Primary Myeloid Sarcoma of Ovary: A Case Report and Review of the Literature.

Myeloid sarcoma (granulocytic sarcoma or chloroma) is a tumor formed by myeloid precursor cells in any localization other than the bone marrow. It can occur without underlying acute myeloid leukemia (AML) or other myeloid neoplasms. Herein, we present a forty-two-year-old female patient who underwent surgery because of a left adnexal mass. Microscopic examination of the specimen revealed cord-like arrangement of the tumor cells with a diffuse growth of small blue cells effacing the ovarian stroma. Adult granulosa cell tumor was in the differential given the scanty cytoplasm of the tumor and in fact was the diagnosis of the referring institution. Further microscopic evaluation with immunohistochemical analysis at our institution revised the diagnosis to myeloid sarcoma. Myeloid sarcoma is a difficult tumor to diagnose due to its rarity, especially in the absence of a history of leukemia, and correct tissue diagnosis is essential for its treatment.

IgG4-Related Disease of the Ovary.

Immunoglobulin G4-related disease is characterized by dense fibrosis, obliterative phlebitis, and lymphoplasmacytic infiltration that contains abundant IgG4 positive plasma cells. It causes tumefactive lesions in the involved organs and is most commonly seen in the salivary glands, pancreas, and retroperitoneum. Ovarian involvement has been reported in only two cases. In our case, a 58-year-old female patient presented with abdominal distention and pain. Pelvic computed tomography revealed a soft tissue lesion compatible with the omental cake, several intraabdominal implants, and bilateral adnexal fullness. A laparotomy was performed under suspicion of peritoneal carcinomatosis secondary to bilateral adnexal mass. In the histopathologic examination, abundant lymphoplasmacytic infiltration and dense fibrosis were observed in both ovaries and the peritoneum. In the areas of greatest density, the density of IgG4-positive plasma cells was found to range from 40 to 50 per high-power field. The patient was accepted as suffering from probable IgG4-related disease because of the bilateral involvement of the ovaries and the histopathological findings. In conclusion, we present this case to draw attention to the fact that IgG4-related disease can also be seen in the ovary.

Primary low grade myxoid liposarcoma of the ovary: A case report and review of literature.

A 20-year-old female patient presented with the complaint of pelvic pain. Radiological studies showed a cystic mass in the left ovary. Histological examination revealed a myxoid tumor with a chicken wire-like, thin vascularization. The diagnosis of the lesion, morphologically resembling myxoid liposarcoma was supported by demonstration of rearrangement of the DDIT3 gene by fluorescence in situ hybridization.