A rare case of ovarian inclusion cyst combined with cholesterosis and ossification

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Relevance: Tumors and tumor-like masses of the ovaries account for up to 14% of tumors of the female genital organs. The incidence of malignant ovarian neoplasms in pregnant women does not exceed 3–6%. The leading cause of ovarian tumor-like masses is considered to be hormonal disorders, although the influence of inflammation is not excluded. The most common epithelial tumors of the ovaries are believed to arise from inclusion cysts. Ovarian tumors, regardless of their histotype, except for hormone-producing ones, are characterized by a long-term asymptomatic course and this is one of the reasons for late diagnosis.

Case report: The article presents a clinical observation of a patient who had an ovarian mass that was found during a planned cesarean section. The mass which originated from the ovarian tissue was not soldered to the surrounding tissues and it was completely excised. The patient did not have any complaints related to ovarian lesions. The morphological examination revealed cholesterosis and ossification in the inclusion cyst. Cholesterosis is manifested by the accumulation of lipids, especially cholesterol esters and triglycerides, in macrophages. It is usually observed in the gallbladder, but it is very rare in the ovaries and remains understudied. Focal non-teratogenic ossification in the ovaries is an extremely rare pathology.

Conclusion: Cholesterosis and ossification in the ovary are rare pathological processes. The immunohistochemical study made it possible to clarify the pathogenesis of the accumulation of lipids and cholesterol crystals in the inclusion cyst.

Texto integral

Acesso é fechado

Sobre autores

Elena Fedotova

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Email: kris6060@mail.ru
ORCID ID: 0000-0002-2975-1014

PhD, Associate Professor at the Prof. D.D. Lokhov Department of Pathological Anatomy with course of Forensic Medicine

Rússia, 194110, Russia, St. Petersburg, Litovskaya str., 2

Tatyana Shalonya

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Autor responsável pela correspondência
Email: tanyaiudina@mail.ru
ORCID ID: 0000-0001-5544-2971

PhD, Assistant at the Prof. D.D. Lokhov Department of Pathological Anatomy with course of Forensic Medicine

Rússia, 194110, Russia, St. Petersburg, Litovskaya str., 2

Olga Sergienko

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Email: lelya.sergienko.80@mail.ru
ORCID ID: 0000-0003-3785-4598

Perinatal Center, Head of the Department of Pathology of Pregnancy

Rússia, 194110, Russia, St. Petersburg, Litovskaya str., 2

Ruslan Nasyrov

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Email: rrmd99@mail.ru
ORCID ID: 0000-0001-8120-2816

Dr. Med. Sci., Professor, Head of the Prof. D.D. Lokhov Department of Pathological Anatomy with course of Forensic Medicine

Rússia, 194110, Russia, St. Petersburg, Litovskaya str., 2

Bibliografia

  1. Адамян Л.В., Попов А.А., Козаченко А.В. Беременность и доброкачественные опухоли яичников. Акушерство и гинекология: новости, мнения, обучение. 2015;4:58-62. [Adamyan L.V., Popov A.A., Kozachenko A.V. Pregnancy and benign ovarian tumors. Obstetrics and Gynecology: News, Opinions, Training. 2015;4:58-62. (in Russian)].
  2. Соломатина А.А., Кавтеладзе Е.В. Опухоли и опухолевидные образования яичников при беременности. Акушерство и гинекология: новости, мнения, обучение. 2017;1:89-97. [Solomatina A.A., Kavteladze E.V. Tumors and ovarian masses at pregnancy. Obstetrics and Gynecology: News, Opinions, Training. 2017;1:89-97. (in Russian)]. https://dx.doi.org/10.24411/2303-9698-2017-00023.
  3. Бахидзе Е.В. Опухоли яичника у беременных. Журнал акушерства и женских болезней. 2011;LX(3):190-6. [Bakhidze E.V. Ovarian tumors in pregnancy. Journal of Obstetrics and Women's Diseases. 2011;LX(3):190-6. (in Russian)].
  4. Хмельницкий О.К. Патоморфологическая диагностика гинекологических заболеваний (руководство). СПб.: СОТИС; 1994. 480 с. [Khmelnitsky O.K. Pathological diagnosis of gynecological diseases (Guide). SPb.: SOTIS; 1994. 480 p. (in Russian)].
  5. Асатурова А.В. Источники происхождения серозных карцином яичника высокой степени злокачественности. Злокачественные опухоли. 2019;9(3s1):9-14. [Asaturova A.V. Sources of origin of high-grade serous ovarian carcinomas. Malignant tumors. 2019;9(3s1):9-14. (in Russian)] https://dx.doi.org/10.18027/2224-5057-2019-9-3s1-9-14.
  6. Смолякова Р.М., Гуляева Ю.В. Молекулярно-генетический профиль рака яичников: диагностическая и клиническая значимость. Экологический вестник. 2011;3:51-6. [Smolyakova R.M., Gulyaeva Yu.V. Molecular genetic profile of ovarian cancer: diagnostic and clinical significance. Ecological Bulletin. 2011;3:51-6. (in Russian)].
  7. Пешиков О.В. Влияние особенностей строения яичников на развитие акушерско-гинекологической патологии (обзор). Уральский медицинский журнал. 2019;5(173):99-106. [Peshikov O.V. Influence of ovarian structural features on the development of obstetric and gynecological pathology (review). Ural Medical Journal. 2019;5(173):99-106. (in Russian)]. https://dx.doi.org/10.25694/URMJ.2019.05.18.
  8. Гасымова Д.М., Рухляда Н.Н. Клинико-анамнестические особенности пациенток с осложнениями доброкачественных опухолей и опухолевидных образований яичников. Российский вестник акушера-гинеколога. 2017;17(4):72-7. [Gasymova D.M., Rukhliada N.N. Clinical and anamnestic characteristics of patients with complications of benign tumors and tumor-like masses of the ovary. Russian Bulletin of Obstetrician-Gynecologist. 2017;17(4):72-7. (in Russian)]. https://dx.doi.org/10.17116/rosakush201717472-77.
  9. Ашрафян Л.А., Антонова И.Б., Ивашина С.В., Люстик А.В., Ульянова А.В., Вашакмадзе С.Л. Ранняя диагностика рака эндометрия и яичников. Практическая онкология. 2009;10(2):71-5. [Ashrafyan L.A., Antonova I.B., Ivashina S.V., Lustik A.V., Ulyanova A.V., Vashakmadze S.L. Early diagnosis of endometrial and ovarian cancer. Practical Oncology. 2009;10(2):71-5. (in Russian)].
  10. Министерство здравоохранения Российской Федерации. Письмо от 04.12.2018 N 15-4/10/2-7838 «Диагностика и лечение доброкачественных образований яичников с позиции профилактики рака». [Ministry of Health of the Russian Federation. Letter dated December 4, 2018 N 15-4/10/2-7838 «Diagnostics and treatment of benign ovarian tumors from the perspective of cancer prevention» (in Russian)].
  11. Graham L. ACOG releases guidelines on management of adnexal masses. Am. Fam. Physician. 2008;77(9): 1320-3.
  12. de Haan J., Verheecke M., Amant F. Management of ovarian cysts and cancer in pregnancy. Facts Views Vis Obgyn. 2015; 7(1): 25-31.
  13. Glanc P., Brofman N., Salem S., Kornecki A., Abrams J., Farine D. The prevalence of incidental simple ovarian cysts >or= 3 cm detected by transvaginal sonography in early pregnancy. J. Obstet. Gynaecol. Can. 2007;29(6):502-6. https://dx.doi.org/10.1016/s1701-2163(16)32460-4.
  14. Bunyavejchevin S., Phupong V. Laparoscopic surgery for presumed benign ovarian tumor during pregnancy. Cochrane Database Syst. Rev. 2013;2013(1): CD005459. https://dx.doi.org/10.1002/14651858.CD005459.pub3.
  15. Pearl J.P., Price R.R., Tonkin A.E., Richardson W.S., Stefanidis D. Guidelines for the use of laparoscopy during pregnancy. SAGES, May 2017. https://www.sages.org/publications/guidelines/guidelines-for-diagnosis-treatment-and-use-of-laparoscopy-for-surgical-problems-during-pregnancy/
  16. Ribic-Pucelj M., Kobal B., Peternelj-Marinsek S. Surgical treatment of adnexal masses in pregnancy: indications, surgical approach and pregnancy outcome. J. Reprod. Med. 2007;52(4):273-9.
  17. Савельева Г.М., Сухих Г.Т., Серов В.Н., Радзинский В.Е., ред. Акушерство: национальное руководство. М.: ГЭОТАР-Медиа; 2015. 1080 с. [Savelyeva G.M., Sukhikh G.T., Serov V.N., Radzinsky V.E., ed. Obstetrics: National Guide. Moscow: GEOTAR-Media; 2015. 1080 p. (in Russian)].
  18. Vidhale S.A., Chavarkar S.P., Sudhamani S., Rao R. Cholesterolosis of ovary associated with benign serous cystadenoma. Indian J. Pathol. Microbiol. 2022;65(2):496-8. https://dx.doi.org/10.4103/IJPM.IJPM_373_20.
  19. Chetty R., Reddy I., Batitang S. Xanthelasma or xanthoma of the fallopian tube. Arch. Pathol. Lab. Med. 2003;127(11):e417-9. https://dx.doi.org/10.5858/ 2003-127-e417-XOXOTF.
  20. Zhang X.S., Dong H.Y., Zhang L.L., Desouki M.M., Zhao C. Xanthogranulomatous inflammation of the female genital tract: report of three cases. J. Cancer. 2012;3:100-6. https://dx.doi.org/10.7150/jca.3929.
  21. Yu E.H., Song Y.J., Lee H.Z., Lee N.K., Choi K.U., Suh D.S. et al. Non-teratomatous ossification of the ovary, a rare entity: case report and review of the literature. Int. J. Clin. Exp. Pathol. 2020;13(9):2356-62.
  22. Мартынов С.А., Липатенкова Ю.И., Адамян Л.В., Данилов А.Ю., Клименченко Н.И. Эффективность ультразвуковых методов исследования в дифференциальной диагностике опухолей и опухолевидных образований яичников у беременных. Акушерство и гинекология. 2014;8:33-9. [Martynov S.A., Lipatenkova Yu.I., Adamyan L.V., Danilov A.Yu., Klimenchenko N.I. Efficiency of ultrasound studies in the differential diagnosis of ovarian tumors and tumoroids in pregnant women. Obstetrics and Gynecology. 2014;(8):33-9. (in Russian)].

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar
2. Fig. 1. Fixed macropreparation. A lumpy area of the wall of an ovarian cyst. View from the outer surface of the cyst

Baixar (1MB)
Metadados
3. Fig. 2. Inclusion cyst filled with atheromatous masses. Focal calcification of the cyst wall (arrow). Hematoxylin and eosin staining. x40

Baixar (1MB)
Metadados
4. Fig. 3. Groups of cells with finely vacuolated and granular cytoplasm at the border with the cyst cavity. Hematoxylin and eosin staining. x400

Baixar (1MB)
Metadados
5. Fig. 4. Areas of bone tissue with red bone marrow. Hematoxylin and eosin staining. x400

Baixar (1MB)
Metadados
6. Fig. 5. Accumulation of macrophages at the border with the cyst cavity. Immunohistochemical reaction with CD68 antibodies. x400

Baixar (1MB)
Metadados

Declaração de direitos autorais © Bionika Media, 2024