas of fluid are seen.
It causes downwards eccentric impingement on the urinary bladder and uterus. The bowel loops are peripherally displaced.
No suspicious lymphadenopathy.
Special thanks: Dr. H.K.Anand
The patient went on to have a resection.
Gross pathology:
The intra-operative specimen showed solid mass with myxoid and hemorrhagic areas. No capsular breach
Histopathology:
Revealed yolk sac tumor, predominantly exhibiting a polyvesicular vitelline pattern. In addition, endometroid like and reticular patterns also seen.
Case Discussion
This is a case of ovarian germ cell tumor/yolk sac tumor, a very rare but aggressive type of malignancy.
In cases of large abdomino-pelvic masses, the radiologist must try to include in the report, the origin of mass, morphological characteristics, anatomical plane extension and also if any suspicious or evident nodes/metastasis.
Closest differentials can be mentioned in diagnostic dilemma masses.