The first case of Anti-N-methyl-d-aspartate receptor encephalitis (Anti-NMDAR encephalitis) associated with ovarian mucinous cystadenoma: A case report

ObjectiveAnti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune and paraneoplastic encephalitis caused by the N-methyl-d-aspartate receptor antibody which is related to tumors, such as teratomas of the ovaries. To our knowledge, this is the first reported case of Anti-NMDAR encephalitis associated with ovarian mucinous cystadenoma.Case reportA 23-year-old woman with a flu-like illness, confused mental status, and behavioral changes presented to the hospital. A right-sided ovarian tumor was detected during the work-up and was suspected to be a teratoma that might have caused the encephalitis. A laparoscopic right salpingo-oophorectomy (RSO) was performed. Histopathological examination revealed a mucinous cystadenoma. She recovered gradually and had complete resolution of symptoms after surgical removal of the mucinous cystadenoma and immunotherapy.ConclusionEven though anti-NMDAR encephalitis is caused by ovarian teratoma because it contains various types of tissues, ovarian tumors in anti-NMDAR encephalitis may not be limited to ovarian teratomas.     

Ovarian mucinous cystadenoma with leiomyomatous mural nodule

A case of an ovarian mucinous cystadenoma with a leiomyomatous mural nodule is described. The diagnosis was confirmed by immunohistochemical methods. This is the first report of a mural nodule of leiomyomatous nature, thus widening the histologic spectrum that may be encountered in these lesions.     

A case of torsion of a mucinous cystadenoma in triple-X syndrome with pure gonadal dysgenesis

Triple-X female characterized by primary amenorrhea and pure gonadal dysgenesis is extremely rare. We present a patient of triple-X syndrome who has not had menarche or the development of the secondary sexual characteristics. She had a hypoplastic uterus and streaked gonads on both sides with a twisted mucinous cystadenoma in the right adnexa.     

Primary ovarian mucinous carcinoid tumor: A case report and review of literature

ObjectiveOnly a few cases of primary ovarian mucinous carcinoid tumor have been documented in the literature till date. We present a case of primary ovarian mucinous carcinoid tumor, atypical type, and review the reported cases.Case reportA 33-year-old woman with a left ovarian tumor was diagnosed with primary ovarian mucinous carcinoid tumor, atypical type. She underwent left salpingo-oophorectomy and ipsilateral lymph node dissection. After 5 years, the tumor recurred on the right side, with large para-aortic lymphadenopathy that caused hydronephrosis. Complete surgical staging was performed, followed by nine cycles of weekly paclitaxel and gemcitabine. The tumor progressed after discontinuing the chemotherapy, and the patient died of disease 26 months after recurrence.ConclusionOur patient demonstrated a more aggressive clinical course compared to that reported in previous literature. Based on this experience, complete surgical staging is highly recommended after the patient accomplished her fertility plan. Ovarian carcinoid tumors are relatively chemoresistant compared with epithelial ovarian cancers. The regimen of weekly paclitaxel and gemcitabine stabilized the disease but did not reach remission of the tumor. Further studies are required to determine the appropriate chemotherapy regimen.     

Laparoscopic management of a large recurrent benign mucinous cystadenoma of the ovary

Introduction Benign mucinous cystadenomas account for 15% of all ovarian neoplasms and up to 80% of all mucinous tumors. Laparoscopy has become an accepted method of management for ovarian cysts and its role is expanding as large benign adnexal masses more than 10 cm can be managed safely and effectively. Case report We report a 25-year-old nulliparous lady with a huge benign mucinous cystadenoma managed by laparoscopic cystectomy, followed by an early recurrence within 2 months. Left salpingo-oophorectomy was performed on a repeat laparoscopy due to suspicion of malignancy on ultrasound. Pathology revealed a benign cyst. Conclusion Since mucinous tumors are usually benign and multilocular, management of young patients is challenging, especially in the case of recurrence which is very rare.     

Voluminous mucinous cystadenoma of the ovary in a 13-year-old girl

BACKGROUND: Mucinous cystadenoma of the ovary constitutes about 15% of ovarian tumors. It is more common in women between 20 and 40, but is rare in teenagers and exceptional in pre-menstrual girls. Malignant transformation is possible in 5-10% of cases. Spontaneous or iatrogenic breaks are more common. It makes the different diagnosis of pseudomixoma peritonei more difficult. CASE REPORT: A 13-year-old girl came to the National Cancer Institute "Regina Elena" of Rome, with increasing abdominal distension over 2 months. The abdominal mass was removed and a left salpingo-oophorectomy was performed. Histological examination of the mass revealed a 40-cm diameter mucinous cystadenoma of the ovary. CONCLUSION: The rapid enlargement of the ovarian mass, the young age and the difficulty of certain pre-operative diagnosis, make this case interesting. Management of this pathology and fertility-conserving treatment need careful follow-up because of the possibility of recurrence in the remaining ovary.     

A Huge Ovarian Mucinous Cystadenoma in a 15-Year-Old Girl with Situs Inversus Totalis: Report of a Rare Case

BackgroundOvarian mucinous cystadenomas with situs inversus totalis are infrequent in pubertal girls. Surgical techniques on their treatment without affecting ovary anatomical and physiological function have always been a great challenge.CaseA 15-year-old girl presented with abdominal distension and pain due to some huge growths. Computed tomography imaging showed that the heart and whole abdomen viscera were inversely located. Two big low-density masses were found in the abdominopelvic cavity. An exploratory laparotomy was performed and 2 tumors were removed. Pathology confirmed a mucinous cystadenoma.Summary and ConclusionOvarian mucinous cystadenomas with situs inversus totalis can be detected with detailed physical and radiological examination. For adolescent female patients, particular attention should be paid to protect the reproductive anatomical structure during surgery.     

Removal of enormous bilateral mucinous cystadenomas of the ovaries with abdominal plastic reconstruction

Introduction  Bilateral mucinous cystadenoma of the ovary are extremely rare. These tumors are benign and might lead to abdominal distension, if no secondary symptoms occur and patient delay the consultation of physicians. Case  A 60-year-old patient was admitted to the internal medicine department for constipation and dyspnoea. Transabdominal punctions were performed because of suspected ascitis. Finally the patient was transferred to the gynecological department after forced diuresis did not reduce the suspected ascites and a CT scan showed large intraabdominal masses. Tumor excision was initiated and final histology revealed bilateral mucinous cystadenoma of the ovaries. Discussion  Huge intraabdominal tumors that almost double a patient’s body weight can hardly be malign. Total tumor excision is necessary because the heterogeneous composition requires careful examination by pathologists to rule out borderline tumors and non-invasive carcinomas. After tumor excision an abdominal wall reconstruction might be necessary because of the laxity and redundancy of the skin.     

Ovarian Masses: Changing Clinico Histopathological Trends

Objective

To study the clinical and histopathological presentation of ovarian masses.

Method

Retrospective analysis of 205 cases from May 2009 to June 2013.

Results

Incidence of ovarian masses was 6.9 %. Among 205 cases, 68 % were neoplastic. Among the neoplasms, 87.8 % were benign, 10 % malignant, and 2.2 % borderline. Mean ages of malignant and benign neoplasm were 41 and 39 years, respectively. 42.9 % malignant tumors presented with non-specific abdominal and constitutional symptoms. Serous cystadenoma was the commonest benign tumor (67 %) followed by Mucinous (19 %) and Dermoid (11.6 %). Most common malignant ovarian tumor was Serous cystadenocarcinoma (42.9 %). Out of the malignant cases, all were primary except one secondary deposit from Non-Hodgkin’s Lymphoma. Only 28.6 % presented at stage I, remaining presented at stage III/IV.

Conclusion

Ovarian neoplasms have twice the incidence of non-neoplasms. Mean age of malignant tumors is decreased. Rising trend in Mucinous cystadenoma is noted.

     

Ovarian mucinous cystic tumor of borderline malignancy with a mural nodule of anaplastic spindle cell carcinoma: a case report

Ovarian cystic tumors with a mural nodule are a rare entity. We report a case of a mural nodule of anaplastic spindle cell carcinoma in an ovarian mucinous cystic tumor of borderline malignancy. The patient was a 45-years-old Japanese woman who presented with an ovarian cyst. She suffered from mature cystic teratoma of both ovaries 9 years before the present history. Image analysis and laboratory data showing a high serum CA19-9 level suggested ovarian malignancy. She underwent bilateral salpingo-oophorectomy with hysterectomy and omentectomy. There was a mural nodule in the ovarian mucinous cystic lesion. Microscopically, the nodule was composed of spindle-shaped cells with severe nuclear atypia. Immunohistochemical analysis allowed the cells to be categorized as anaplastic spindle cell carcinoma. Fifteen months after the operation the patient is alive without any clinical findings of tumor recurrence. To the best of our knowledge in the English literature, this is the first report of a mural nodule of an anaplastic spindle cell carcinoma within an ovarian mucinous cystic borderline tumor harboring previously confirmed cystic teratoma.     

Recurrent mucinous cystadenoma: a laparoscopic approach

The second most common epithelial tumor of the ovary is mucinous-type, and it constitutes 8–10% of all ovarian tumors. The recurrence of mucinous cystadenoma is very rare after complete excision. Only four such cases have been reported till date. The case presented in this report is the fifth, who had her initial surgery performed by gynecologic oncology team by laparotomy and was followed up by the same group. After recurrence at the same ovary, the patient underwent laparoscopic evaluation and unilateral salpingoophorectomy was performed. The final histopathological diagnosis was mucinous cystadenoma, just the same as the initial cyst.     

Carcinosarcoma-like mural nodule in intestinal-type mucinous ovarian of borderline malignancy: a case report

Epithelial ovarian tumors of borderline malignancy are tumors with histologic features and biologic behavior between benign and frankly malignant epithelial ovarian neoplasms. To date, we cannot accurately predict the patients who are prone to an aggressive course of disease. Here, we present a 35-year-old patient with carcinosarcoma-like mural nodule in intestinal-type mucinous ovarian tumor of borderline malignancy. Foci of intraepithelial carcinoma (about 10%) without stromal invasion are also noted. Total hysterectomy, bilateral salpingo-oophorectomy, appendectomy, and omentectomy were performed, and the frozen pathology during operation showed mucinous tumor of borderline malignancy of left ovary on April 18, 2002. The patient was followed at our outpatient department for 19 months after operation and was free of the disease without any adjuvant chemotherapy. It is difficult to determine whether intestinal-type borderline mucinous tumors with intraepithelial carcinoma are associated with a worse prognosis compared with those with epithelial atypia alone due to disparate results in the published literature. In contrast, most patients with mural nodules of anaplastic carcinoma have had a malignant, often rapid, course. However, too few cases of carcinosarcoma-like mural nodule in mucinous tumor have been published to warrant a conclusion regarding their prognosis.     

Giant mucinous cystadenocarcinoma: a case report

We present a mucinous cystadenocarcinoma weighing 10 kg in a postmenopausal woman and the way how we managed the case. Received: 7 December 2001 / Accepted: 29 December 2001 Correspondence to N. K. Kuşcu     

Retroperitoneal primary mucinous adenocarcinoma with a mural nodule of anaplastic tumor: a case report and literature review.

A 38-year-old female presented with a lower abdominal mass. During the operation the mass was found to be retroperitoneal and was excised. Gross examination revealed a mucin-containing cystic lesion with a mural nodule. On microscopic examination, the cystic areas were lined by an invasive mucinous adenocarcinoma and the nodule was composed of an anaplastic sarcomatoid tumor that was immunoreactive for cytokeratin. This present case is the 21st example of a retroperitoneal primary mucinous cystadenocarcinoma and the fourth with a mural nodule. Three of four cases with a mural nodule, including our case, had a rapidly fatal outcome.     

Massive ovarian edema associated with ovarian serous cystadenoma: a case report and review of the literature

Abstract.   Khalbuss WE, Dipasquale B. Massive ovarian edema associated with ovarian serous cystadenoma: a case report and review of the literature. Int J Gynecol Cancer 2006; 16(Suppl. 1): 326–330.
Massive ovarian edema is a rare entity that can be confused with an ovarian neoplasm. A few ovarian lesions have been reported that are associated with massive ovarian edema. This article describes the first case of an ovarian serous cystadenoma associated with a massive ovarian edema. The patient was a 17-year-old female who was referred to the emergency room because of lower abdominal pain. Subsequent ultrasound and computed tomography scanning studies revealed an abdominopelvic cystic mass suggestive of an ovarian neoplasm. She underwent an exploratory laparoscopy, and a left salpingo-oophorectomy was performed. The specimen weighed 1610 g and consisted of a cystic mass measuring 17 × 15 × 8 cm attached to a solid mass measuring 13 × 11 × 4 cm. Microscopy revealed a cystic and a solid lesion. The cystic structure was composed of a flat or cuboidal single-layer lining showing ciliated epithelium and focal areas of papillary structures compatible with a diagnosis of ovarian serous cystadenoma. The solid mass had an intact capsule and diffuse interstitial edema, preserving the overall structure of the ovary and sparing the outer cortex. These findings are compatible with the diagnosis of ovarian massive edema. This report of an association of serous cystadenoma with massive ovarian edema broadens the histologic spectrum in which a massive ovarian edema may be encountered.     

Giant benign mucinous cystadenoma growing during pregnancy: a case report

A 32-year-old woman, gravida 4, para 2, was diagnosed with a benign right ovarian mucinous cystadenoma. It was diagnosed in the tenth week of pregnancy, measured 47 x 69 mm, and reached 190 x 152 mm at 23 weeks of gestation. Laparotomy was performed and the ovarian cystic mass was removed in the second trimester. The patient had postoperative tocolytic therapy and progesterone medication. She is at the 35th gestation week and no other antenatal complication has been reported. A case of giant mucinous cystadenoma is presented with clinical follow-up details.     

Prognostic significance of lymphadenectomy and prevalence of lymph node metastasis in clinically-apparent stage I endometrioid and mucinous ovarian carcinoma

Objective

The aim of the present study was to investigate the prevalence of lymph node (LN) metastasis in women with apparent stage I ovarian carcinoma of endometrioid or mucinous histology and to examine the prognostic significance of LN sampling/dissection (LND) on patient survival.