A RARE CASE OF EXTRA OVARIAN SEX CORD STROMAL TUMOUR PRESENTING AS BROAD LIGAMENT MASS SYNCHRONOUS OVARIAN MASS; PATHOLOGIC PATTERN REVEALS MIX GRANULOSA FIBROMA, TYPE OF MIX MESONEPHRIC AND MULLERIAN ORIGIN
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 49
Abstract
PRESENTATION OF CASE A 30 yrs. female presented to OPD with a mass abdomen. FNAC of the mass showed papillary-adenocarcinoma. She had undergone B/L excision of the mass, which was a broad ligament mass, revealed on laparotomy. HPS and IHC revealed it to be malignant high-grade mixed sex cord stromal tumour (granulosa and fibroma type). DIFFERENTIAL DIAGNOSIS These tumours are to be differentiated from other small cell carcinomas like undifferentiated sarcomas, endometrial stromal sarcoma and lymphoma, by a panel of IHC inhibin, CK, EMA, Chromogranin, CD 10. They have to be differentiated from primary broad ligament carcinoma, which has a papillary arrangement of cells, with foci of transitional cells. As the initial FNAC showed adenocarcinoma and absence of transitional cells, this excludes primary endometria broad ligament carcinoma. CLINICAL DIAGNOSIS High grade extra ovarian mix sex cord stromal, probably of Mullerian and mesonephric origin, associated with B/L synchronous ovarian tumour. DISCUSSION OF MANAGEMENT Hysterectomy and B/L Salpingoopherectomy, with Tumour Debulking. Role of adjuvant chemotherapy and radiotherapy is unknown.
Authors and Affiliations
Smruti Sudha Pattnaik, Sushil Kumaar Giri, Jita Parija, Padmalaya Devi, Kunal Goutam, Janmejaya Mohapatra, Bhagyalaxmi Nayak, Manoranjan Mohapatra
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