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Pathology of Mucinous Tumors

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Diagnostic Pathology of Ovarian Tumors

Abstract

Mucinous tumors include mucinous cystadenomas (a benign tumor which comprises 13% of benign ovarian epithelial neoplasms); atypical proliferative mucinous tumors (APMT or borderline tumors); mucinous tumors with mural nodules, and invasive mucinous carcinomas. This chapter describes these tumors’ macroscopic and microscopic features, clinical outcomes, immunophenotype, molecular biology, differential diagnoses, and diagnostic pitfalls.

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References

  1. Ronnett BM, Kajdacsy-Balla A, Gilks CB, et al. Mucinous borderline ovarian tumors: points of general agreement and persistent controversies regarding nomenclature, diagnostic criteria, and behavior. Hum Pathol. 2004;35:949–60.

    Article  PubMed  Google Scholar 

  2. Seidman JD, Kurman RJ, Ronnett BM. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol. 2003;27:985–93.

    Article  PubMed  Google Scholar 

  3. Ronnett BM, Zahn CM, Kurman RJ, et al. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19:1390–408.

    Article  PubMed  CAS  Google Scholar 

  4. Seidman JD, Horkayne-Szakaly I, Haiba M, Boice CR, Kurman RJ, Ronnett BM. The histologic type and stage distribution of ovarian carcinomas of surface epithelial origin. Int J Gynecol Pathol. 2004;23:41–4.

    Article  PubMed  Google Scholar 

  5. Gilks CB, Kobel M, Kalloger SE, et al. Significant differences in tumor cell type in early versus advanced stage ovarian carcinoma. Mod Pathol. 2009;22 Suppl 1:215A.

    Google Scholar 

  6. Gilks CB. Subclassification of ovarian surface epithelial tumors based on correlation of histologic and molecular pathologic data. Int J Gynecol Pathol. 2004;23:200–5.

    Article  PubMed  Google Scholar 

  7. Heintz AP, Odicino F, Maisonneuve P, et al. Carcinoma of the ovary. In: FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet. 2006;95 suppl 1:S161–92.

    Article  PubMed  Google Scholar 

  8. Seidman JD, Soslow RA, Vang R, et al. Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images. Hum Pathol. 2004;35:918–33.

    Article  PubMed  Google Scholar 

  9. Seidman JD, Khedmati F. Exploring the histogenesis of ovarian mucinous and transitional cell (Brenner) tumors: a study of 120 tumors. Arch Pathol Lab Med. 2008;132:1753–60.

    PubMed  Google Scholar 

  10. Lee KR, Scully RE. Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with ‘pseudomyxoma peritonei’. Am J Surg Pathol. 2000;24:1447–64.

    Article  PubMed  CAS  Google Scholar 

  11. Nomura K, Aizawa S, Hano H. Ovarian mucinous borderline tumors of intestinal type without intraepithelial carcinoma: are they still tumors of low malignant potential? Pathol Int. 2004;54:420–4.

    Article  PubMed  Google Scholar 

  12. Riopel MA, Ronnett BM, Kurman RJ. Evaluation of diagnostic criteria and behavior of ovarian intestinal- type mucinous tumors: atypical proliferative (borderline) tumors and intraepithelial, microinvasive, invasive, and metastatic carcinomas. Am J Surg Pathol. 1999;23:617–35.

    Article  PubMed  CAS  Google Scholar 

  13. Rodriguez IM, Prat J. Mucinous tumors of the ovary: a clinicopathologic analysis of 75 borderline tumors (of intestinal type) and carcinomas. Am J Surg Pathol. 2002;26:139–52.

    Article  PubMed  Google Scholar 

  14. Hart WR. Mucinous tumors of the ovary: a review. Int J Gynecol Pathol. 2005;24:4–25.

    PubMed  Google Scholar 

  15. Shappell HW, Riopel MA, Smith-Sehdev AE, Ronnett BM, Kurman RJ. Diagnostic criteria and behavior of ovarian seromucinous (endocervical-type mucinous and mixed cell-type) tumors: atypical proliferative (borderline) tumors, intraepithelial, microinvasive, and invasive carcinoma. Am J Surg Pathol. 2002;26:1529–41.

    Article  PubMed  Google Scholar 

  16. Rodriguez IM, Irving JA, Prat J. Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases. Am J Surg Pathol. 2004;28:1311–8.

    Article  PubMed  Google Scholar 

  17. Nagai Y, Kishimoto T, Nikaido T, et al. Squamous predominance in mixed- epithelial papillary cystadenomas of borderline malignancy of mullerian type arising in endometriotic cysts: a study of four cases. Am J Surg Pathol. 2003;27:242–7.

    Article  PubMed  Google Scholar 

  18. Lee KR, Nucci MR. Ovarian mucinous and mixed epithelial carcinomas of mullerian (endocervical-like) type: a clinicopathologic analysis of four cases of an uncommon variant associated with endometriosis. Int J Gynecol Pathol. 2003;22:42–51.

    Article  PubMed  Google Scholar 

  19. Dube V, Roy M, Plante M, et al. Mucinous ovarian tumors of mullerian-type: an analysis of 17 cases including borderline tumors and intraepithelial, microinvasive, and invasive carcinomas. Int J Gynecol Pathol. 2005;24:138–46.

    Article  PubMed  Google Scholar 

  20. Nomura K, Aizawa S. Noninvasive, microinvasive, and invasive mucinous carcinomas of the ovary: a clinicopathologic analysis of 40 cases. Cancer. 2000;89:1541–6.

    Article  PubMed  CAS  Google Scholar 

  21. Kim KR, Lee HI, Lee SK, et al. Is stromal microinvasion in primary mucinous ovarian tumors with “mucin granuloma” true invasion? Am J Surg Pathol. 2007;31:546–54.

    Article  PubMed  Google Scholar 

  22. Bague S, Rodriguez IM, Prat J. Sarcoma-like mural nodules in mucinous cystic tumors of the ovary revisited: a clinicopathologic analysis of 10 additional cases. Am J Surg Pathol. 2002;26:1467–76.

    Article  PubMed  Google Scholar 

  23. Provenza C, Young RH, Prat J. Anaplastic carcinoma in mucinous ovarian tumors: a clinicopathologic study of 34 cases emphasizing the crucial impact of stage on prognosis, their histologic spectrum, and overlap with sarcomalike mural nodules. Am J Surg Pathol. 2008;32:383–9.

    Article  PubMed  Google Scholar 

  24. Leitao MM, Boyd J, Hummer A, et al. Clinicopathologic analysis of early-stage sporadic ovarian carcinoma. Am J Surg Pathol. 2004;28:147–59.

    Article  PubMed  Google Scholar 

  25. Chen S, Leitao MM, Tornos C, Soslow RA. Invasion patterns in stage I endometrioid and mucinous ovarian carcinomas: a clinicopathologic analysis emphasizing favorable outcomes in carcinomas without destructive stromal invasion and the occasional malignant course of carcinomas with limited destructive stromal invasion. Mod Pathol. 2005;18:903–11.

    Article  PubMed  Google Scholar 

  26. Ludwick C, Gilks CB, Miller D, et al. Aggressive behavior of stage I ovarian mucinous tumors lacking extensive infiltrative invasion: a report of four cases and review of the literature. Int J Gynecol Pathol. 2005;24:205–17.

    Article  PubMed  Google Scholar 

  27. McKenney JK, Soslow RA, Longacre TA. Ovarian mature teratomas with mucinous epithelial neoplasms: morphologic heterogeneity and association with pseudomyxoma peritonei. Am J Surg Pathol. 2008;32:645–55.

    Article  PubMed  Google Scholar 

  28. Vang R, Gown AM, Zhao C, et al. Ovarian mucinous tumors associated with mature cystic teratomas: morphologic and immunohistochemical analysis identifies a subset of potential teratomatous origin that shares features of lower gastrointestinal tract mucinous tumors more commonly encountered as secondary tumors in the ovary. Am J Surg Pathol. 2007;31:854–69.

    Article  PubMed  Google Scholar 

  29. McCluggage WG. Immunohistochemical and functional biomarkers of value in female genital tract lesions. Int J Gynecol Pathol. 2006;25:101–20.

    Article  PubMed  Google Scholar 

  30. Baker PM, Oliva E. Immunohistochemistry as a tool in the differential diagnosis of ovarian tumors: an update. Int J Gynecol Pathol. 2005;24:39–55.

    PubMed  Google Scholar 

  31. Vang R, Gown AM, Barry TS, et al. Cytokeratins 7 and 20 in primary and secondary mucinous tumors of the ovary: analysis of coordinate immunohistochemical expression profiles and staining distribution in 179 cases. Am J Surg Pathol. 2006;30:1130–9.

    PubMed  Google Scholar 

  32. Ji H, Isacson C, Seidman JD, et al. Cytokeratins 7 and 20, Dpc4, and MUC5AC in the distinction of metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors: Dpc4 assists in identifying metastatic pancreatic carcinomas. Int J Gynecol Pathol. 2002;21:391–400.

    Article  PubMed  Google Scholar 

  33. Vang R, Gown AM, Barry TS, et al. Ovarian atypical proliferative (borderline) mucinous tumors: gastrointestinal and seromucinous (endocervical-like) types are immunophenotypically distinctive. Int J Gynecol Pathol. 2006;25:83–9.

    Article  PubMed  Google Scholar 

  34. Vang R, Gown AM, Wu LS, et al. Immunohistochemical expression of CDX2 in primary ovarian mucinous tumors and metastatic mucinous carcinomas involving the ovary: comparison with CK20 and correlation with coordinate expression of CK7. Mod Pathol. 2006;19:1421–8.

    Article  PubMed  CAS  Google Scholar 

  35. Vang R, Gown AM, Farinola M, et al. p16 expression in primary ovarian mucinous and endometrioid tumors and metastatic adeno­carcinomas in the ovary: utility for identification of metastatic HPV-related endocervical adenocarcinomas. Am J Surg Pathol. 2007;31:653–63.

    Article  PubMed  Google Scholar 

  36. Vang R, Gown AM, Barry TS, et al. Immunohistochemistry for estrogen and progesterone receptors in the distinction of primary and metastatic mucinous tumors in the ovary: an analysis of 124 cases. Mod Pathol. 2006;19:97–105.

    Article  PubMed  CAS  Google Scholar 

  37. Cuatrecasas M, Villanueva A, Matias-Guiu X, Prat J. K-ras ­mutations in mucinous ovarian tumors: a clinicopathologic and molecular study of 95 cases. Cancer. 1997;79:1581–6.

    Article  PubMed  CAS  Google Scholar 

  38. Gemignani ML, Schlaerth AC, Bogomolniy F, Barakat RR, Lin O, Soslow R, et al. Role of KRAS and BRAF gene mutations in mucinous ovarian carcinoma. Gynecol Oncol. 2003;90:378–81.

    Article  PubMed  CAS  Google Scholar 

  39. Mayr D, Hirschmann A, Lohrs U, Diebold J. KRAS and BRAF mutations in ovarian tumors: a comprehensive study of invasive carcinomas, borderline tumors and extraovarian implants. Gynecol Oncol. 2006;103:883–7.

    Article  PubMed  CAS  Google Scholar 

  40. Kurman RJ, Shih leM. Pathogenesis of ovarian cancer: lessons from morphology and molecular biology and their clinical implications. Int J Gynecol Pathol. 2008;27:151–60.

    PubMed  Google Scholar 

  41. McAlpine JN, Wiegand KC, Vang R, et al. HER2 overexpression and amplification is present in a subset of ovarian mucinous carcinomas and can be targeted with trastuzumab therapy. BMC Cancer. 2009;9:433.

    Article  PubMed  Google Scholar 

  42. Yemelyanova AV, Vang R, Judson K, et al. Distinction of primary and metastatic mucinous tumors involving the ovary: analysis of size and laterality data by primary site with reevaluation of an algorithm for tumor classification. Am J Surg Pathol. 2008;32:128–38.

    Article  PubMed  Google Scholar 

  43. Khunamornpong S, Suprasert P, Pojchamarnwiputh S, et al. Primary and metastatic mucinous adenocarcinomas of the ovary: evaluation of the diagnostic approach using tumor size and laterality. Gynecol Oncol. 2006;101:152–7.

    Article  PubMed  Google Scholar 

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Seidman, J.D., Yemelyanova, A. (2011). Pathology of Mucinous Tumors. In: Soslow, R., Tornos, C. (eds) Diagnostic Pathology of Ovarian Tumors. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9751-7_9

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  • DOI: https://doi.org/10.1007/978-1-4419-9751-7_9

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-9750-0

  • Online ISBN: 978-1-4419-9751-7

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