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Mature cystic teratomas (dermoid cysts) of the ovary are very rarely associated with androgen production. The source of androgens in these cysts may be tumours such as Sertoli–Leydig cell tumour or Leydig cell hyperplasia. In this study, we present a case of virilisation in a postmenopausal female patient, where Leydig cell hyperplasia in a mature...
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Context 1
... pelvic pain, with ovaries left in situ. Total blood count showed mild erythrocytosis and slightly increased Haematocrit (Htc) and Haemoglobin (HB) (Rbc = 5.25 (10 12 /L), Hct = 48.2%, HB = 159 g/ l (120-150)), with all other values within normal limits. CT of abdomen and pelvis with contrast reported a minimally complex 5 cm right ovarian cyst (Fig. 1). Both adrenals had normal morphology. Simple hepatic cysts and a small left renal calculus were also noted. The patient's serum markers were HCG=<1.2 IU/L (<5), Testosterone = 37.0 nmol/L (0.1-1.4), Alpha-fetoprotein 6.7kU/L (0.0-10.0) and CA125 = 5.8ku/L (0.0-35.0). The patient underwent laparoscopic bilateral salpingo-oophorectomy ...
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... view of the unusual morphology and CDK4 positivity in the adipose tissue (Fig. 3), fluorescence in situ hybridization (FISH) analysis for MDM2 gene amplification was performed using the Vysis MDM2/CEP 12 FISH Probe, Abbot Diagnostic. Although MDM2 gene amplification is not entirely specific for ALT, it has been used successfully as an adjunctive tool for ALT diagnosis (Thway et al., 2015). The results showed no evidence of amplification, and the features were regarded as benign adipocytic differentiation within an androgen secreting teratoma. ...
Citations
Mature cystic teratomas are benign tumours of the ovary but rarely certain unusual gross and microscopic findings might complicate
their diagnosis or may have an impact on their clinical outcome. Here, we are presenting a case series of five unusual pathological
presentations of mature cystic teratomas of ovary. Out of five cases, three cases were of collision tumours, in which combination of
mature cystic teratoma is seen with mucinous cystadenoma in two cases, and with serous cystadenoma in one case. True collision
tumours are defined as histologically distinct neoplasms in the same tissue or organ without any histologic admixture or intermediate
cell population zone between two components. These tumours are located in various organs but ovarian location is rare. Mature cystic
teratoma is the most common component of collision combinations in the ovary. All classes of ovarian tumours, benign, borderline and
malignant may collide and therefore, clinical outcomes in collision tumours depend on individual tumour characteristics. The fourth
case was of a mature cystic teratoma associated with a distinct haemangiomatous component. Mature cystic teratoma associated with
prominent haemangiomatous component is a very rare finding with only few case reports in the literature and it should be differentiated
from true ovarian haemangioma, lymphangioma, and angiosarcoma. The fifth case was of bilateral mature cystic teratomas associated
with a well-defined lipomatous lesion in right sided mature cystic teratoma mimicking lipoma. Lipomatous ovarian lesions are very
rare and mature cystic teratoma with prominent adipocytic proliferation is also an exceedingly uncommon finding and it should be
differentiated from true ovarian lipoma and other atypical lipomatous proliferations. Most of these tumours remain clinically and
radiologically unrecognised, therefore their histological recognition is essential for adequate patient management.
