Article Data

  • Views 350
  • Dowloads 119

Original Research

Open Access

Primary gynaecological tumours mistaken for metastases: report of two cases with review of literature

  • P.A. Menon1,*,
  • G. Kousparos2
  • G.A. Culora1

1Department of Cellular Pathology, Guy’s & St. Thomas’ NHS Foundation Trust, London, England

2Department of Cellular Pathology, St. George’s Hospital, Blackshaw Road, London, UK

DOI: 10.12892/ejgo201201109 Vol.33,Issue 1,January 2012 pp.109-115

Published: 10 January 2012

*Corresponding Author(s): P.A. Menon E-mail: Padma.Menon@gstt.nhs.uk

Abstract

We describe two neoplasms of rare occurrence, one of ovarian and the other of uterine origin that were sent for consultation. Both lesions were diagnosed as metastatic carcinomas by pathologists with special interest in gynaecological pathology. The cases were referred for a second opinion because of subsequent failure to identify the primary source. We discuss the differential diagnoses, the need for generous sampling particularly in ovarian mucinous neoplasms and the value of including particular antibodies in the panel to aid the diagnostic process. Metastatic tumours mimicking primary tumours are always challenging. These two cases illustrate the need to be vigilant against the reverse scenario as well.

Keywords

Ovary; Mucinous neoplasms; Uterus; Neoplasms; Sex cord-like differentiation

Cite and Share

P.A. Menon,G. Kousparos,G.A. Culora. Primary gynaecological tumours mistaken for metastases: report of two cases with review of literature. European Journal of Gynaecological Oncology. 2012. 33(1);109-115.

References

[1] Clement P.B., Scully R.E.: “Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of fourteen cases”. Am. J. Clin. Pathol., 1976, 66, 512.

[2] Hurrell D.P., McCluggage W.G.: “Uterine tumour resembling ovarian sex cord tumour is an immunohistochemically polyphenotypic neoplasm which exhibits coexpression of epithelial, myoid and sex cord markers”. J. Clin. Pathol., 2007, 60, 1148.

[3] Irving J.A., Carinelli S., Prat J.: “Uterine tumours resembling ovarian sex cord tumours are polyphenotypic neoplasms with true sex cord differentiation”. Mod. Pathol., 2006, 19, 17.

[4] Baker P., Oliva E.: “Endometrial stromal tumours of the uterus: a practical approach using conventional morphology and ancillary techniques”. J. Clin. Pathol., 2007, 60, 235.

[5] Nogales F., Tavassoli F.A.: “Sex cord like tumours”. In: Tavassoli F.A., Devilee P. (eds.). World Health Organization classification of tumours. Pathology and genetics. Tumours of the breast and female genital organs. Lyon, IARC Press, 2003, 255.

[6] Kabbani W., Deavers M.T., Malpica A., Burke T.W., Liu J., Ordoñez N.G. et al.: “Uterine tumor resembling ovarian sex-cord tumor: report of a case mimicking cervical adenocarcinoma”. Int. J. Gynecol. Pathol., 2003, 22, 297.

[7] McCluggage W.G.: “Value of inhibin staining in gynaecological pathology”. Int. J. Gynecol. Pathol., 2001, 20, 79.

[8] Czernobilsky B.: “Uterine tumors resembling ovarian sex cord tumors: an update”. Int. J. Gynecol. Pathol., 2008, 27, 229.

[9] Zámecník M., Staník M.: “Uterine tumor resembling ovarian sex cord tumor (UTROSCT). Report of case suggesting neoplastic origin of intratumoral myoid cells”. Cesk. Patol., 2006, 42, 145.

[10] Gupta M., de Leval L., Selig M., Oliva E., Nielsen G.P.: “Uterine tumors resembling ovarian sex cord tumors: an ultrastructural analysis of 13 cases”. Ultrastruct. Pathol., 2010, 34, 16.

[11] Biermann K., Heukamp L.C., Büttner R., Zhou H.: “Uterine tumor resembling an ovarian sex cord tumor associated with metastasis”. Int. J. Gynecol. Pathol., 2008, 27, 58.

[12] Lee K.R., Young R.H.: “The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases”. Am. J. Surg. Pathol., 2003, 27, 281.

[13] McCluggage W.G., Wilkinson N.: “Metastatic neoplasms involving the ovary: a review with an emphasis on morphological and immunohistochemical features”. Histopathology, 2005, 47, 231.

[14] Dionigi A., Facco C., Tibiletti M.G., Bernasconi B., Riva C., Capella C.: “Ovarian metastases from colorectal carcinoma. Clinicopathologic profile, immunophenotype, and karyotype analysis”. Am. J. Clin. Pathol., 2000, 114, 111.

[15] Chu P., Wu E., Weiss L.M.: “Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases”. Mod. Pathol., 2000, 13, 962.

[16] McCluggage W.G., Young R.H.: “Immunohistochemistry as a diagnostic aid in the evaluation of ovarian tumors”. Semin. Diagn. Pathol., 2005, 22, 3.

[17] Ronnett B.M., Zahn C.M., Kurman R.J., Kass M.E., Sugarbaker P.H., Shmookler B.M.: “Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishing pathological features, site of origin, prognosis and relationship to ‘pseudomyxoma peritonei’”. Am. J. Surg. Pathol., 1995, 19, 1390.

[18] Ronnett B.M., Shmookler B.M., Diener-West M., Sugarbaker P.H., Kurman R.J.: “Immunohistochemical evidence supporting the appendiceal origin of pseudomyxoma peritonei in women”. Int. J. Gynecol. Pathol., 1997, 16, 1.

[19] Seidman J.D., Horkayne-Szakaly I., Haiba M., Boice C.R., Kurman R.J., Ronnett B.M.: “The histologic type and stage distribution of ovarian carcinomas of surface epithelial origin”. Int. J. Gynecol. Pathol., 2004, 23, 41.

[20] McCluggage W.G.: “My approach to and thoughts on the typing of ovarian carcinomas”. J. Clin. Pathol., 2008, 61, 152.

[21] Seidman J.D., Kurman R.J., Ronnett B.M.: “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.

[22] Vang R., Gown A.M., Zhao C., Barry T.S., Isacson C., Richardson M.S., Ronnett B.M.: “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.

[23] McKenney J.K., Soslow R.A., Longacre T.A.: “Ovarian mature teratomas with mucinous epithelial neoplasms: morphologic heterogeneity and association with pseudomyxoma peritonei”. Am. J. Surg. Pathol., 2008, 32, 645.

[24] Ronnett B.M., Seidman J.D.: “Mucinous tumors arising in ovarian mature cystic teratomas: relationship to the clinical syndrome of pseudomyxoma peritonei”. Am. J. Surg. Pathol., 2003, 27, 650.

[25] Marquette S., Amant F., Vergote I., Moerman P.: “Pseudomyxoma peritonei associated with a mucinous ovarian tumor arising from a mature cystic teratoma. A case report”. Int. J. Gynecol. Pathol., 2006, 25, 340.

[26] Mandal S., Kawatra V., Khurana N.: “Mucinous cystadenocarcinoma arising in mature cystic teratoma ovary and associated pseudomyxoma peritonei: report of a case”. Arch. Gynecol. Obstet., 2008, 278, 265.

[27] Hwang J.H., So K.A., Modi G., Lee J.K., Lee N.W., Lee K.W., Kim I.: “Borderline-like mucinous tumor arising in mature cystic teratoma of the ovary associated with pseudomyxoma peritonei”. Int. J. Gynecol. Pathol., 2009, 28, 376.

[28] Pranesh N., Menasce L.P., Wilson M.S., O’Dwyer S.T.: “Pseudomyxoma peritonei: unusual origin from an ovarian mature cystic teratoma”. J. Clin. Pathol., 2005, 58, 1115.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time

Conferences

Top