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ovarian endometrioid carcinoma

Wednesday 10 August 2016

PO

Images

- endometrioid adenocacinoma

- secretory features seen in ovarian endometrioid carcinoma

- sertoliform endometrioid carcinoma

Macroscopy

- Cystic, solid, hemorrhagic
- Papillary formations are absent or inconspicuous
- 5% bilateral
- Mean 11 cm, range 3-22 cm

Microscopy

- Either non-cystic villoglandular pattern, glandular confluence or stromal disappearance
- Stromal invasion is defined as confluent glandular growth, stromal disappearance or obvious stromal invasion
- Resembles endometrial endometrioid adenocarcinoma ( endometrium ), usually well differentiated
- 50% have squamous metaplasia (morules or keratin pearls, formerly called adenoacanthomas), 40% of well differentiated tumors have adenofibromatous component
- 10% are associated with luteinized stroma cells
- May contain luminal but not cytoplasmic mucin,
- may have clear cells (but lacks the architecture of clear cell carcinoma, Am J Surg Pathol 2007;31:1203)
- Vascular invasion rare

Variants

- sertoliform endometrioid carcinoma

Differential Diagnosis

- ovarian granulosa cell tumor or ovarian Sertoli-Leydig tumor

  • usually younger patients with endocrine symptoms,
  • no squamous metaplasia,
  • no typical endometrioid features elsewhere,
  • no mucin,
  • no adenofibroma component,
  • keratin negative

- ovarian metastatis of a colonic carcinoma

  • dirty necrosis,
  • garland pattern,
  • CDX2+, CK20+

- ovarian metastatis of an endometrial adenocarcinoma

  • high grade,
  • bilateral,
  • multinodular,
  • surface implants,
  • prominent angiolymphatic invasion within ovarian stroma

- mixed endometrioid and mucinous ovarian carcinoma

  • > 10% mucinous component

- yolk sac tumor / endodermal sinus tumor

See also

- ovarian carcinomas

- ovarian tumors

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