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ovarian mucinous adenocarcinoma

Friday 14 January 2011

ovarian mucinous carcinoma; Mucinous cystadenocarcinoma / carcinoma

|PO|

Images

- http://www.webpathology.com/image.asp?case=526&n=14

Macroscopy

- Primary tumors are usually unilateral, > 10 cm, smooth capsule, cystic and solid areas of tumor evenly distributed throughout ovary without discrete nodularity.

Microscopy

- Stromal invasion;
- more solid growth, atypia, stratification, papillae, loss of glandular architecture, necrosis (resembles colon carcinoma),
- greater complexity of glands than borderline tumors
- Stromal invasion may be infiltrative with disorderly penetration of stroma by neoplastic glands, single cells or cell clusters, may have desmoplastic response or expansile (confluent) with complex arrangement of glands,
-  cysts or papillae lined by malignant epithelium with minimal or no intervening stroma with a broad, sharply defined border
- Glands are almost always intestinal type
- confluent glands and high-grade nuclear features.
- Endocervical type usually has other epithelial components (serous, endometrioid, squamous)
- Carcinoma often merges with borderline or benign mucinous tumors
- Rarely has signet ring cells, but differs from Krukenberg tumor
- In cystic cases, the cyst wall can show papillae and cribriform glands lined by highly atypical cells with frequent mitoses.
- The underlying stroma is penetrated by nests of malignant cells with possible desmoplastic response.

Grading

- Not standardized, and does not predict prognosis independent of stage (Am J Surg Pathol 2000;24:1447)
- Grade 1-no solid areas
- Grade 2-up to 50% solid foci
- Grade 3-more than 50% solid foci

Severe nuclear atypia can increase raise grade I or II carcinomas by one grade

Differential diagnosis

- ovarian endometrioid carcinoma
- ovarian metastasis / metastatic tumor

  • bilateral tumors of any size,
  • unilateral tumor @<@ 10-12 cm,
  • exceptions are often metastatic colorectal and endocervical carcinomas (Am J Surg Pathol 2008;32:128)

See also

- ovarian tumors

- ovarian carcinomas

  • ovarian adenocarcinomas

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