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case_images: Magnetic resonance imaging (MRI) of the pelvic cavity (T2-weighted image). The MRI suggested potential malignancy due to multiple cystic-solid masses (the largest one 7.6*6.6cm, yellow arrow) originating from the adnexal region, accompanied by intra-cyst bleeding.
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case_images: The magnetic resonance imaging suggested potential malignancy due to multiple cystic-solid masses originating from the adnexal region accompanied by intracyst bleeding ( Figure 1 ). Figure S1 ). Furthermore, Pearson correlation coefficients for signature features between the EU and CCOC were 0.9364 (P<0.0001), between the EU and EOC were 0.816 (P<0.0001), and between the EOC and CCOC were 0.8852 (P<0.0001) ( Supplementary Figure S1 ).
case_images: Hematoxylin-eosin staining in bilateral ovary tumors and endometrotic lesions. (A) The endometrioid adenocarcinoma in the left ovary with grade 2 (x20); (B) The borderline endometrioid adenocarcinoma area in the left ovary (x10); (C) The endometriotic area and atypical endometriotic area in the left fallopian tube (x10); (D) The clear cell carcinoma in the right ovary (x20); (E) The endometriotic lesion in the right ovary (x10).
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case_images: The left ovarian mass was consistent with ovarian endometrioid carcinoma that was moderately differentiated with large areas of necrosis, and the surrounding glands showed atypical endometriotic lesions and endometriotic lesions ( Figures 2A, B ). Ectopic endometrial glands and mesenchymal components were observed within the localized wall of the left fallopian tube tissue, consistent with endometriosis with focal ectopic glands with atypia ( Figure 2C ). The right ovarian mass was consistent with ovarian clear cell carcinoma and was surrounded by endometriotic cysts and corpus luteum cysts with haemorrhage ( Figures 2D, E ).
case_images: Immunohistochemistry (IHC) in bilateral ovary tumors and endometrotic lesions (x10). (A, B) Endometrioid ovarian cancer cells exhibited positive monoclonal expression of ER (+60%) and PR (+60%); (C, D) Clear cell ovarian cancer cells have no expression of ER, PR; (E) Clear cell ovarian carcinoma cells exhibited strong positive HNF-1beta expression; (F-H) Atypical endometriotic lesion, endometriotic lesions of left ovary and right ovary also showed positive expression of HNF-1beta.
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case_images: In particular, hepatocyte nuclear factor 1 beta (HNF-1beta) showed strong positive expression in the CCOC, positive expression in the atypical endometriotic lesions of the left ovary, and patchy expression in the endometriotic lesions of both ovaries ( Figure 3 ).
case_images: Pathway enrichment analysis revealed different gene pathways in eutopic endometrium (A), clear cell ovarian cancer (B) and endometrioid ovarian cancer (C). Twenty-nine gene pathways were identified enriched in both clear cell ovarian cancer and endometrioid ovarian cancer (D). The TGF-beta signaling pathway and lysine degradation pathway were uniquely enriched in endometrioid ovarian cancer and clear cell ovarian cancer, respectively (E).
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case_images: Pathway enrichment analysis revealed different gene pathways for the three samples ( Figures 4A-C ). Twenty-nine gene pathways involving oestrogen metabolism, age, angiogenesis, apoptosis, and tumorigenesis, among others, were identified as enriched in both the EOC and CCOC samples ( Figure 4D ). The TGF-beta signalling pathway and lysine degradation pathway were uniquely enriched in the EOC and CCOC, respectively ( Figure 4E ).