A case of an enlarging posterior mediastinal Müllerian cyst after ovarian tumor surgery

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  • Kawamura Tomoyuki
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Kobayashi Naohiro
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Sugai Kazuto
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Kikuchi Shinji
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Goto Yukinobu
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Sato Yukio
    Department of General Thoracic Surgery, Tsukuba University Hospital

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  • 増大傾向を示した卵巣腫瘍術後の後縦隔Müller管囊胞の1例

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Abstract

<p>The patient was a 43-year-old woman who had undergone unilateral ovariectomy for a right ovarian granulosa cell tumor two years previously. Follow-up CT revealed a well-circumscribed and homogenous mediastinal tumor, of 21×14×26 mm. The tumor was located anteriorly to the left side of the fourth thoracic vertebra and had been enlarging. Chest MRI revealed a low intensity in the T1-weighted image and high intensity in the T2-weighted image, which indicated that the tumor was a cystic lesion. For diagnosis and treatment, thoracoscopic posterior mediastinal tumor resection was performed. The tumor had a thin capsule within the fluid component and had no adhesion or continuity with the surrounding tissue, including nerves. Pathologically, the inner cells of the tumor capsule formed a mixed monolayer and multilayered ciliated columnar epithelium that partially protruded into the lumen, with a papillary appearance. Immunohistologically, the epithelia were positive for estrogen and progesterone receptors. From these results, the tumor was diagnosed as a Müllerian cyst. In the literature, Müllerian cysts have been associated with menopause, obesity, and surgery for gynecological diseases. In the present case, the tumor grew after surgery for an ovarian tumor.</p>

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