Microcystic stromal tumor resected by laparoscopic surgery

Abstract

We report a case of microcystic stromal tumor (MCST) resected by laparoscopy. MCST is a very rare ovarian tumor with distinctive microcystic features and a characteristic stromal tumor immunopheno-type. The present case was a 26-year-oId woman who underwent laparoscopic surgery for suspected endometrial cyst of the left ovary. The mass was 8 cm in size and contained bloody fluid, and after attempting cystectomy, we eventually performed left salpingo-oophorectomy with a final postoperative pathological diagnosis of MCST. Although MCST has not yet been associated with malignancy, there are reported links to mutations in the β-catenin gene, and long-term prognosis is still unknown. As MCST resection by laparoscopy has not yet been fully described in the literature, the current case provides an example of when an unexpected, potentially malignant mass is encountered during routine cystectomy and details its subsequent management laparoscopically.

Ovarian Microcystic Stromal Tumor: A Case Report and Literature Review

“…This neoplasm exhibits some distinctive morphological and immunochemical features. In most cases, the tumor has variable islands of monotonous round to ovoid cells with microcystic spaces and has diffusely strong immunoreactivity for CD10, vimentin, WT-1, and β-catenin (nuclei) and is negative for EMA (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). These features are readily apparent and permit the correct diagnosis.…”

Ovarian microcystic stromal tumor: Radiologic-pathologic correlation

“…CT shows a heterogeneous mass with hypo- and hyperattenuating areas, while FDG uptake on PET corresponds to solid cellular components. Although MR images were not obtained in our patient, Murakami et al reported MRI findings in a 26 year old with ovarian MST, revealing a predominantly cystic lesion with high-signal intensity on T2-weighted imaging and isosignal intensity on T1-weighted imaging ( Murakami et al, n.d. ). These imaging findings reliably reflect underlying histopathologic characteristics and may aid in early recognition of these benign neoplasms.…”

“…Microcystic stromal tumors fall within the group of pure stromal tumors, which also includes fibromas, thecomas, Leydig and steroid cell tumors ( Kurman, 2014 ). Ovarian MST, like other sex cord-stromal tumors, has generally been found in younger patients with reported ages ranging from the 20s to the 60s ( Oliva, 2014 ; Horta, 2015 ; Murakami et al, n.d. ). These tumors are typically unilateral, often <5 to 10 cm in size without associated hormone-mediated symptoms and with a favorable clinical course that has not yet been associated with malignancy ( Oliva, 2014 ; Irving et al, 2015 ; Murakami et al, n.d. ).…”

“…Previous reports of ovarian MST suggest a large pelvic mass with a dominant cystic component and peripheral FDG avidity ( Lee et al, 2016 ). On MR, the dominant cystic component has shown to be homogenously high T2 (fluid) signal on T2 weighted images with mild to moderate peripheral enhancement ( Murakami et al, n.d. ). On ultrasound, ovarian MSTs present with anechoic cystic component with peripheral color Doppler vascularity.…”

Ovarian sex cord-stromal tumors: an update on clinical features, molecular changes, and management

“…22 Microcystic Stromal Tumors Microcystic stromal tumors are very rare and present in patients between the ages of 20 and 60. 23 On immunostaining, microcystic stromal tumors have shown the expression of CD10, vimentin, and Wilms tumor 1, while sex cord-stromal markers (α-inhibin and calretinin) and epithelial membrane antigen are negative. 24 Nuclear expression of β-catenin occurs in microcystic stromal tumors.…”