A 51-year-old gravida 5 para 5 (5005) presented with an increasing abdominal girth and a palpable abdominal mass. She was initially diagnosed with ovarian new growth and underwent exploratory laparotomy. Intraoperatively, the uterus, Fallopian tubes, and ovaries were grossly normal and a large mass was seen attached to the cecum where the appendix should be referral to surgery service was done. Right hemicolectomy and ileostomy were performed. The histopathology report was “suggestive of a Müllerian adenosarcoma (MAS) involving the appendix and cecum.” Microscopic examination showed evidence of endometriosis with no evidence of sarcomatous overgrowth, features that are favorable prognostic factors associated with higher disease-free survival. Postoperatively, the plan of management was hormonal therapy. Extragenital MAS is rare. This case is the fourth case to be reported in the literature to arise from the colon. Although there is still no standard of treatment, accurate diagnosis is imperative for appropriate management.
Appendix ; Cecum ; Colon ; Endometriosis

A 44‑year‑old woman presented with an abnormal vaginal discharge. She was initially diagnosed with cervical intraepithelial neoplasia‑1 through Papanicolaou smear and was managed with cryotherapy and completed human papillomavirus vaccinations. Nine years later, gynecologic examination showed a cervical mass, and biopsy revealed a signet‑ring cell‑type mucinous adenocarcinoma. Extensive systemic evaluation performed revealed no other malignancies. Radical hysterectomy was performed, and final pathology report showed a primary signet-ring cell cervical carcinoma stage 1B2. Concurrent chemotherapy with adjuvant external beam radiation therapy was then given. The patient has no evidence of disease for 24 months now since diagnosis. Primary signet‑ring cell carcinoma of the cervix is rare. It is diagnosed when no other tumor is found in extragenital sites, histology consists of signet‑ring morphology, tumor includes areas of adenocarcinoma in situ, and case has a prolonged survival. Overall patient education plays a vital role in management.
Papanicolaou Test ; Papillomavirus Infections ; Carcinoma, Signet Ring Cell ; Human Papillomavirus Viruses

A three-cell type malignant mixed germ cell tumor of the ovary is very rare neoplasm. Presently, there has been no reported incidence of the three-cell type mixed germ cell tumor in the literature. Malignant germ cell tumors comprise less than 5% of all ovarian neoplasms. Mixed germ cell tumors, most of which have only two elements.

This is a case report of a 22-year old, nulligravid, who presented with hypogastric pain and increased abdominal girth. Clitoromegaly was noted at puberty. Patient has normal secondary sexual characteristics and menarche. A large multi-separated cystic abdominopelvic mass was seen on ultrasound. Intraoperatively, the left ovary was transformed into a solid tumor measuring 13.5cm x 7cm x 7cm, dangling separately from the left fallopian tube, such that a left oophorectomy. The uterus was hypoplastic. A thin, white, fibrous tissue inferior to the right fallopian tube was seen, which may represent the right ovary, signifying gonadal dysgenesis. For the purposes of staging, peritoneal fluid cytology, bilateral lymph node dissection infracolic omentectomy, liverand para-aortic lymph node palpation were also performed. Final histopatholic diagnosis was malignant mixed germ cell tumor comprising three element, andodermal sinus tumor (70%), dysgerminoma (25%) and embryonal carcinoma (5%). Patients was diagnosed to have malignant mixed germ cell tumor, left ovary, stage IA; hypoplastic uterus; gonadal dysgenesis, right. Adjuvant chemotherapy was advised due to the aggressive nature of the predominant cell type. Reproductive function is further compromised in the presence of the hypoplastic uterus and gonadal dysgenesis.

Human ; Female ; Young Adult ; Dysgerminoma ; Carcinoma, Embryonal ; Gonadal Dysgenesis ; Ovarian Neoplasms ; Turner Syndrome ; Uterus ; Ovariectomy