A 26-Year-Old Woman Is Being Evaluated for Lower Abdominal Discomfort

A 26-year-old woman is being evaluated for lower abdominal discomfort.  Medical history is significant for mild intermittent asthma and migraines without aura.  She has never been pregnant.  The patient is sexually active with her husband and they use condoms for contraception.  She drinks alcohol socially and does not use tobacco or illicit drugs.  Her mother was diagnosed with breast cancer at age 52 and her grandfather died of colon cancer at age 77.  BMI is 30 kg/m².  Ultrasound of the abdomen reveals a right-sided adnexal mass that is subsequently removed with laparoscopic surgery.  Histologic findings are shown in the image below: Which of the following is the most likely diagnosis?

A) Ectopic pregnancy
B) Endometriosis
C) High-grade serous ovarian carcinoma
D) Mature teratoma
E) Polycystic ovary syndrome

Correct Answer:

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