Microcystic stromal tumor resected by laparoscopic surgery

Huge Ovarian Microcystic Stromal Tumor Presenting As Acute Abdomen in a Patient With Familial Adenomatous Polyposis: A Case Report With Magnetic Resonance Imaging Findings

Microcystic stromal tumors (MCST) are rare sex cord-stromal tumors with distinctive microcystic features and stromal tumor immunophenotypes. Few reports have discussed MCST from the perspective of magnetic resonance imaging (MRI). In this report, we describe the MRI findings of MCST, review our case, and discuss it based on previous reports. A 24-year-old female with a history of familial adenomatous polyposis (FAP) presented to the emergency department with complaints of lower abdominal pain. A plain abdominal computed tomography scan revealed a huge ovarian tumor measuring 19 cm. MRI revealed an isointense ovarian tumor on T1-weighted images and a heterogeneous high signal intensity on T2-weighted images. Contrast-enhanced MRI demonstrated enhancement confined to the capsular structures. Based on the tumor size and MRI findings, malignancy could not be definitively excluded. However, considering the clinical presentation, a diagnosis of tumor infection was made, and an open adnexectomy was subsequently performed. Pathological examination confirmed the diagnosis of MCST, and the patient's condition progressed without apparent recurrence one year after surgery. In previous reports, MCST has been associated with FAP, and almost all cases were benign. Patients diagnosed with FAP can reduce the risk of acute abdominal pain by using less invasive treatments, as long as they keep up with regular checkups and screenings.

Microcystic stromal tumor of the ovary: a recurrent case with somatic CTNNB1 missense mutation

Microcystic stromal tumors (MCSTs) of the ovary are rare sex cord-stromal tumors that are considered benign neoplasms because almost all cases display unilateral, localized lesions and have benign outcomes, except for one recurrent case with familial adenomatous polyposis and another initial metastatic case with a CTNNB1 mutation. We report herein a sporadic case that relapsed as intra-abdominal spread 9 years and 1 month after primary left salpingo-oophorectomy for torsion of the ovarian tumor pedicle. The tumor relapsed as multiple disseminations at the subabdominal wall, Douglas pouch, and omentum. Histologically, the tumor cells formed microcysts and infiltrated the surrounding adipose tissue, similar to the invasive implants of ovarian epithelial borderline tumors. Mutation analysis of the recurrent tumor revealed a somatic CTNNB1 p.S33Y activated missense mutation and a germline KDR p.Q472H variant. In conclusion, long-term clinical follow-up may be needed to detect any recurrence of MCST, irrespective of familial adenomatous polyposis.

A 46-Year-Old Woman with Primary Infertility and a Diagnosis of Microcystic Stromal Tumor of the Ovary Confirmed by Histology and Gene Sequencing: A Case Report and Review of the Literature

Patient: Female, 46-year-old

Final Diagnosis: Microcystic stromal tumor of the ovary

Symptoms: Abdominal pain • vaginal bleeding

Medication: —

Clinical Procedure: —

Specialty: Pathology

Ovarian sex cord-stromal tumors: an update on clinical features, molecular changes, and management

Sex cord stromal-tumors are rare tumors of the ovary that include numerous tumor subtypes of variable histological features and biological behavior. Surgery is the main therapeutic modality for the management of these tumors, while chemotherapy and hormonal therapy may be used in some patients with progressive and recurrent tumors. Several studies investigated molecular changes in the different tumor types. Understanding molecular changes underlying the development and progression of sex cord-stromal tumors provides valuable information for diagnostic and prognostic biomarkers and potential therapeutic targets for these tumors. In this review, we provide an update on the clinical presentation, molecular changes, and management of sex cord-stromal tumors.

Ovarian Microcystic Stromal Tumor: A Case Report and Literature Review

Background: Microcystic stromal tumor is a recently described subtype of ovarian tumor characterized by microcystic pattern and diffuse immunoreactivity for CD10, vimentin, and β-catenin and negative for EMA. However, its diagnostic criterion and standard treatment remain unclear. Case presentation: We report a rare case of a left side microcystic stromal tumor with diameter about 7 cm in a 25-year-old female and summarize all cases of MCST reported in this study. The present patient underwent left ovarian tumor resection. Generally, the tumor was solid and cystic mixed. Immunohistochemically, the tumor was expressed CD10, WT1, cyclin D1 and vimentin, and nuclear immunoreactivity for β-catenin but negative for α-inhibin, calretinin, CK AE1/AE3, PLAP, SALL-4, CK7, P53, EMA, CD99, AFP, desmin, CgA, E-cadherin, and melanA. Conclusion: Unilateral ovary, solid-cystic, and a larger than 4-8 cm pelvic mass without serious abdominal pain are its clinical features. The immunophenotype of vimentin+/CD10+/WT-1+/β-catenin+(nuclei)/cyclin D1+ is supportive of diagnosis. For these patients, unilateral oophorectomy dissection could be selected.

Ovarian microcystic stromal tumors: clinical, radiological, and pathological studies of two cases

We observed two unusual cases of ovarian microcystic stromal tumors (MST). These two patients had no obvious clinical symptoms, and the imaging findings were separately diagnosed as cystic teratoma and ovarian malignant tumors. Significantly, during the operation, none of the pathologists considered the possibility of MST. The two cases showed similar morphological and immunophenotypic characteristics: some nests were made up of microcysts with round or oval shapes, and the cavity was bright and empty. In some areas, the cell nests of micro cysts were not obvious and were identified as solid cell nests. The tumor cells contained eosinophilic cytoplasms and neutral nuclei. Mitotic figures were rare. Immunohistochemistry indicated that the tumor cells were all positive for CD10, vimentin, WT1, and β-catenin, but negative for Cytokeratin, α-inhibin, CD99, ER, PR, S-100, EMA, CD56, CgA, Syn, Pax-8, Desmin, SMA, and calretinin. The Ki67 index was less than 5%. Based on the above characteristics, a diagnosis of ovarian MST was made after the operation. The final repeated CT scan revealed no recurrence during the post-surgical course. Here the clinical, radiological and pathological characteristics of these two cases diagnosed as ovarian MST are presented in order to help avoid future misdiagnosis and over-treatment.

Ovarian microcystic stromal tumor: Radiologic-pathologic correlation

Ovarian microcystic stromal tumor (MST) is characterized by microcysts, solid cellular regions with lobulated growth, and collagenous or fibrous stroma forming hyaline plaques. While several reports have evaluated the unique pathologic and immunohistochemical profile of these tumors, there has been limited description of the radiologic findings of ovarian microcystic stromal tumor in the literature. We present a case of a 66 year old female who presented for evaluation of a new cystic pelvic mass found to have ovarian microcystic stromal tumor. To our knowledge, this is one of the first reports to evaluate the radiologic features associated with this tumor. An enhanced understanding of the correlation between imaging appearance and specific histopathologic findings may aid in the early recognition of this rare neoplasm.