Unusual Ovarian Malignancies in Ascitic Fluid

Abstract

Ovarian tumors of germ cell and sex-cord stromal derivation rarely exfoliate malignant cells in serous effusions. A precise tissue diagnosis in these cases may be possible on serous body fluid cytology with a combined clinical and cytopathologic approach.Ascitic fluid samples from 2 young women aged 23 and 25 years presenting with abdominal mass were cytologically analyzed, with relevant histochemical and immunohistochemical stains performed on cell block/histologic sections. Cytologically, the cases were interpreted as, or suspected to be, adenocarcinomas. However, subsequent histopathologic examination showed them to be yolk sac tumor (YST) and juvenile granulosa cell tumor (JGCT). Following histopathologic diagnosis, cytologic materials were reviewed, which revealed certain features such as hyaline globules in YST and distinct tubular structures in JGCT. These cytologic findings in view of the younger age of the patients should have prompted the correct diagnosis.This study emphasizes the importance of a combined clinical and cytologic approach when dealing with serous body fluid materials from uncommon ovarian malignancies such as YST and JGCT. This simple and systematic approach is of great practical value in identifying certain cytomorphologic features that may aid in correct diagnosis.