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Torsion of Collision Tumor: Dermoid Cyst and Fibrothecoma with Postmenopausal Bleeding

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ABSTRACT

The term collision tumor refers to the coexistence of two adjacent but histological distinct tumors with no histological admixture at the interface. Collision tumors involving ovaries are extremely rare. A collision tumor composed of a dermoid cyst and fibrothecoma is extremely rare in menopausal women. The mechanism of the development of collision tumor is uncertain. During clinical evaluation, differentiation of characters of these ovarian tumors is important to decide appropriate treatment strategies and for good prognosis. We report an unusual clinical manifestation of the torsion of a dermoid cyst and fibrothecoma in the right ovary with postmenopausal bleeding.

No MeSH data available.


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Microscopic features of collision tumor. (A) Microscopic features of solid component of ovarian fibrothecoma composed of fascicles of spindle cells with centrally placed nuclei and a moderate amount of pale cytoplasm without atypia or myxoid change (H & E, original magnification ×100). (B) Microscopic features of cystic component of ovarian mature cystic teratoma composed of skin adnexa and cystic cavity lined by squamous epithelium (H & E, original magnification ×100).
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Figure 2: Microscopic features of collision tumor. (A) Microscopic features of solid component of ovarian fibrothecoma composed of fascicles of spindle cells with centrally placed nuclei and a moderate amount of pale cytoplasm without atypia or myxoid change (H & E, original magnification ×100). (B) Microscopic features of cystic component of ovarian mature cystic teratoma composed of skin adnexa and cystic cavity lined by squamous epithelium (H & E, original magnification ×100).

Mentions: The uterus and left adnexa appeared normal, and a large right ovarian tumor of approximately 12 cm diameter was rotated counterclockwise with a 720 degree arc. No enlargement of lymph nodes around the mass was found. Right salpingo-oophorectomy was performed for frozen biopsy. After confirming the frozen pathologic results as fibrothecoma and benign dermoid cyst, total hysterectomy and left salpingo-oophorectomy were performed. Permanent pathological examination demonstrated a collision tumor composed of fibrothecoma and benign dermoid cyst. Macroscopically, the resected tumors in both cases showed a unilocular cystic tumor adjacent to a solid tumor. Microscopically, the cystic tumors were composed of cutaneous tissues and the solid tumors consisted of spindle cells with lipid-rich cytoplasm, arranged in interlacing bundles. The cystic tumor and the solid tumor were completely separate and no transitional features were recognized histologically (Fig. 2). The postoperative course was uneventful.


Torsion of Collision Tumor: Dermoid Cyst and Fibrothecoma with Postmenopausal Bleeding
Microscopic features of collision tumor. (A) Microscopic features of solid component of ovarian fibrothecoma composed of fascicles of spindle cells with centrally placed nuclei and a moderate amount of pale cytoplasm without atypia or myxoid change (H & E, original magnification ×100). (B) Microscopic features of cystic component of ovarian mature cystic teratoma composed of skin adnexa and cystic cavity lined by squamous epithelium (H & E, original magnification ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016499&req=5

Figure 2: Microscopic features of collision tumor. (A) Microscopic features of solid component of ovarian fibrothecoma composed of fascicles of spindle cells with centrally placed nuclei and a moderate amount of pale cytoplasm without atypia or myxoid change (H & E, original magnification ×100). (B) Microscopic features of cystic component of ovarian mature cystic teratoma composed of skin adnexa and cystic cavity lined by squamous epithelium (H & E, original magnification ×100).
Mentions: The uterus and left adnexa appeared normal, and a large right ovarian tumor of approximately 12 cm diameter was rotated counterclockwise with a 720 degree arc. No enlargement of lymph nodes around the mass was found. Right salpingo-oophorectomy was performed for frozen biopsy. After confirming the frozen pathologic results as fibrothecoma and benign dermoid cyst, total hysterectomy and left salpingo-oophorectomy were performed. Permanent pathological examination demonstrated a collision tumor composed of fibrothecoma and benign dermoid cyst. Macroscopically, the resected tumors in both cases showed a unilocular cystic tumor adjacent to a solid tumor. Microscopically, the cystic tumors were composed of cutaneous tissues and the solid tumors consisted of spindle cells with lipid-rich cytoplasm, arranged in interlacing bundles. The cystic tumor and the solid tumor were completely separate and no transitional features were recognized histologically (Fig. 2). The postoperative course was uneventful.

View Article: PubMed Central - PubMed

ABSTRACT

The term collision tumor refers to the coexistence of two adjacent but histological distinct tumors with no histological admixture at the interface. Collision tumors involving ovaries are extremely rare. A collision tumor composed of a dermoid cyst and fibrothecoma is extremely rare in menopausal women. The mechanism of the development of collision tumor is uncertain. During clinical evaluation, differentiation of characters of these ovarian tumors is important to decide appropriate treatment strategies and for good prognosis. We report an unusual clinical manifestation of the torsion of a dermoid cyst and fibrothecoma in the right ovary with postmenopausal bleeding.

No MeSH data available.


Related in: MedlinePlus