Contributed by Leena T. Lourduraj, MD, Manju Nath, MD and Dilip Gupta, MD
Published on line in June 2001
A 15-year-old girl presented with an ovarian mass. On exploratory laparotomy, a twisted ovarian cyst with appendiceal adhesions was noted. The fallopian tube was dilated with multiple nodules on the surface. She was treated by right oophorectomy followed by chemotherapy (Bleomycin, Etoposide & Cisplatin). After a disease-free interval of 14 months, she presented with a recurrent abdominal mass. She underwent a second exploratory laparotomy for the excision of pelvic soft tissue mass, sigmoid epiploica and portion of the sigmoid colon.
The enlarged ovary measured 16 X 14 X 8 cms and weighed 1020 grams. The cut surface was variegated, with multicystic and solid areas. The cystic areas contained gelatinous dark brown material. The solid areas showed focal areas of necrosis and hemorrhage. The fallopian tube was dilated with numerous cystic nodules, up to 1 cms, on the surface.
The pelvic soft tissue specimen consisted mostly of blood admixed with red-tan, soft tissue fragments, measuring 20.5 x 16.0 x 6.5 cms. Also noted were small fragments of gelatinous tan white tissue. The external serosal surface of the sigmoid colon was focally hemorrhagic with adherent blood clot. This area of external hemorrhage was diffuse in nature, extending deeper into the serosal fat. However the colonic mucosa was red-tan and smooth. There was no gross evidence of tumor mass infiltration into the bowel wall. The other two specimens received were omentum with focal areas of hemorrhage, and sigmoid epiploica with areas of white tan, firm fibrous tissue.