Fig. 4

Histologic analyses of the ovaries. Both ovaries showed infiltration by poorly differentiated squamous cell carcinoma. a, b In the right ovary there were multiple cystic gland-like structures (arrows) lined by flat to cuboidal or ciliated epithelium. c The glandular epithelium was intimately intermingled with infiltrative clusters of the squamous cell carcinoma (arrow) leading to an initial diagnosis of a teratoma with malignant transformation. dIn situ hybridization for high risk human papillomaviruses, however, was positive in the squamous cell carcinoma cells and negative in the cystic glandular epithelium, strongly arguing against this interpretation of the findings