case_images: PMC7193213_01
case_images: A 40-year-old female underwent a pelvic ultrasound for abnormal uterine bleeding. Axial (a and b) and sagittal (c) ultrasound images demonstrate an incidental complex left adnexal lesion with a solid component demonstrating diffuse hypoechogenicity (long arrow) and posterior shadowing (curved arrow) in addition to punctate echogenic calcifications (short arrow) with internal Doppler enhancement.
case_images: JCIS-10-22-g001.jpg
case_images: PMC7193213_01_JCIS-10-22-g001.jpg
case_images: F1
case_images: Initial ultrasound imaging identified a complex solid and cystic 5 cm left adnexal mass with the solid component representing the dominant portion of the lesion [Figure 1].
case_images: A 40-year-old female with an incidental left adnexal lesion on ultrasound underwent subsequent computed tomography (CT) imaging. Axial (a and b), coronal (c), and sagittal (d) CT images demonstrate an enhancing solid (long arrow) and cystic (curved arrow) left adnexal mass with thinly septated amorphous and punctate calcifications (short arrow).
case_images: JCIS-10-22-g002.jpg
case_images: PMC7193213_01_JCIS-10-22-g002.jpg
case_images: F2
case_images: A subsequent computed tomography confirmed the findings of an enhancing solid and cystic mass in the left adnexa [Figure 2].
case_images: A 40-year-old female with an incidental left adnexal lesion on ultrasound underwent subsequent magnetic resonance imaging (MRI). Axial T1 (a), T1 fat saturation (b), T2 (c), axial (d), coronal (e), and sagittal post-gadolinium MRI sequences demonstrate an enhancing cystic (anterior) and solid (posterior) lesion (d-f, long arrow) with mild T1 hyperintensity of the cystic component (a and b, curved arrow) and markedly T2 hypointensity of the dominant solid fibrous component (c, short arrow). No central necrosis was present.
case_images: JCIS-10-22-g003.jpg
case_images: PMC7193213_01_JCIS-10-22-g003.jpg
case_images: F3
case_images: Following this, an magnetic resonance imaging (MRI) was performed [Figure 3].
case_images: A 40-year-old female underwent surgical excision of an incidental left adnexal lesion. Hematoxylin and eosin stain (50x) of the surgical specimen is demonstrated. Nests of transitional- type epithelium within a fibrous stroma characteristic for Brenner tumor were present (left) in association with a cystic tumor showing a single row of uniform mucin-rich columnar cells with basal nuclei lining glands and cysts characteristic for mucinous cystadenoma (right). The microscopic appearance correlated with macroscopic features of both solid and cystic areas within the tumor.
case_images: JCIS-10-22-g004.jpg
case_images: PMC7193213_01_JCIS-10-22-g004.jpg
case_images: F4
case_images: Corresponding histopathology confirmed the solid component consisted of transitional-type epithelium within a fibrous stroma characteristic of Brenner tumor and the cystic tumor showed a single row of uniform mucin-rich columnar cells with basal nuclei lining glands and cysts characteristic for mucinous cystadenoma [Figure 4].