IMR Press / CEOG / Volume 47 / Issue 4 / DOI: 10.31083/j.ceog.2020.04.5340
Open Access Case Report
Pulmonary-derived papillary adenomatoid proliferation arising in ovarian mature cystic teratoma
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1 Frontier Pathology, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
2 Gynaecology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
3 Department of Oncology, Queen Alexandra Hospital, Portsmouth, United Kingdom
4 School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
Clin. Exp. Obstet. Gynecol. 2020, 47(4), 611–613; https://doi.org/10.31083/j.ceog.2020.04.5340
Submitted: 22 August 2019 | Accepted: 16 October 2019 | Published: 15 August 2020
Abstract

Introduction: Primary lung papillary neoplasms are very rare and less than 30 cases of papillary adenomas have been described. Lung-derived papillary lesions arising in ovarian mature cystic teratoma are extremely rare and, to the best of the authors’ knowledge, only one case has been reported. Herein they report the second case and discuss the differential diagnoses. Case Report: A 32-year-old woman presented with bilateral ovarian mature cystic teratoma (MCT) (“dermoid”). The right side teratoma, very close to the thyroid tissue (struma ovarii), presented a morphologically benign mass, with complex papillary structures and psammoma bodies, which mimicked a thyroid papillary carcinoma (TPC). Immunohistochemistry showed diffuse positive staining with EMA, cytokeratins, and patchy positive staining with TTF1 and surfactant apoprotein A. Thyroglobulin, PAX-8, HMBE1, chromogranin, synaptophysin, CD56, CEA, p63, and BRAF were negative. The work-up for metastasis was negative. Close clinical and instrumental follow-up was decided following consultation with the lung and gynaecological multidisciplinary team. Conclusion: This is the second case of benign appearing, lung-derived papillary neoplasm arising in an ovarian MCT. In view of the clinical context, histological criteria used in lung pathology cannot be applied with confidence in this case. The most appropriate term would be pulmonary-derived papillary adenomatoid proliferation. This novel entity will be useful for pathologists and clinicians in diagnosing and differentiating this very rare disease from other lesions arising in ovarian teratomas.

Keywords
Lung
Ovary
Teratoma
Papillary
Adenoma
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