p12 - guest1

[ArchivalUser]

A 32-year-old woman visits her gynecologist for a Pap smear. On physical examination, her gynecologist palpates
a large adnexal mass on the right. After ultrasound confirmation of a large ovarian mass, a laparotomy is
scheduled, and the mass is removed. Pathologic examination of the mass demonstrates a cystic cavity filled with
hair and keratin debris, and the wall contains skin, adnexal tissue, thyroid tissue, and neural tissue. All of the
tissues are similar to those normally found, and no malignant changes are seen. Which of the following is the
most likely diagnosis?


A. Immature teratoma

B. Leiomyoma

C. Leiomyosarcoma

D. Mature teratoma

E. Rhabdomyosarcoma

[ArchivalUser]

D. Mature teratoma

[ArchivalUser]

D.

[ArchivalUser]

dd

[ArchivalUser]

d

[ArchivalUser]

Dddd

[ArchivalUser]

Explanation:

The correct answer is D. The lesion is a mature teratoma. Teratomas located in the ovary and containing a hair
and keratin filled cyst are sometimes called dermoid cysts. Teratomas contain cells of a variety of types, often
including skin, skin adnexal structures (hair follicles, sweat glands, sebaceous glands), connective tissues,
neural tissue, muscle, and thyroid tissue. If immature tissues such as primitive neuroepithelial cells or
developing skeletal muscle cells are seen, the lesion is considered potentially malignant and classified as an
immature teratoma (choice A).

Leiomyomas (choice B) are benign tumors of smooth muscle (e.g., uterine "fibroids"), usually in the female
genital tract.

Leiomyosarcomas (choice C) are rare malignant tumors of smooth muscle, usually in the female genital tract.

Rhabdomyosarcomas (choice E) are malignant skeletal muscle tumors with a predilection for the head and neck
and urogenital regions in children.