Mucinous adenocarcinoma of the ovary

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Mucinous adenocarcinoma of the ovary is a malignant ovarian tumour.

It is also known as ovarian mucinous adenocarcinoma and ovarian mucinous carcinoma.

General

  • Malignant.
  • May arise in endometriosis.[1]
  • Poor response to chemotherapy vis-à-vis serous carcinoma.[2]

Gross

Features:

  • Multiloculated.
  • Sticky, gelatinous fluid (glycoprotein).
  • +/-Necrosis.
  • Typically unilateral.[3]

Microscopic

Features:

  • Mucinous differentiation.
    • Tall columnar cells in glands with apical mucin.
      • May have an endocervical-like or intestinal-like appearance - see subtypes.
  • Invasive morphology - one of the following:
    1. Back-to-back glands/confluent growth pattern.
    2. Desmoplastic stromal response.
    3. Cribriforming of glands.
  • Malignant characteristics:
    • +/-Nuclear atypia.
    • +/-Necrosis.
    • No cilia.

DDx:

Subtypes

  1. Endocervical type.
    • Less likely to be malignant.
    • More common than malignant type.
  2. Intestinal type.
    • More likely to be malignant.
    • +/-Goblet cells.
      • One large clear apical vacuole.
    • If it doesn't look like intestine to you... it probably isn't.
    • May vaguely resemble colorectal adenocarcinoma (hyperchromatic, columnar nuclei, nuclear pleomorphism).

Comparison of mucosa:

IHC

See also

References

  1. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1097. ISBN 0-7216-0187-1.
  2. Shimada, M.; Kigawa, J.; Ohishi, Y.; Yasuda, M.; Suzuki, M.; Hiura, M.; Nishimura, R.; Tabata, T. et al. (Jun 2009). "Clinicopathological characteristics of mucinous adenocarcinoma of the ovary.". Gynecol Oncol 113 (3): 331-4. doi:10.1016/j.ygyno.2009.02.010. PMID 19275957.
  3. Offman, SL.; Longacre, TA. (Sep 2012). "Clear cell carcinoma of the female genital tract (not everything is as clear as it seems).". Adv Anat Pathol 19 (5): 296-312. doi:10.1097/PAP.0b013e31826663b1. PMID 22885379.