[Malignant mesodermal mixed tumor of the ovary with neuro-ectodermic differentiation]

A striking ovarian tumour was observed in a post-menopausal, 54-year-old woman. Most of the tumour shows histologic features of a malignant mesodermal (müllerian) mixed tumour. However, this tumour harbours a peculiar component suggesting neuroectodermal neoplasia. Histochemical and immunohistochemical studies demonstrate focal pheochromocytomatous (or paraganglionic) and ganglionic differentiations. Several types of cells could be identified: ganglion cells (NSE +, neurofilaments +), pheochromocytes or paraganglion cells (chromogranin +), Schwann cells (S 100 protein +), and neuroblastomatous elements (NSE +). This neoplastic component could be compared with compound tumours such as pheochromocytomaganglioneuroblastoma or gangliocytic paraganglioma. This type of tumour has not been reported in ovary, notably in association with a mesodermal mixed tumour. Such observation prompts us to consider tumours of somatic origin containing germ cell-type elements, with a review of the literature.