A short note of epithelial ovarian tumor: Part 2 - mucinous tumors
20-25% of all ovarian neoplasm 1
Most likely occurs in middle adult life, usually benign (80%) or borderline (10%) 1
Mutation of KRAS proto-oncogene (68% in benign tumor cases 2, 40-71% in malignant tumor cases 3)
Risk factors: Lower parity, No history of tubal ligation, Smoking 4
usually unilateral (bilateral ovarian mucinous tumors always requires exclusion of metastasis)
Pseudomyxoma perionei presented with mucinous ascites, associated with appendiceal mucinous neoplasm (used to believe to be associated with mucinous tumor of ovary)Â
Prognosis of invasive mucinous carcinoma stage 1 is very good, expansile invasive pattern tends to have better prognosis
Gross🔎: Unilateral, large, multiloculated cystic tumors filled with sticky, gelatinous fluid (rarely involved surface of ovary)
Microscopic feature🔬:
| Histology | Microscopic features |
|---|---|
| Cystadenoma | Cyst lined by columnar epithelial cell with apical mucin (mucinous epithelium) usually resemble gastric or intestinal type (+Goblet cells) differentiation |
| Adenofibroma | Cyst lined by mucinous epithelium + fibromatous stroma |
| Borderline | more complex architecture + epithelial stratification + tufting ± papillary intraglandular growth |
| Intraepithelial carcinoma | marked nuclear atypia, high mitotic activity but no stromal invasion |
| Mucinous carcinoma | cytological atypia + stromal invasion spanning >= 5mm, 2 type of stromal invasion: expansile (architecturally complex + confluent gland), Destructive (grand with irregular contour or nest or single cells) |
"Mucinous Cystadenoma of Ovary" by Ed Uthman is licensed under CC BY 2.0.
"Ovarian mucinous cystadenoma - alt -- low mag" by Nephron is licensed under CC BY-SA 3.0.
High magnification image of ovarian mucinous cystadenoma shows mucinous epithelium lining of cyst. ("Ovarian mucinous cystadenoma - a3 -- high mag" by Nephron is licensed under CC BY-SA 3.0.)
Reference:
- Robbins & Cotran Pathologic Basis of Disease 10th Edition
- https://www.pathologyoutlines.com/topic/ovarytumormucinousbenign.html
- https://www.pathologyoutlines.com/topic/ovarytumormucinouscarcinoma.htmlÂ
- Mallen, A.R., Townsend, M.K., & Tworoger, S.S. (2018). Risk Factors for Ovarian Carcinoma. Hematology/oncology clinics of North America, 32 6, 891-902 .
Random quiz: A middle aged woman presents with a large, unilateral, multilocurated cystic ovarian mass. Gross examination shows cysts filled with gelatinous material. Pathohistology examination shows cysts lined by columnar epithelium resembling intestinal type with goblet cells, no nucleus atypia, no stromal invasion. Which molecular alteration most likely occurs in these tumor cells?
I am currently just a final year med student, this is my study note and is not intended as medical advice. The content may contains inaccurency