Unraveling the enigma: FATWO and its clinicopathologic implications
Gaurav Khastgir1, Sujata Siwatch2, Vanita Jain1
1Obstetrics & Gynaecology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
BMJ Case Reports
|July 30, 2024
Summary
Female Adnexal Tumour of probable Wolffian Origin (FATWO) is a rare gynecological neoplasm. Diagnosis can be challenging due to non-specific symptoms and imaging, but this case highlights successful identification and management.
Area of Science:
- Gynecologic Oncology
- Pathology
- Rare Tumors
Background:
- Female Adnexal Tumour of probable Wolffian Origin (FATWO) is a rare neoplasm originating from mesonephric remnants.
- Diagnosis is challenging due to rarity, non-specific symptoms, histological heterogeneity, and unclear radiological features.
Purpose of the Study:
- To present a case of FATWO in a postmenopausal woman.
- To highlight diagnostic challenges and confirm the utility of immunohistochemistry in identifying FATWO.
Main Methods:
- Case report of a postmenopausal woman with a 2-year history of lower abdominal pain.
- Pelvic examination, imaging (ultrasound/CT), staging laparotomy, histopathology, and immunohistochemistry (calretinin, WT-1).
Main Results:
- A solid, fibrous right adnexal mass measuring 8x8 cm was identified.
- Histopathology and immunohistochemistry confirmed FATWO with a focal gyriform pattern, positive for calretinin and WT-1.
- The patient remained recurrence-free five years post-surgery.
Conclusions:
- FATWO is a rare gynecological tumor requiring a high index of suspicion.
- Immunohistochemistry is crucial for accurate diagnosis of FATWO.
- This case demonstrates successful management and favorable prognosis for FATWO.
