Figure 4.

Inter-tumor heterogeneity detected by ctDNA analysis in a patient diagnosed with synchronous tumors on both ovaries. In a tumor sample from the right ovary, a PIK3CA and an ARID1A pathogenic variants were identified. This tumor consisted of a clear cell carcinoma with a papillary growth pattern. In the matched plasma sample, in addition to these two variants, a CTNNB1 pathogenic variant was detected. We tested a tumor sample from the left ovary by Sanger sequencing, in which the three variants were identified. The left ovarian tumor consisted of a squamous cell carcinoma with abundant keratinization.