Ovarian tumors mucinous

Epithelial ovarian tumors are composed of cells that cover the surface of the ovary, such as serous, mucinous, endometrioid, clear cell, and poorly differentiated adenocarcinomas. 

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. 

Tashiro, Y, Yonezawa, S., Kim, Y. S., and Soto, E. 1994. Immunohistochemical study of mucin carbohydrates and core proteins in human ovarian tumors. Hum. Pathol. 25 364-312. 

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. 

Most primary ovarian tumors are negative for CK20 and CDX2. The exception is the intestinal type of mucinous ovarian tumor, which is positive for CK7, and variably positive for CK20 and CDX2. 

Adenocarcinoma of GIT transitional cell carcinoma, mucinous ovarian tumors... 

In addition to the sex-cord stromal tumors, a variety of other benign and primary and metastatic malignant ovarian tumors may have a functioning stroma with estrogenic or androgenic production. However, these elevations will remain commonly subclinical. These tumors include mucinous tumors, rarely endometrioid carcinoma, malignant germ cell tumors, and mucinous metastatic carcinomas [37]. 

Carcinoid tumors are frequently associated with a mature cystic teratoma or a mucinous ovarian tumor. Unlike most cystic teratomas, they are predominantly found in postmenopausal women. The course is usually benign rarely will metastases be found. Carcinoid syndrome is uncommon. 

Brenner tumors present rare ovarian tumors that occur at a mean age of 50 years. Brenner tumors constitute l%-3% of ovarian tumors. They are mostly henign, with less than 2% demonstrating borderline or malignant transformation. They are typically small, solid, unilateral ovarian tumors, with 60% of these tumors found under 2 cm in size. Extensive calcification may he observed. The vast majority is discovered incidentally in pathologic specimen of the adnexa. Brenner tumors rarely produce estrogen, and then they may be associated with endometrial thickening [87]. If cystic components are found in Brenner tumors, they may be associated with cystadenomas [88]. Up to 20% of Brenner tumors are associated with mucinous cystadenomas or other epithelial neoplasm (Fig. 9.34). 

Patients with malignant tumors of the ovary and borderline tumors account for 21% and 4% of primary ovarian tumors, respectively [12], Among these, epithelial cancer constitutes for the vast majority with 85%. Serous epithelial and mucinous ovarian cancer account for the majority of epithelial ovarian cancers and present approximately 49% and 36% of all ovarian epithelial tumors, respectively [3], Endometrioid cell cancers account for 8%. The other cancers occur with equal frequency of 2% [3],... 

Federici, M. F., Kudryashov, V., Saigo, P. E., Finstad, C. L., and Llyod, K. O. 1999. Selection of carbohydrate antigens in human epithelial ovarian cancers as targets for immunotherapy Serous and mucinous tumor exhibit distinctive patterns of expression. Int. J. Cancer 87 193-198. 

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). 

Ronnett BM, Kurman RJ, Zahn CM, et al. Pseudomyxoma peritonei in women a clinicopathologic analysis of 30 cases with emphasis on site of origin, prognosis, and relationship to ovarian mucinous tumors of low malignant potential. Hum Pathol. 1995 26 509-524. 

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. 

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. 

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. 

FIGURE 18.24 Many non-mucinous ovarian epithelial tumors, particularly serous tumors, exhibit positive staining for CA125. This microscopic serous carcinoma, found in a woman with a family history of ovarian cancer, illustrates the typical strong membranous staining pattern. 

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