Myxoma of the Ovary

Clinical Image 120 Myxoma of the OvaryMyxomas are benign tumors that generally arise from the heart, soft tissues, muscle, skin and bone (1).Herein we present a myxoma case found on the ovary.A 12-year-old girl was under follow-up for menstrual irregularities for 1 year and pelvic ultrasonography revealed bilateral para-ovarian simple semisolid lesions.Pelvic magnetic resonance imaging was performed, and a cystic lesion (65×4 cm) in the right adnexal region that was hyperintense on T2-AG and hypointense on T1-AG was observed (Figure 1a).Ovarian tumor markers and routine laboratory evaluations were all within normal limits.The right adnexal para-ovarian cystic mass was completely excised.Macroscopically cutting the surface of a cystic tissue sample totally 6×4.5×3 cm dimensions was bloody, and a solid myxoid area of 3×2.5 cm was observed on one side (Figure 1b).Microscopically, there was a tumor consisting of stellate or spindle-shaped tumor cells in a large myxoid matrix (Figure 1c).There was not any increase in cellularity, nuclear polymorphism, mitosis or necrosis determined in the tumor (Figure 1d).Histochemically, positive staining with Alcian blue was observed in myxomatous stroma (Figure 1e).Immunohistochemical evaluation revealed diffuse positive staining with smooth muscle actin and vimentin, and negative staining with desmin, inhibin, cytokeratin and S-100 protein in the tumor (Figure 1f).Based on these findings, the patient was diagnosed with ovarian myxoma.Written informed consent was obtained from the patient before the aforementioned work was carried out.Ovarian myxoma is quite a rare condition that is a rare entity (2).Histologically, these tumors are produced from the cells in a random sequence in a myxoid matrix without an infiltrative growth pattern, mitotic activity, cytological atypia or necrosis (3,4).The differential diagnosis of ovarian myxomas with other ovarian myxoid lesions should be performed.The differential diagnosis includes angio-myxomas, fibromas with widespread myxoid degeneration, and primary ovarian stromal lesions containing high amounts of myxoid matrix, such as massive edema, or non-ovarian stromal lesions that are generally