European Journal of Obstetrics & Gynecology and Reproductive Biology 183 (2014) 203–204
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LETTER TO THE EDITOR—BRIEF COMMUNICATION Incidental diagnosis of ectopic adenohypophyseal tissue in an ovarian dermoid cyst: a case report Dear Editors, We report a case of a 33-year-old nulligravid woman admitted to our institution in May 2014 with an incidental ultrasound ﬁnding of a 5 cm right adnexal mass. Medical and gynecological history was unremarkable and she did not complain of visual changes, galactorrhea or any other endocrinologic symptoms. Pelvic examination revealed an enlarged and tender right ovary. Transvaginal ultrasound showed a 56 48 mm right ovarian unilocular cyst, containing anechoic and hyperechoic components with posterior acoustic shadowing, poorly vascularized, suggestive of a dermoid cyst. The left ovary appeared normal in size and morphology. Blood hormone levels were normal with normal serum prolactin (PRL) concentration (22 ng/mL), and tumor markers (CEA, CA125, CA19-9) were negative.
At the end of June 2014, the patient underwent laparoscopic right cystectomy. At operation, the ovarian cyst was 6 cm in diameter, with a regular and smooth surface. Histological examination revealed that the right ovarian cyst was a mature cystic teratoma with an intracystic 6 mm nodule of benign adenohypophyseal tissue (Fig. 1A). PAS and reticulin stains demonstrated well-preserved (non-adenomatous) follicular architecture (Fig. 1B), and immunohistochemistry delineated the presence of the major different adenohypophysial hormones, though biased toward PRL cells (75–80% of cells PRL+) (Fig. 1C); GH and ACTH were positive in 10% of cells, TSH in