case_images: PMC6885789_01
case_images: Preoperative CT images of the right adnexal mass.
case_images: CRIPA2019-7894581.001.jpg
case_images: PMC6885789_01_CRIPA2019-7894581.001.jpg
case_images: fig1
case_images: A CT of the abdomen and pelvis demonstrated the complex mass containing internal calcification, fluid, fat and soft tissue (Figure 1).
case_images: (a) Low power view of teratoma showing skin, glandular epithelium, and cartilage. There is infiltration of malignant glands within the cyst wall (H&E x40). (b) Transition of benign squamous epithelium to dysplastic surface glandular epithelium and underlying invasive atypical glands with intraluminal dirty necrosis. (c) Invasive glands lined by intestinal-type epithelium and containing intraluminal necrosis. (d) Perineural invasion of infiltrating glands.
case_images: CRIPA2019-7894581.002.jpg
case_images: PMC6885789_01_CRIPA2019-7894581.002.jpg
case_images: fig2
case_images: The atypical glands were lined by pleomorphic cells with hyperchromatic enlarged nuclei and luminal dirty necrosis (Figures 2(a)-2(d)).
case_images: (a) CK20 is strongly positive in tumour. (b) CDX2 in strongly positive in tumour cell nuclei. (c) CK7 is patchy variable positive. (d) MUC-2 is strongly positive.
case_images: CRIPA2019-7894581.003.jpg
case_images: PMC6885789_01_CRIPA2019-7894581.003.jpg
case_images: fig3
case_images: Immunohistochemical staining showed the tumour cells were strongly positive for CK20, CDX2, focally positive for CK7 and negative for CD30, PAX-8, Vimentin, ER, PR, and CD10 (Figures 3(a)-3(c)). MUC-2 staining was also performed and showed cytoplasmic positivity in tumoural cells consistent with intestinal differentiation (Figure 3(d)).