EP34.36: A case of a non‐HPV related cervical squamous carcinoma: a case report

Abstract

We report two cases of ovarian teratoma, the immature and mature, demonstrating similar, high risk of malignancy sonographic features.Case 1: A 21-year-old woman was referred due to recurrent lower abdominal pain and right ovarian mass with CA-125 of 34.3 U/ml. Transabdominal and transvaginal sonography demonstrated a right ovarian multilocular-solid mass measuring 14x11x9cm. Irregular internal solid components reaching 5 cm in maximal dimension were observed on the posterior wall. The solid tissue was nonhomogenous with dispersed calcifications causing acoustic shadows. The liquid content was of low-level echogenicity. Few wide septa were depicted. The colour Doppler imaging showed intense vascular signals within the solid components and septa. The external borders of the tumour were regular. There was a positive sliding sign without tenderness. No normal ovarian tissue could be demonstrated. There were no ascites or signs of extra-ovarian metastases. The uterus and the left ovary were normal. According to IOTA ADENEX assessment, the risk of malignancy was 21%.Case 2: A 12-year-old girl was referred due to fever of unknown origin, and pelvic mass was discovered during the evaluation. The patient denied abdominal pain. Transabdominal and transrectal sonography demonstrated a right unilocular-solid ovarian mass measuring 9x8x7cm. The sonographic features of this mass were similar to those of Case 1, including intense vascular signals within the solid component on colour Doppler. IOTA ADENEX assessment revealed the risk of malignancy of 33%.Both patients underwent surgical excision of the masses. The histopathology revealed an immature cystic teratoma in Case 1 and a mature teratoma in Case 2.Our cases demonstrate that predicting immature teratoma using IOTA criteria is difficult; apparently ''malignant'' sonographic features can lead to false positive diagnosis.