Primitive Neuroectodermal Tumor in an Ovarian Cystic Teratoma: Natural Killer and Neuroblastoma Cell Analysis
A 31-year-old, gravida 3, para 3, Caucasian woman, was referred with abdominal distension and general fatigue for 2 months. Pelvic ultrasound and computed tomography of the pelvis and abdomen showed a large left ovarian mass measuring 17 × 11 cm in diameter. Her preoperative serum cancer markers showed an elevated cancer antigen 125 (Ca125) level of 102 U/ml (normal range <35 U/ml) and a lactate dehydrogenase level of 511 U/l (normal range 125–220 U/l). Serum levels of cancer antigen 19.9, CEA and calcium were within normal ranges. She underwent exploratory laparotomy, which revealed a large, solid left ovarian mass with diffuse and nodular disseminations on the peritoneum, omentum, with retroperitoneal pelvic and periaortic lymph nodes enlargement. The left ovarian mass was removed and sent for pathologic evaluation. Immunohistochemistry showed positive cells for synaptophysin, neuron-specific enolase, chromogranin, CD56 and neurofilaments and confirmed the diagnosis of neuroblastoma arising in ovarian teratoma.\nWritten informed consent for publication of this case report was obtained from the patient. Approval was obtained from the Review Board of the Spedali Civili of Brescia. Informed consent was provided according to the Declaration of Helsinki.