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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 611-613    DOI: 10.31083/j.ceog.2020.04.5340
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Pulmonary-derived papillary adenomatoid proliferation arising in ovarian mature cystic teratoma
S. Lane1, A. Newman1, M. Vergine1, K. Allan1, F. Usifo2, C.C. Yeoh3, S. Rahimi1, 4, *()
1Frontier Pathology, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
2Gynaecology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
3Department of Oncology, Queen Alexandra Hospital, Portsmouth, United Kingdom
4School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
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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.

Key words:  Lung      Ovary      Teratoma      Papillary      Adenoma     
Submitted:  22 August 2019      Accepted:  16 October 2019      Published:  15 August 2020     
*Corresponding Author(s):  S. Rahimi     E-mail:  rahimi.siavash@gmail.com

Cite this article: 

S. Lane, A. Newman, M. Vergine, K. Allan, F. Usifo, C.C. Yeoh, S. Rahimi. Pulmonary-derived papillary adenomatoid proliferation arising in ovarian mature cystic teratoma. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 611-613.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.5340     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/611

Figure 1.  — A papillary neoplasm, with psammoma bodies (double arrows), arising within a cystic cavity lined partly by respiratory-type epithelium and partly by squamous epithelium. Mature neural tissue (long arrow) intermingled with thyroid tissue (short arrow) are present.

Figure 2.  — Papillae with fibro-vascular cores covered by cubic epithelium with nuclear overlapping, clearing, and grooving (arrows). In the left corner, psammoma bodies are identified.

Figure 3.  — Immunohistochemistry shows positive staining with surfactant apoprotein A (A) and negative staining with thyroglobulin with positive internal control (B).

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