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Atypical reactive ovarian surface epithelium, a pitfall in pathologic assessment.
N E Aydin1, O Celik, S Hasçalik
1Department of Pathology, T. Ozal Medical Center, Inonu University, Malatya, Turkey.
Summary
Benign ovarian masses can present with concerning features. Reactive ovarian surface epithelium can mimic malignancy, highlighting the need for thorough pathological evaluation.
Area of Science:
- Gynecologic Pathology
- Surgical Pathology
- Reproductive Medicine
Background:
- Ovarian masses require careful histopathological diagnosis to differentiate benign from malignant conditions.
- Torsion of ovarian masses, even benign ones, can lead to significant hemorrhage and diagnostic challenges.
Observation:
- A torsioned, hemorrhagic benign ovarian mass was surgically managed in a young woman.
- A wedge biopsy of the contralateral ovary showed atypical superficial cell clusters, initially suspicious for malignancy.
Findings:
- Extensive pathological and clinical review confirmed the atypical foci were reactive ovarian surface epithelium.
- Initial interpretations by expert pathologists included metastatic carcinoma, deciduoid changes, or histiocytic infiltration.
Implications:
- This case underscores the importance of distinguishing reactive epithelial changes from true malignancy in ovarian biopsies.
- Accurate diagnosis is crucial for appropriate patient management and avoiding unnecessary aggressive treatment for benign conditions.