ovarian mucinous adenocarcinoma

|PO|

Images

 http://www.webpathology.com/image.asp?case=526&n;=14

Macroscopy

 Primary tumors are usually unilateral, > 10 cm, smooth capsule, cystic and solid areas of tumor evenly distributed throughout ovary without discrete nodularity.

Microscopy

 Stromal invasion;
 more solid growth, atypia, stratification, papillae, loss of glandular architecture, necrosis (resembles colon carcinoma),
 greater complexity of glands than borderline tumors
 Stromal invasion may be infiltrative with disorderly penetration of stroma by neoplastic glands, single cells or cell clusters, may have desmoplastic response or expansile (confluent) with complex arrangement of glands,
  cysts or papillae lined by malignant epithelium with minimal or no intervening stroma with a broad, sharply defined border
 Glands are almost always intestinal type
 confluent glands and high-grade nuclear features.
 Endocervical type usually has other epithelial components (serous, endometrioid, squamous)
 Carcinoma often merges with borderline or benign mucinous tumors
 Rarely has signet ring cells, but differs from Krukenberg tumor
 In cystic cases, the cyst wall can show papillae and cribriform glands lined by highly atypical cells with frequent mitoses.
 The underlying stroma is penetrated by nests of malignant cells with possible desmoplastic response.

Grading

 Not standardized, and does not predict prognosis independent of stage (Am J Surg Pathol 2000;24:1447)
 Grade 1-no solid areas
 Grade 2-up to 50% solid foci
 Grade 3-more than 50% solid foci

Severe nuclear atypia can increase raise grade I or II carcinomas by one grade

Differential diagnosis

 ovarian endometrioid carcinoma
 ovarian metastasis / metastatic tumor

• bilateral tumors of any size,
• unilateral tumor @<@ 10-12 cm,
• exceptions are often metastatic colorectal and endocervical carcinomas (Am J Surg Pathol 2008;32:128)

See also

 ovarian tumors

• ovarian malignant tumors
  • ovarian mucinous tumors

 ovarian carcinomas

• ovarian adenocarcinomas