Ovarian mucinous carcinoma

Importantly, other mucinous neoplasms with morphologic intestinal features, the colloid carcinoma of the lungi45 with goblet cells (100%), and a subset of ovarian mucinous carcinomas (64%) are CDX2 positive. The majority of the colloid lung tumors are TTF-1 positive, a feature that allows distinction from metastatic colorectal mucinous carcinoma. Ovarian mucinous carcinomas may be separated from gastrointestinal mucinous carcinomas by virtue of typical immunostaining for CK7 in the ovarian tumors. 

Layton, G. T., Devine, P. L., Warren, J. A., Birrell, G., Xing, P., Ward, B. G., and McKenzie, 1. F., (1990), Monoclonal antibodies reactive with the breast carcinoma-associated mucin core protein repeat sequence peptide also recognise the ovarian carcinoma-associated sebaceous gland antigen. Tumour Biol. 11, 274-286. 

Other CDX2-I- tumors include colloid lung carcinomas (also positive for TTF-1) and ovarian mucinous carcinomas (CK7-I- with CK20 expression weaker than CK7). 

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 Gynecol Pathol. 2002 21 391-400. 

Ovarian mucinous carcinoma MUC5-AC+ MUC-2-CDX2 (variable)... 

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 1421-1428. 

Ovarian mucinous Ca Prostatic Ca Ovarian serous carcinoma Primary seminal vesicle Ca... 

Chou YY, Jeng YM, Kao HL, et al. Differentiation of ovarian mucinous carcinoma and metastatic colorectal adenocarcinoma by immunostaining with beta-catenin. Histopathology. 2003 43 151-156. 

Prat J, Young RH, Scully RE. Ovarian mucinous tumors with foci of anaplastic carcinoma. Cancer. 1982 50 300-304. 

Chan YF, Ho HC, Yau SM, et al. Ovarian mucinous tumor with mural nodules of anaplastic carcinoma. Gynecol Oncol. 1989 35 112-119. 

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. 

Wilms tumor gene product (WTl) has been established as a good marker for mesothelial cells. Studies have also demonstrated that WTl is a highly sensitive and specific marker of serous carcinomas of ovarian surface epithelial origin (both ovarian and extra-ovarian). Mucinous and micropapillary breast carcinomas may express WTl and thus confound the distinction between breast carcinoma and metastatic ovarian serous carcinoma (Fig. 21.13). ° ... 

Estrogen receptor (ER) Breast and endometrium carcinoma Ovarian serous, mucinous and endometrioid carcinoma. Breast and endometrial epithelium, endometrial stromal cells and... 

CA 125 is a mucin-like glycoprotein antigenic determinant expressed on the surface of coelomic epithelium and human ovarian carcinoma cells however, it does not appear to be specific for ovarian cancer because elevated levels have been reported in breast and colorectal cancers. Studies have shown increased CA 125 levels in patients with ovarian cancer, whereas decreased CA 125 levels in chemotherapy are associated with improved possibility for survival. Some studies have shown failure of CA 125 levels to return to normal after chemotherapy, indicating... 

In another study involving patients with metastatic breast, colorectal and ovarian cancer, increased anti-sTn titers were correlated with better survival. Even if before treatment, elevated titers of antibodies against the mucin MUC1, were correlated with a poor response to immunotherapy, CTL precursors to the MUC1 were detected in carcinoma patients [208], A vaccine using 10 pg/ml MUC1-KLH mixed with Detox was injected s.c. in breast cancer patients treated with cyclophosphamide. A weak antibody response, and an ex vivo CTL response against HLA-matched adenocarcinoma cell lines were seen. No correlation with the clinical outcome was available [209],... 

Recently, Caduff et al. (1999) have evaluated abnormalities in p53 and Ki-ra.v in malignant and borderline ovarian tumors of various histological types in paraffin-embedded tissues. The patterns of these genetic alterations in borderline and malignant neoplasms were compared and correlated with cell type and stage. This preliminary molecular analysis suggests that serous borderline tumors have the same molecular features usually associated with malignancy but are unlikely to represent a precursor of invasive serous carcinoma. On the other hand, mucinous borderline tumors may represent a precursor or variant of mucinous carcinoma of the ovary. 

Increases in both serum and urine TATI are common in ovarian cancer. In mucinous ovarian cancers, approximately 45% of patients have increased TATI in stage I, and 90% to 100% have increases by stage Fifly-five percent to 60% of patients with late stage endometrial cancer have increased serum TATI however, only 20% show an increase in early stages. TATI is increased in cervical cancer, but squamous cell carcinoma antigen (SCCA) and CEA are better markers. 

FR expression may also be dependent on the histological classification of a tissue or cancer. For example, using a recently developed quantitative assay for measuring functional FR in cells and tissues, it was found that normal ovarian tissue and the mucinous form of ovarian cancer express very low levels of FR ( 1 pmol FR/ mg protein unpublished data, Endocyte, Inc., West Lafayette, IN). However, serous ovarian carcinomas express high amounts of FR, with the average expression level being 30 pmol FR/mg protein, or about 30-fold higher than that of the normal... 

CK20 K20 Most gastrointestinal carcinomas mucinous ovarian, biliary. 

CK20 (+) colorectal, pancreas, mucinous ovarian, Merkel cell, and urothelial carcinomas. 

Pure and mixed mucinous breast carcinomas may be WT1+ however, staining is rarely intense compared with serous ovarian carcinomas. 

Mesothelin is a 40-kD glycoprotein of unknown function that is strongly expressed in mesothelial cells, ovarian serous cells, and pancreatic-bile duct cells. Using monoclonal antibody 5B2, Ordonez found it to immu-nostain normal mesothelial cells, mesotheliomas, non-mucinous ovarian carcinomas, and occasionally other neoplasms. Ordonez concluded that mesothelin staining could be used to diagnose mesotheliomas, although it was expressed in 14 of 14 ovarian carcinomas, 12 of 14 pancreatic ductal adenocarcinomas, 7 of 12 desmoplastic small round cell tumors, and 9 of 9 synovial sarcomas. Therefore, this antibody should be interpreted carefully. 

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