DIAGNOSTIC CASE #50 - CYTOLOGY
Question: An 11-year-old girl presented to the Emergency Department with acute abdominal pain. She had previously been well and had no significant past medical history. Physical examination revealed a palpable abdominal mass approximately 10 cm. in diameter which the patient denied being aware of. A variety of blood studies were performed and all were normal except for a beta-HCG level of 600,000 of mIU/mL. Ultrasound revealed a normal size uterus and a mass involving the right adnexa. She was taken to surgery which revealed a 10 cm. left ovarian mass. The remainder of her pelvic organs appeared normal.

Multiple sections of the ovarian mass were examined. Figures 1-3 show findings from beneath the ovarian capsule.

What is your diagnosis? What would you do next? 

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