Benign Mucinous Cystadenoma Research Articles

Mucinous cystadenoma and carcinoid tumor arising from an ovarian mature cystic teratoma in a 60 year-old patient: a case report

BackgroundMature cystic teratomas (MCT) of the ovary are benign ovarian germ cell neoplasms. Malignant transformation is possible but rare and ovarian carcinoid tumors in MCT are among the most extremely rare subtypes.Case presentationWe report a case of a 60-year-old Iranian woman suffering from postmenopausal bleeding and hypogastric pain for the last 40 days. An adnexal mass was detected during the physical examination. Ultrasound imaging showed a (55 × 58) mm mass in the left ovary. Total abdominal hysterectomy, bilateral salpingooophorectomy and comprehensive staging surgery were performed for the patient. Intraoperative frozen section of the left ovarian mass was indicative of a malignant tumor. She was diagnosed with a carcinoid tumor with benign mucinous cystadenoma arising on MCT of the ovary, confirmed in the histopathology and immunohistochemistry examination. The tumor was classified as low grade and no chemotherapy cycles were considered. The patient was followed up long-term and no recurrence was observed during 14 months of examinations.ConclusionOvarian carcinoids arising from MCT are rare neuroendocrine neoplasms, and proper diagnosis of these tumors requires careful histopathology evaluation and appropriate examination. Therefore, it is necessary to consider these tumors as a possible differential diagnosis and evaluate them in individuals (especially postmenopausal women) who have abdominal pain or abnormal bleeding and a palpable mass.

Discriminative diagnosis of ovarian endometriosis cysts and benign mucinous cystadenomas based on the ConvNeXt algorithm

PurposeThe objective of this study was to develop a deep learning model, using the ConvNeXt algorithm, that can effectively differentiate between ovarian endometriosis cysts (OEC) and benign mucinous cystadenomas (MC) by analyzing ultrasound images. The performance of the model in the diagnostic differentiation of these two conditions was also evaluated. MethodsA retrospective analysis was conducted on OEC and MC patients who had sought medical attention at the Fourth Affiliated Hospital of Harbin Medical University between August 2018 and May 2023. The diagnosis was established based on postoperative pathology or the characteristics of aspirated fluid guided by ultrasound, serving as the gold standard. Ultrasound images were collected and subjected to screening and preprocessing procedures. The data set was randomly divided into training, validation, and testing sets in a ratio of 5:3:2. Transfer learning was utilized to determine the initial weights of the ConvNeXt deep learning algorithm, which were further adjusted by retraining the algorithm using the training and validation ultrasound images to establish a new deep learning model. The weights that yielded the highest accuracy were selected to evaluate the diagnostic performance of the model using the validation set. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) was calculated. Additionally, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and odds ratio were calculated. Decision curve analysis (DCA) curves were plotted. Results: The study included 786 ultrasound images from 184 patients diagnosed with either OEC or MC. The deep learning model achieved an AUC of 0.90 (95 % CI: 0.85–0.95) in accurately distinguishing between the two conditions, with a sensitivity of 90 % (95 % CI: 84 %-95 %), specificity of 90 % (95 % CI: 77 %-97 %), a positive predictive value of 96 % (95 % CI: 91 %-99 %), a negative predictive value of 77 % (95 % CI: 63 %-88 %), a positive likelihood ratio of 9.27 (95 % CI: 3.65–23.56), and a negative likelihood ratio of 0.11 (95 % CI: 0.06–0.19). The DCA curve demonstrated the practical clinical utility of the model. ConclusionsThe deep learning model developed using the ConvNeXt algorithm exhibits high accuracy (90 %) in distinguishing between OEC and MC. This model demonstrates excellent diagnostic performance and clinical utility, providing a novel approach for the clinical differentiation of these two conditions.

Cistoadenoma mucinoso gigante de ovario

Although ovarian mucinous cystadenoma has a benign growth, it can grow to be very large. We present the case of a 70-year-old patient who came to the clinic for recurrent and diffuse abdominal pain. On physical examination, a large mass was palpated that occupied the entire abdominal cavity, up to the xiphoid appendix, rounded, retentive, with defined edges, non- painful, non-movable. Presence of edema in lower limbs. During the surgical act, a myomatous uterus and a giant left ovarian cyst measuring approximately 40 x3 0 cm and weighing 13.6 kg were identified. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The biopsy confirmed the diagnosis of benign ovarian mucinous cystadenoma and uterine leiomyomatosis. The postoperative period progressed favorably. The incidence of giant ovarian cystadenoma is relatively unknown due to the lack of a standardized concept and currently available advanced imaging modalities. Keywords: Ovary, Ovarian cysts, Mucinous cystadenoma, Ovarian neoplasms.

An enormous benign primary retroperitoneal mucinous cystadenoma: a case report and literature review of a seldom seen abdominal pathology.

Retroperitoneal neoplasia comprise less than 2% of all tumours. benign primary retroperitoneal mucinous cystadenoma (PRMC) is an extremely rare tumour. Their clinical course is overall silent unless the patient presents with a vague abdominal or pelvic pain, abdominal distention, or a palpable mass. Their aetiology remains theorized and since 1989, only 46 cases (excluding ours) worldwide were documented in the literature. The majority of cases were discovered in females but the overall tumour incidence rate is still undetermined due to its rarity. Well-timed recognition of this pathology permits the necessary curative surgical intervention to take place. We hereby illustrate the rare case of a 23-year-old female who presented to the surgical clinic complaining solely of an unexplained gradual increase of the abdominal contour. Their presurgical radiological analysis yielded an intraabdominal large-sized well-demarcated retroperitoneal mass. Thorough resection of the mass was accomplished via open surgery. The subsequent microscopic analysis of excised tumour yielded the diagnosis of primary retroperitoneal mucinous cystadenoma of benign nature. Primary retroperitoneal mucinous cystadenoma is a seldom seen tumour. The scarcity of its occurrence is further highlighted by the published data. Based on their conclusive review of the available published English-based literature, ours is the 47th documented case of a benign PRMC and it is the first documented case from our country; Syria. The impact of these findings warrants raising awareness on the subject and considering PRMC as a differential diagnosis when presented with a similar case in the clinical practice.

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms.

To evaluate intraoperative factors predicting appendiceal pathology during gynecologic oncology surgery for suspected mucinous ovarian neoplasms. We conducted a retrospective study on 225 patients with mucinous ovarian neoplasms who underwent surgery for an adnexal mass with concurrent appendectomy between 2000 and 2018. Regression analyses were used to evaluate intraoperative factors, such as frozen section of the ovarian mass and surgeon's impression of the appendix in predicting appendiceal pathology. Most patients (77.8%) had a normal appendix on final pathology. Abnormal appendix cases (n = 26) included: metastasis from high-grade adenocarcinoma of the ovary (n = 1), neuroendocrine tumor of the appendix (n = 4), and low-grade appendiceal mucinous neoplasms (n = 26; 23 associated with a mucinous ovarian adenocarcinoma, 2 with a benign mucinous ovarian cystadenoma, and 1 with a borderline mucinous ovarian tumor). Combining normal intraoperative appearance of the appendix with benign or borderline frozen section yielded a negative predictive value of 85.1%, with 14.9% of patients being misclassified, and 6.0% having a neuroendocrine tumor or low-grade appendiceal neoplasm. Benign or borderline frozen section of an ovarian mucinous neoplasm and normal appearing appendix have limited predictive value for appendiceal pathology. Appendectomy with removal of the mesoappendix should be considered in all cases of mucinous ovarian neoplasm, regardless of intraoperative findings.

Coexistence of a huge Brenner's tumour and mucinous cystadenoma in a 62-year-old female: a case report from Syria.

In this manuscript, the authors report a case of a 62-year-old nulliparous Syrian woman who presented with severe abdominal distension, which was followed by laparotomy and the excision of a 25×20cm-cyst; its pathological examination confirmed a benign Brenner's tumour and mucinous cystadenoma. Ovarian Brenner and mucinous are usually benign and can rarely grow asymptomatically to very big sizes. Herein, the authors aim to emphasize the importance of excluding malignancy by pathology examination. Walthard cell nests undergo metaplasia to give rise to different kinds of Brenner and mucinous neoplasm formations according to their genetic alterations. This paper adds to the available literature, which is still poor, by providing evidence of the first case of this rare combination from Syria with a review of different theories of origin and differential diagnoses. More studies directed towards exploring this combination's genetic origin are needed to boost our understanding of ovarian tumours in general.

Giant mucinous cystadenoma of the pancreas in a young female

Cystic tumors of the pancreas are rare and may be confused with hydatid cysts, especially in endemic areas. The incidence of cystic neoplasms of the pancreas is relatively rare in the pediatric population and young adults. We present a 21-year-old female with a well-defined giant multiloculated cystic lesion in the body and tail of the pancreas, which was diagnosed as a hydatid cyst elsewhere. The patient underwent laparoscopic spleen-preserving distal pancreatectomy. There was no visible communication between the mucinous cystic neoplasm and the pancreatic duct. Histopathology confirmed the diagnosis of benign mucinous cystadenoma of the pancreas. Ambiguity in the management of the lesion arises when mucinous cystadenoma is commonly misdiagnosed as pancreatic pseudocyst because the surgical management is entirely different.

A 24 kgs giant mucinous cystadenoma in a post-menopausal woman: A rare case report

Mucinous cystadenomas are among the most common benign ovarian neoplasms. Abdominal cystic tumours are highly prevalent. Due to the availability of superior imaging techniques, they are now diagnosed more commonly and considerably earlier. Over time, these adnexal masses can lead to fatal complications, such as ovarian torsion or haemorrhage. Incidental findings of these tumours are common as many of these patients are asymptomatic. 45-year-old female presented with abdominal distension for 1 year with polymenorrhagia. An exploratory laparotomy relieved a giant tumour weighing of 24.870 kgs drained 30 Litres of serous fluid. Histopathology revealed benign ovarian mucinous cystadenoma. A multidisciplinary approach in the preoperative, intraoperative and postoperative stages of management optimizes patient outcomes.

A combination of immunohistochemical markers, MUC1, MUC5AC, PAX8 and growth pattern for characterization of mucinous neoplasm of the ovary

ObjectiveBecause mucinous carcinomas are rare tumors that affect several organ sites and are known to originate from different tissues, leading to frequent misdiagnoses, the objective was to characterize the differences...

An ovarian mucinous cystadenoma, presenting with umbilical herniation

A postmenopausal lady presented with an uncomplicated umbilical hernia and a hugely distended abdomen without any other overt symptoms. A large pelvi-abdominal lump was palpable. CT showed a huge mass which filled up the entire pelvis and most of the abdomen, with a part of it protruding through the umbilicus. Diagnosis was established histopathologically, as a benign mucinous cystadenoma of the ovary.

Mucinous Cystadenoma of the Ovary Associated with Hyperplasia of Stromal Leydig Cells in Pregnant Woman

Background: The hormonally induced non-neoplastic lesions of ovarian stroma during pregnancy must be recognized by pathologist in order to avoid mistaking them for true tumors.
 Case report: A 28-year-old woman was delivered of a healthy infant by cesarean section. As an incidental finding, a multicystic tumor in the left ovary was found and resected. Histopathology was consistent with benign mucinous cystadenoma. In addition, within the stroma beneath the lining mucinous epithelium, a dense population of cohesive polygonal cells with abundant eosinophilic cytoplasm, typically resembling the Leydig cells, was seen. They were uniform without atypia, accompaning by minimal proliferative activity. They strongly expressed vimentin, inhibin, CD99 and calretinin. The final diagnosis of mucinous cystadenoma associated with hyperplasia of stromal Leydig cells was made.
 Conclusions: Leydig cell hyperplasia belongs to the specific changes of ovarian stroma associated with pregnancy. The present case stresses that in such situation the pathologists should be aware of it and not confuse it with a tumor.

Histopathological study of ovarian lesions at a tertiary care hospital

Background: Ovary is the commonest site of neoplastic and non-neoplastic lesion, can present in childhood to postmenopausal age group and accounts for the most prevalent cause of hospital admissions. Aims & Objectives: (1) To know about various histopathological types of ovarian lesions presented and diagnosed. (2) To study the incidence of ovarian lesions with respect to patient’s age. (3) To study the frequency of ovarian lesions in terms of non-neoplastic or neoplastic, benign or malignant, unilateral or bilateral, etc.Materials and Method: This is a descriptive study which was carried out at B.J. Medical College, Ahmedabad for a period of three years from 1st January 2018 to 31st December 2020. A Total of 225 cases of ovarian lesions were received and processed in the Pathology Department. Hematoxylin and Eosin stained slides were examined. We have included parameters like Age wise incidence, Nature of Lesion, Frequency & Laterality in this study.Results: Out of 225 cases, 197 cases (87.56%) were unilateral and 28cases (12.44%) were bilateral, 98 cases (43.56%) were non neoplastic & 127 cases (56.44%) were neoplastic. Majority of cases 112(49.78%) belong to age group of 20-39 years. The most common non-neoplastic lesion seen was Follicular Cyst followed by simple and corpus luteal cyst. Among neoplastic lesions, 120 cases (94.49%) were benign & 1 case (0.78%) was borderline & 6 cases (4.73%) were malignant. In benign ovarian neoplasm, most commonly seen lesion were serous cyst adenoma followed by benign cystic teratoma and mucinous cyst adenoma. In malignant cases, maximum were of serous cyst adenocarcinoma and endometrioid carcinoma. Conclusion: Ovarian Lesions both non-neoplastic and neoplastic include a variety of morphological features and show a particular age wise incidence. Role of histopathological evaluation remains always important in both diagnosis & management of such cases, particularly in cases of Malignant Lesions in order to save the patient’s life.

Laparoendoscopic Single-Site Surgical Techniques for Management of Adnexal Masses in Pregnancy

Study Objective To demonstrate key techniques that can be utilized in laparoendoscopic single-site surgery (LESS) for removal of an adnexal mass in pregnancy. Design This video demonstrates skills for removal of an adnexal mass in pregnant patients using LESS. If able to be contacted, patients were followed until delivery. Setting All surgeries were performed at an academic hospital. Patients or Participants Three pregnant women who each required removal of an adnexal mass underwent LESS. First, a 30-year-old G1P0 presented with a persistent 7.1 cm simple ovarian cyst concerning for torsion. Second, a 21-year-old G2P0010 had a 17.4 cm benign ovarian mucinous cystadenoma. Third, a 32-year-old G3P2002 presented with a 10.5 cm complex adnexal mass. Interventions LESS was performed in three pregnant women. An adnexal mass can be removed through the single-site umbilical incision with several key techniques that can be applied to enhance and simplify LESS in pregnancy: (1) gauze placement under a simple ovarian cyst to absorb spillage and to isolate the cyst in order to prevent inadvertent injury; (2) use of V-Loc suture to reapproximate the ovarian parenchyma to preserve ovarian function and avoid difficult knot-tying; (3) extracorporeal surgical approach after drainage of cystic contents and delivery of the collapsed ovarian cyst through the incision; and (4) in-bag tissue extraction of concerning ovarian pathology at the incision. Measurements and Main Results Two simple cystectomies were uncomplicated. The third patient had an uncomplicated oophorectomy after intraoperative pathology revealed a stage IIIA germ cell tumor. The first and third patient had full-term uncomplicated vaginal deliveries, and the second was lost to follow-up at 35 weeks. Conclusion LESS in a gravid uterus is technically challenging due to loss of triangulation of instrumentation. Application of the techniques demonstrated in this video can simplify LESS for removal of an adnexal mass in pregnant women with preservation of pregnancy and resolution of symptoms.

Removal of 132-pound ovarian mucinous cystadenoma: A case report

Ovarian masses larger than 100 pounds are rarely encountered in developed countries given advancements in early diagnosis and treatment. Their successful resections pose unique surgical and anesthetic challenges. An otherwise healthy 38-year-old para 1 woman developed a 50 × 60 cm pelvic mass. An exploratory laparotomy, left salpingo-oophorectomy and anterior abdominal wall reconstruction were performed. A total of 60 L of cystic fluid were drained. Close monitoring of hemodynamics and massive volume resuscitation required intensive care. Inpatient physical rehabilitation reinstated independent mobility. Final pathology revealed benign ovarian mucinous cystadenoma. A multidisciplinary approach in the preoperative, intraoperative and postoperative stages of management optimizes patient outcomes.

The prevalence of EBV and CMV DNA in epithelial ovarian cancer

BackgroundThe underlying cause of epithelial ovarian cancer (EOC) is unknown. It has been theorized that infectious agents could contribute to ovarian tumorigenesis.ObjectiveTo investigate the potential role of oncogenic viral infection in EOC, we examined the prevalence of Epstein-Barr Virus (EBV) DNA and cytomegalovirus (CMV) DNA in EOC tissue samples.MethodsFormalin-fixed, paraffin-imbedded (FFPE) tumor tissue samples from 198 patients included in the Danish Pelvic Mass Study were studied: 163 with serous adenocarcinomas, 15 with endometrioid adenocarcinomas, 11 with mucinous adenocarcinomas, and nine with clear-cell carcinomas. For controls in the EBV analysis, we used 176 tissue samples from patients diagnosed with benign mucinous cystadenomas. EBV and CMV genotyping was performed by real-time polymerase chain reaction with CMV and EBV CE-IVD approved kits. In-situ hybridization (ISH) was performed on the EBV positive samples.ResultsSufficient DNA material was obtained in 191 and 174 tissue samples from cases and controls, respectively. Ten of 191 case samples (5.2%) and one of 174 control samples (0.5%) were positive for EBV DNA (P value = 0.011). CMV DNA was detected in only one case sample (0.5%). ISH confirmed that three of the samples were of stromal origin, while the remaining seven tested negative for EBV.ConclusionsThis study is the first to demonstrate a higher prevalence of EBV DNA in tissue samples from patients with EOC than in a benign control group. However, the cellular origin of seven of the samples could not be determined by ISH analysis. Our study did not support an association between CMV and EOC.

Incidental Gynecologic Tract Neoplasms in Women Undergoing Anterior Pelvic Exenteration for Urothelial Carcinoma.

Urothelial carcinoma (UC) invasive into the muscularis propria or tumors unresponsive to treatment are indications for cystectomy. In females, with the goal of achieving complete cancer eradication and for concerns of UC extension into the adjacent pelvic organs, this may also warrant resection of the gynecologic organs. This study is aimed to assess the prevalence of unanticipated gynecologic neoplasms in anterior pelvic exenteration specimens. A retrospective review of pathology reports to identify women undergoing anterior pelvic exenteration for UC was performed (N=221), and incidentally discovered gynecologic tract neoplasms were recorded. Concomitant malignant or premalignant lesions of the gynecologic tract were identified in 8 patients (3.6%). These included endometrial adenocarcinoma [endometrioid type, International Federation of Gynecology and Obstetrics grade 1 (n=2, 0.9%)], cervical high-grade squamous intraepithelial lesion (n=2, 0.9%), Sertoli-Leydig cell tumor of intermediate differentiation (n=1, 0.5%), endometrioid adenocarcinoma of the ovary (n=1, 0.5%), and high-grade serous carcinoma of the ovary (n=1, 0.5%) and fallopian tube (n=1, 0.5%). Benign uterine neoplasms included leiomyomas (n=81, 37%), adenomyoma (n=3, 1.4%), and adenomatoid tumors (n=2, 0.9%). Benign ovarian neoplasms included serous cystadenoma (n=7, 3%), serous cystadenofibroma (n=4, 2%), benign Brenner tumor (n=5, 2.3%), mature teratoma (n=4, 2%), stromal luteoma (n=2, 0.9%), mucinous cystadenoma (n=1, 0.5%), thecoma (n=1, 0.5%), and endometrioid cystadenoma (n=1, 0.5%). Involvement of the gynecologic tract by UC was identified in 11 patients (5%). Spread of UC to the reproductive organs is rare in anterior pelvic exenteration specimens. Coexisting neoplasms of the gynecologic tract are occasionally identified, therefore careful evaluation of these organs is necessary.

Mucinous Cystadenoma of the Urachus and Review of Current Classification of Urachal Mucinous Cystic Neoplasms.

Urachal neoplasms are uncommon and represent a minor portion of bladder tumors. According to the recently updated World Health Organization classification (2016), these tumors are classified as adenomas, adenocarcinomas, nonglandular neoplasms, and mixed carcinomas. The mucinous cystic neoplasms represent a small percentage of urachal tumors with morphologic spectrum ranging from benign mucinous cystadenoma to borderline mucinous cystic tumor of low malignant potential and to malignant mucinous cystadenocarcinoma. Benign urachal mucinous cystic adenomas are exceedingly rare, and only a few cases have been reported in the literature to date. The goal of this review is to summarize the clinical features, histopathologic characteristics, treatment, and prognosis of urachal mucinous cystadenoma in light of differentiating them from mucinous cystic tumor of low malignant potential and mucinous cystadenocarcinoma.

Minimally Invasive Surgery at Paropakar Maternity and Women’s Hospital

Aims: The purpose of this study is to review the reintroduced minimally invasive surgical practice in the hospital after a couple of decades long gap. Methods: It is a two years (2015 to 2017) retrospective cross-sectional study carried out in Paropakar Maternity and Women’s Hospital. The patients with pre-operative diagnosis of benign condition underwent laparoscopic surgery; hysteroscopy was diagnostic and operative both. Data were collected by demographics, indication of surgery, nature of surgery, complications, hospital stay and histo-pathological reports. Data were entered in the SPSS and MS-excel. Results were presented as tables and graphs.Results: Sixty five and 39 women underwent laparoscopic surgery and hysteroscopy respectively. None of them had major complications and hospital stay was1-3 days in majority. The most common age group was 31-35 years. Preoperative diagnoses of them were adnexal tumor in 47 women, fibroid uterus in six, AUB in two, ectopic pregnancies in four, PCOD in two and one women each with primary sub-fertility and POP Q II with elongated cervix. Laparoscopic cystectomy was performed on 25 women for the adnexal masses while 13 women underwent laparoscopic oophorectomy for the ovarian masses. Total laparoscopic hysterectomy was the second commonest surgery (n=12). On histopathological examination of the ovarian tissues, mature cystic teratoma was the commonest finding (n=18) followed by the endometriotic cysts (n=9), benign serous cystadenoma (n=7) and mucinous cystadenoma (n=4). Conclusions: Laparoscopy and hysteroscopy procedures have become the alternative in surgical modality at this hospital.

Mucinous cystadenoma of the ovary with stromal luteinization and hyperestrinism in a post-menopausal female

Rare cases of virilization caused by ovarian tumors with functioning stroma have been reported, typically during pregnancy. The authors report a case of a post-menopausal 60-year-old woman who presented with breast tenderness and vaginal bleeding and was found to have an 18.4-cm adnexal mass by imaging. Cystectomy revealed a benign mucinous cystadenoma with stromal luteinization associated with elevated estradiol levels and features of hyperestrinism. Due to the high clinical suspicion of a malignancy, a total abdominal hysterectomy with bilateral salpingo-oophorectomy and appendectomy was performed. These hormonally induced changes must be recognized to avoid misinterpretation of a malignancy.

Single-Site Laparoscopic Surgery for a Huge Ovarian Mass

Abstract Background: Single-site laparoscopy is accepted in gynecologic surgery. A few published cases of single-site laparoscopy had ovarian masses large enough to be over the umbilicus. This report highlights the technique and outcome of removing a huge 38-cm ovarian mass through a single-site laparoscopic incision. Case: A 48-year-old female was examined due to progressive enlargement of her abdomen for 6 months. An axial computed tomography scan confirmed that she had a benign-appearing, 38.3 × 29.5 × 22.4–cm right adnexal mass. The mass was removed through a single-site laparoscopic incision with the aid of drainage by an Endobag.tm The operating time was 105 minutes with less bleeding than might have occurred with conventional total laparoscopy. Results: This patient's postoperative hospital stay was 1 day. The histopathologic report on her case revealed that she had a benign mucinous cystadenoma. Conclusions: Single-site laparoscopy can be performed safely for patients who have large, benign-appear...