case_images: PMC11822274_01
case_images: A 51-year-old female with a primary ovarian carcinoid and two bilateral mature cystic teratomas.. A-C. Serial axial contrast-enhanced CT images show two fat-density mass lesions in both adnexa uteri (arrowheads, A, B), a 5 cm x 4.2 cm x 5 cm heterogeneous enhancing solid mass (arrow, C) at the anterior portion of the uterus (U), and two mild homogeneous enhancing mass lesions, representing leiomyomas (L).. D. Axial turbo spin-echo T2-weighted image (left upper) shows a mass (arrows) with central high signal intensity and peripherally low intensity. Axial T1-weighted (middle upper) and axial contrast-enhanced T1-weighted DIXON images (right upper) show peripheral solid portion with homogeneous contrast enhancement similar to that of the uterus (U). The diffusion-weighted image (b-value = 1000 s/mm2) (left lower) shows a high signal intensity, and the ADC map (right lower) shows a low ADC value in the peripheral solid portion.. E. The gross specimen shows a central cystic component and a peripheral yellowish-grey soft fibrotic tumor (arrow). Adapted from Choi et al. Medicine (Baltimore) 2023;102:e34391.. F. On microscopic examination (H&E stain, x 3) (left) of the ovarian mass, tumor cell nests are surrounded by thick fibrotic stroma (left, below the black line). The remaining normal ovary and ovarian capsule are shown (left, above the black line). The periphery of the tumor is cellular, and the center is cystic (left, arrow). Microscopic examination (H&E stain, x 56) (right) shows a mature cystic teratoma (right, inside the black circle). The cyst wall has no epithelial lining cells but contains hair (right, dotted arrow).. ADC = apparent diffusion coefficient, DIXON = water-selective fat saturation method, H&E = hematoxylin and eosin
case_images: jksr-86-166-g001.jpg
case_images: PMC11822274_01_jksr-86-166-g001.jpg
case_images: F1
case_images: Serial abdominopelvic CT revealed two, bilateral, adnexal, fat-density mass lesions (Fig. 1A, B). Additionally, a heterogeneous enhancing solid mass measuring 5 cm x 4.2 cm x 5 cm was observed at the anterior portion of the uterus (Fig. 1C). T2-weighted images (T2WI) (Fig. 1D). The peripheral solid portion showed homogeneous contrast enhancement similar to that of the uterus (Fig. 1D), demonstrated a high signal intensity on high-b-value (b = 1000) diffusion-weighted imaging, and a low apparent diffusion coefficient (ADC) value on the ADC map, indicating moderate diffusion restriction. Gross examination revealed a central cystic component and a peripheral yellowish-grey soft and fibrotic tumor (Fig. 1E), coexisting with one mature cystic teratoma. Tumor cell nests were surrounded by abundant fibrotic stroma and blood vessels (Fig. 1F). A unilocular cyst was observed in the remaining right ovary (Fig. 1F).