case_images: PMC11208801_01
case_images: Preoperation and operation specimen. (a) Abdominal computed tomography scan on admission showed a left ovarian tumor which was 6 cm in diameter and contained high-density lesion. Magnetic resonance imaging of the abdomen at initial diagnosis: (b) the high-intensity lesion using T1-weighted images became (c) low-intensity on fat-suppression. (d)The tumor contained fluid, cartilage, skin, and skin appendage, and it was pathologically diagnosed as a mature cystic teratoma.
case_images: CRIOG2024-2223281.001.jpg
case_images: PMC11208801_01_CRIOG2024-2223281.001.jpg
case_images: fig1
case_images: Computed tomography showed a left ovarian tumor (6 cm in diameter) without lymphadenopathy or obvious hepatosplenomegaly (Figure 1(a)). Magnetic resonance imaging revealed a suspected mature cystic teratoma (Figures 1(b) and 1(c)). The tumor was pathologically diagnosed as a mature cystic teratoma (Figure 1(d)), and microscopic examination did not reveal any cells indicative of hematological malignancies within the tumor.
case_images: Clinical course of the disease.
case_images: CRIOG2024-2223281.002.jpg
case_images: PMC11208801_01_CRIOG2024-2223281.002.jpg
case_images: fig2
case_images: Four months after surgery, both the DAT and IAT results were negative (Figure 2).
case_images: Additional laboratory investigation. (a) The lanes indicate albumin, alpha1 globulin, alpha2 globulin, beta1 globulin, beta2 globulin, and gamma globulin from left. IAT of the mature cystic teratoma contents revealed stronger aggregation observed at all concentrations of the tumor contents (ranging from 10 to 10,000) compared with the patient's serum. Lanes 1 to 4 show the IAT of the mature cystic teratoma contents, and lanes 5 to 8 present that of the patient's serum. Lanes 1 to 4, or 5 to 8 indicate the dilution with normal saline as 1 : 10, 1 : 100, 1 : 1000, and 1 : 10000 from left, respectively. (b) The protein fraction of the tumor contents showed an increase in the gamma-globulin and beta1-globulin fraction; (c) no increase was observed in the gamma-globulin and beta1-globulin fraction of the patient's serum harvested before. (d) Immunofixation electrophoresis of the tumor contents showed IgG-kappa M protein.
case_images: CRIOG2024-2223281.003.jpg
case_images: PMC11208801_01_CRIOG2024-2223281.003.jpg
case_images: fig3
case_images: The IAT performed on the contents of the mature cystic teratoma showed agglutination at all tested dilutions of the tumor extract (ranging from 1 : 10 to 1 : 10,000), a reaction more pronounced than that observed with the patient's own serum (as depicted in Figure 3(a)). The protein fraction of the tumor contents showed an increase in the beta1-globulin fraction and a slight increase in the gamma-globulin fraction (Figure 3(b)), which was not observed in the patient's serum harvested before treatment (Figure 3(c)). Furthermore, immunofixation electrophoresis of the tumor contents revealed monoclonal antibodies of IgG-kappa type (Figure 3(d)).