Case 29

A 70-year-old female presented with a 8.0 cm ovarian mass. Frozen section was done and a malignant process can not be ruled out. Here is the BSO-TAH specimen.

1.What's the morphology impression and the immunostains?

IHC

• Pan-keratin
• PAX8
• EMA
• Calretinin, Inhibin

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You can vote for more than one answer.

Answer

2. The fallopian tube section in this patient showed:

   
   

   

   P53 diffusely nuclear positive >80%

   
   

   

   P53 diffusely nuclear positive >80%

   
   

   

   P53 diffusely nuclear positive >80%

   
   

   

   Benign unremarkable tube but the right corner starting to look like bluer (high N:C ratio)

   3. What's the interpretation of the fallopian tube finding?

Answer

4. Taking all the findings together, what's the top line of the yolk sac tumor

diagnosed in this 70-year-old lady?

A: Yolk sac tumor in ovary and tubal serous carcinoma

B: Somatically derived yolk sac cell tumor, arising from high-grade serous carcinoma

Answer

References: https://tumourclassification.iarc.who.int/chaptercontent/34/177

Case credit: UCSD Pathology

Author: Wangpan Jackson Shi, MD