College of American Pathologists
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2008 — November Case of the Month

Updated December 16, 2008


CAP Foundation November 2008 Online Case of the Month

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A 45-year-old woman presented with vague abdominal pain. Ultrasound revealed a predominately solid right ovarian mass and mild ascites. A hysterectomy and bilateral salpingooophorectomy were performed. The uterus and left adnexa were unremarkable. The right ovary was replaced by a 10.0 x 4.0 x 4.0 cm, 850 g, predominately solid, red-brown, focally necrotic tumor that demonstrated scattered small hemorrhagic cysts. Immunohistochemical studies revealed focal areas that were thyroglobulin positive and other areas that were synaptophysin positive. Rare areas were positive for both markers. Stains for mucin were negative.

The master list with the correct answer

  • Adenocarcinoma, metastatic
  • Carcinoid, metastatic
  • Granulosa cell tumor
  • Sertoli-Leydig cell tumor
  • Strumal carcinoid
  • Teratoma, mature
  • Thyroid follicular carcinoma, metastatic

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  • Appropriate diagnosis
  • Critique
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