case_images: PMC10536256_01
case_images: Pelvic CT showed huge mass in the right adnexal area (A); chest (lung) CT showed nodule in the lower lobe of the right lung (B); 18F-FDG PET-CT showed that the right pelvic cystic solid mass and the mass uptake of FDG increased obviously, SUVmax = 22.8 (C,D); 18F-FDG PET-CT showed that the hypermetabolic nodule in lower lobe of right lung, SUVmax = 3.8 (E).
case_images: fsurg-10-1278076-g001.jpg
case_images: PMC10536256_01_fsurg-10-1278076-g001.jpg
case_images: F1
case_images: Tomography (CT) scans, both non-contrast and contrast-enhanced, identified a conglomerate cystic-solid mass of mixed density located in the right pelvic region (Figure 1A). Tomography (CT) scans, both non-contrast and contrast-enhanced, revealed the presence of a solid nodule within the subpleural posterior basal segment of the right lower lobe (Figure 1B). This nodule, characterized by spiculated margins and exhibiting signs of pleural retraction, measured approximately 1.1 cm x 0.9 cm. Tomography/Computed Tomography (PET/CT) scan reveals a complex cystic-solid mass in the right pelvic region (Figures 1C,D). The mass measures approximately 5.7 cm x 7.8 cm and exhibits a maximum Standardized Uptake Value (SUVmax) of 22.8, a pattern suggesting the strong possibility of ovarian carcinoma. The scan also identifies a solid nodule in the subpleural posterior basal segment of the right lower lobe (Figure 1E).
case_images: Pathology of the right adnexa showed metastatic adenocarcinoma, mainly solid adenocarcinoma, a few micropapillary carcinoma, pulmonary origin (A); pathological picture of uterus and left adnexa, pelvic cavity lymph node, right pelvic cavity lymph node, para-aortic lymph node and part of omentum majus after radical total hysterectomy and double adnexectomy, there was no metastasis (B); pathology of the nodule in the lower lobe of the right lung showed invasive adenocarcinoma of the lung, the micropapillary pattern (MPP) accounts for approximately 3% (C); pathological picture of examined cancer metastatic lymph nodes (group 7 1/1, group 9 0/1, group 10 0/1) (D).
case_images: fsurg-10-1278076-g002.jpg
case_images: PMC10536256_01_fsurg-10-1278076-g002.jpg
case_images: F2
case_images: The composite of immunohistochemical markers substantiated the classification as metastatic adenocarcinoma, chiefly TTF-1 and NapsinA positive, solid in nature with trace micropapillary features, pinpointing the lung as the neoplastic source (Figure 2A). Pathology after surgery showed no carcinomatous component in the uterus and the left adnexa, pelvic cavity lymph node, right pelvic cavity lymph node, para-aortic lymph node and part of omentum majus (Figure 2B). Paraffin-embedded pathology examination corroborated the manifestation of invasive adenocarcinoma, with salient features including airspace dissemination and extensive affliction of the pulmonary pleura, bronchioles, and nerve structures (Figure 2C). Lymph node pathology presented metastatic infiltration in the seventh group of lymph nodes (Figure 2D).