Presentation
Progressive abdominal distension.
Patient Data
Large mid-line and right para-median pelvicoabdominal multilocular cystic mass lesion measuring about 16 x 24.75 x 23.5 cm along its maximum axial and CC dimensions respectively.
It elicits low T1 and bright T2/SPAIR signal.
It shows thin internal septations (measuring about 2 mm in thickness) with no evidence of papillary projection, soft tissue component or pathological enhancement.
The uterus is average in size, normal signal intensity of myometrium. The endometrium is hyperintense. Preserved junctional zone.
Inconspicuous both ovaries.
No pathologically enlarged abdominal or pelvic lymph nodes.
No free fluid is seen in the cul de sac.
Small umbilical hernia containing omentum.
Special thanks to Dr. Sherihan Fakhry, MD. Lecturer of Diagnostic and Interventional Radiology Department, Cairo University Hospitals.
Intra-operative surgical specimen.
Histopathology:
The examined sections revealed ovarian tissue showing fibrous cyst wall lined mainly by bland looking mucin secreting columnar epithelium and focal ciliated serous epithelium with areas of ulceration and hemorrhage.
No evidence of architectural complexity, cellular stratifications or atypia.
Diagnosis: right benign seromucinous cystadenoma.
Case Discussion
The case was diagnosed as right benign seromucinous cystadenoma.
Ovarian neoplasms can be divided into epithelial tumors, germ cell tumors, sex cord-stromal tumors, and metastatic tumors.
Epithelial tumor is the most common one and represents about 60% of all ovarian tumors.
Serous and mucinous cystadenomas are the commonest type of ovarian epithelial neoplasm. The peak incidence is at the 4th to 5th decades of life.
Serous cystadenoma tends to uni-locular and smaller than the mucinous cystadenoma.
Homogenous internal contents, thin regular walls and septae, and absence of soft tissue components favor benign nature.