Abstract
Dissecting gonadoblastoma (DGB) of the ovary, a recently described terminology, defines a unique distribution of neoplastic germ cells. Here, we report a case of incidental DGB coexistent with an atypical endometriotic cyst occurring in a 23-year-old woman. The ovarian cyst was lined by endometrial-like glands and stroma. Some glands displayed nuclear enlargement and hyperchromasia, and abundant eosinophilic cytoplasm with occasional intracytoplasmic hemosiderin and mucin vacuoles. The neoplastic germ cells resembled those of ovarian dysgerminoma and were diffusely distributed within the ovarian stroma, which was stretched around the wall of the endometriotic cyst. These cells were arranged in nests and cords, possessing clear cytoplasm and centrally located round nuclei with prominent nucleoli and occasional mitoses. Chromosomal analysis revealed a 46,XX karyotype. We describe the clinical, histological, immunophenotypical, and genetic features of ovarian DGB incidentally detected in the ovarian cystectomy specimen of a woman with normal female karyotype.
Highlights
Dissecting gonadoblastoma (DGB) of the ovary, a recently described terminology, defines a unique distribution of neoplastic germ cells
Kao et al [17] described a “dissecting gonadoblastoma (DGB)”, which is a morphological variant of gonadoblastoma
DGB is a variant of classical gonadoblastoma, exhibiting unusual growth patterns and containing germ cell and sex cord elements [18]
Summary
Chromosomal analysis on a peripheral blood specimen revealed 46,XX normal female results (Figure 3), the diagnosis of ovarian DGB coexistent with an atypical endometriotic karyotype (Figure 4). Targeted next-generation sequencing analysis revealed no cyst was established. Chromosomal analysis on a peripheral blood specimen revealed pathogenic mutation in genes that are implicated in homologous recombinant repair, 46,XX normal female karyotype (Figure 4). Targeted next-generation sequencing analysis excluding the possibility of hereditary breast and ovarian cancer syndrome. The patient revealed no pathogenic mutation in genes that are implicated in homologous recombinant reported a normalthe menstrual cycle and no history sexual developmental abnormality. Repair, excluding possibility of hereditary breastofand ovarian cancer syndrome. At three months after surgery, an abdominopelvic computed tomography revealed patient reported a normal menstrual cycle and no history of sexual developmental abnor- no evidence recurrent disease. The serum level of CA 125 was within the normal range
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