case_images: PMC5822781_01
case_images: (a) Macroscopic findings: an irregular, white, and solid tumor of the right ovary. ((b)-(d)) Microscopic findings. (b) Tumor cells are round to ovoid with hyperchromatic nuclei, scant cytoplasm, abundant mitosis, and apoptosis with conspicuous necrosis (hematoxylin-eosin stain (HE), x300). (c) Endometrial carcinoma grade 1 in uterine corpus (HE, x30) with less than half myometrial invasion and no vascular invasion. ((d), (e)) Tumor cells are positive for synaptophysin and neuron-specific enolase (immunostaining, x300).
case_images: CRIOG2018-4383216.001.jpg
case_images: PMC5822781_01_CRIOG2018-4383216.001.jpg
case_images: fig1
case_images: She underwent an urgent laparotomy, which revealed that a white and solid tumor of the right ovary had spontaneously ruptured in the intra-abdominal cavity (Figure 1(a)). The pathological diagnosis was SCOCPT (Figure 1(b)) and grade 1 endometrioid carcinoma of the uterine corpus (Figure 1(c)).
case_images: (a) Enhanced abdominal computed tomography (coronal section) reveals the remaining tumor is approximately 20.3 cm in diameter before irradiation. (b) After radiation therapy, the tumor size decreased to 15.3 cm.
case_images: CRIOG2018-4383216.002.jpg
case_images: PMC5822781_01_CRIOG2018-4383216.002.jpg
case_images: fig2
case_images: A total dose of 26 Gy was given in 13 fractions, and the tumor size decreased to 15.3 cm with improved symptoms (Figure 2).
case_images: The graph shows the time course of the levels of serum lactate dehydrogenase (LDH), cancer antigen 125 (CA125), and neuron-specific enolase (NSE). The patient underwent surgery (S) on day 21; chemotherapy (C) on days 43, 65, and 86; and abdominal irradiation (R) from day 120 to day 140. She died on day 157 (D). The solid line shows levels of LDH, the dashed-line shows levels of CA125, and the dashed-dotted line shows levels of NSE.
case_images: CRIOG2018-4383216.003.jpg
case_images: PMC5822781_01_CRIOG2018-4383216.003.jpg
case_images: fig3
case_images: During the course of treatment, serum LDH levels repeatedly decreased soon after the chemotherapy but increased during drug holidays (Figure 3).