31 year old woman with ovarian tumor, which was excised. (No clinical data or macroscopic view of the tumor is avaliable).  
 
HISTOLOGY: Ovary with a cyst lined with keratinizing squamous epithelium with pancreas and salivary gland serosal-mucinous acini, ductal structures, ganglia and cysts with cuboidal, ciliated epithelial lining in subepidermal stroma (derma). There is abundant mature brain tissue (neuropil) with cyst, lined with cuboidal epithelium (ependima).  
There is a tumor in neuropil, composed of interflowing nests, composed of medium sized monotonous cells with faintly polymorphous nuclei with single nucleoli and vacuolized light eosinophilic cytoplasm. There are few nests of pigmented cells – retina tissue, in the tumor and next to it. There are intraductal eosinophilic structures (plexus chorioideus), ganglia.  
 
IH: PanCK(-); CD56/Synaptophysin/NSE/NFP+; Chrogranin A(-/+); GFAP/CD57(-); S100+.  
 
The diagnosis formulated as:  
Mature (monodermal) ovarian teratoma ("dermoid cyst") with somatic CNS tumor: central neurocytoma (extraventricular) (II° PSO).  
 
Would be grateful for other variants, suggestions and comments.  
 

LynnHirschowitz 2011-05-12 22:21

The morphology and immunoprofile of this tumour (which is arising in relation to the mature central nervous/neuroectodermal elements of this otherwise mature ovarian teratoma) is typical of a central neurocytoma. I have seen and published a similar case in 1997 and attach a copy of the case report. Unfortunately the photomicrographs in my report are in black and white, so they are difficult to compare directly with the tumour in this case. Your photographs are excellent as is the immunohistochemistry, by the way! This is a rare example of secondary neoplastic transformation in a benign mature ovarian teratoma. In the central nervous system these are relatively low grade tumours and surgical excision is usually curative. attachment: Central_Neurocytoma_Arising_Within_a_Mature_Cystic.16.pdf

simvai 2011-05-13 08:05

Thank You for the comments and for the case report.