Mucinous borderline ovarian tumors: Points of general agreement and persistent controversies regarding nomenclature, diagnostic criteria, and behavior

Ronnett, Brigitte M.; Kajdacsy-Balla, André; Gilks, C. Blake; Merino, María J.; Silva, Elvio; Werness, Bruce A.; Young, Robert H.

doi:10.1016/j.humpath.2004.03.006

Cited by 149 publications

(115 citation statements)

References 57 publications

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“…30,52 Microinvasion: A standardised quantitative criterion for distinguishing microinvasion from frankly invasive carcinoma within a borderline tumour has not been established, and varying definitions have been used in different studies, including 1 mm, 2 mm, 3 mm, 5 mm and 10 mm 2 as the upper limits of microinvasion. 29,51,52,57,58 The 2014 WHO Classification suggests a cutoff of 5 mm. 30 Some groups distinguish two patterns of stromal invasion in serous tumours that quantitatively falls short of frankly invasive carcinoma (o 5 mm)-conventional 'microinvasion' (isolated and/or small clusters of eosinophilic cells) and 'microinvasive carcinoma' (glandular or micropapillary patterns qualitatively analogous to low-grade serous carcinoma).…”

Section: Tumour Gradementioning

confidence: 99%

“…51,52,59 Analogous to the situation for serous tumours, some investigators advocate the separation of 'microinvasion' from 'microinvasive carcinoma' in mucinous borderline tumours while others use these two terms synonymously. 57,58 Implants: Extra-ovarian implants occur in approximately 20% of serous borderline tumours and are more common with exophytic neoplasms. The most important adverse prognostic factor for serous borderline tumours is the presence of invasive implants in extra-ovarian tissues, with non-invasive implants having a favourable prognosis.…”

Section: Tumour Gradementioning

confidence: 99%

“…In mucinous borderline tumours, intraepithelial carcinoma is diagnosed in non-invasive foci with marked nuclear atypia. 29,57,58 However, the reproducibility of this diagnosis has not been formally analysed.…”

Section: Carcinosarcoma Subtypesmentioning

confidence: 99%

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Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

et al. 2015

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Section: Tumour Gradementioning

confidence: 99%

Section: Tumour Gradementioning

confidence: 99%

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Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

et al. 2015

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“…[1][2][3] However, some metastatic mucinous carcinomas can manifest one or more features suggesting a primary ovarian tumor, including presentation as a large unilateral tumor in the absence of a known extraovarian primary site and formation of a multicystic tumor exhibiting confluent glandular or expansile, rather than infiltrative, patterns of invasion, thus simulating primary ovarian atypical proliferative (borderline) mucinous tumors with intraepithelial carcinoma or welldifferentiated mucinous carcinomas of confluent glandular type. [4][5][6][7][8][9][10] Despite recognition of the ability of these metastases to simulate primary ovarian tumors and recent studies providing refined diagnostic criteria for ovarian mucinous tumors, 1,2,11,12 the problem of distinguishing these tumors persists. This problem is compounded by the fact that in routine practice metastatic mucinous carcinomas are more common than primary ovarian mucinous carcinomas, 3 with those of gastrointestinal and pancreaticobiliary tract origin being the most commonly encountered types.…”

mentioning

confidence: 99%

Immunohistochemistry for estrogen and progesterone receptors in the distinction of primary and metastatic mucinous tumors in the ovary: an analysis of 124 cases

Vang

Gown²,

Barry³

et al. 2006

Modern Pathology

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109

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Estrogen (ER) and progesterone receptor (PR) expression in primary ovarian mucinous tumors and the utility of these markers for distinguishing metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors have not been extensively investigated. Immunohistochemical studies were performed on 124 mucinous tumors, including 52 primary ovarian tumors (30 atypical proliferative (borderline) mucinous tumors of gastrointestinal type, 11 atypical proliferative (borderline) mucinous tumors of seromucinous (endocervicallike) type, and 11 invasive mucinous carcinomas of usual (gastrointestinal) type) and 72 metastatic mucinous carcinomas in the ovary (primary sites: colorectum (24), pancreas (13), endocervix (eight), stomach (four), gallbladder/bile duct (four), appendix (four), and unknown (15)). All atypical proliferative mucinous tumors of gastrointestinal type, primary ovarian mucinous carcinomas, and metastatic mucinous carcinomas were negative for ER and PR with the exception of three metastatic endocervical adenocarcinomas which exhibited only weak expression of ER without PR. All atypical proliferative mucinous tumors of seromucinous type expressed ER to some degree and seven had some expression of PR. Immunohistochemical assessment of hormone receptor expression is of no value in distinguishing the common types of primary ovarian mucinous tumors (atypical proliferative mucinous tumors of gastrointestinal type and mucinous carcinomas of usual type) from the vast majority of mucinous carcinomas metastatic to the ovary. The above observations on hormone receptor expression in primary ovarian mucinous tumors support the concept that atypical proliferative (borderline) mucinous tumors of gastrointestinal and seromucinous (endocervical-like) Keywords: ovary; mucinous tumor; mucinous carcinoma; metastases; estrogen receptor; progesterone receptor Among ovarian epithelial tumors, the mucinous tumors pose the greatest difficulty with regard to distinction of primary from metastatic tumors. The primary ovarian mucinous tumors, including the atypical proliferative (borderline) tumors and carcinomas, and metastatic mucinous carcinomas in the ovaries are usually easily distinguished when they exhibit characteristic gross and microscopic features. The primary tumors are typically large (usually greater than 15 cm), unilateral multicystic tumors with smooth capsules and are most often unassociated with extraovarian disease. The carcinomas most often arise in association with atypical proliferative (borderline) tumors and while they can exhibit destructive stromal invasion, they frequently display confluent glandular or expansile, rather than infiltrative, patterns of invasion. In contrast, typical features of metastatic mucinous carcinomas in the ovary that distinguish them from primary tumors include bilaterality, smaller size (often less

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“…All the patients in this study in clinically stage Ia had either a borderline tumor or a well differentiated tumor, which may explain why there is no woman so far with any known recurrence despite not all patients in this study had a thorough staging operation. There are controversies related to the diagnosis of borderline tumors and the management of these tumors [13][14][15][16]. The definitions for borderline ovarian tumor have changed over the years.…”

Section: Discussionmentioning

confidence: 99%

Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer

Borgfeldt

Iosif

Måsbäck

2007

European Journal of Obstetrics & Gynecology and Reproductiv

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Results: During the follow-up period of median 92 months, range 11-185 months, no relapse was found in the patients with stage Ia tumors including both the borderline tumors (n=12) and the invasive well (n=9) and moderately (n=1) differentiated ovarian cancers. One patient with poorly differentiated ovarian cancer stage 1c was pregnant at 13 weeks at the primary operation.Although, unilateral oophorectomy was performed she insisted in continuing the pregnancy. At 37 weeks she had a caesarian section and the ovarian cancer was disseminated. Chemotherapy was given but she died less than a year later. No other patient received chemotherapy. In total 30 children was born by 15 patients. Prophylactic removal of the remaining ovary +/-hysterectomy was accepted only in six of the women after completing their desire to have more children. However, several of these patients do not accept the recommendation of prophylactic oophorectomy of the contra lateral ovary and hysterectomy after completion of childbearing age. Conclusions4

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Mucinous borderline ovarian tumors: Points of general agreement and persistent controversies regarding nomenclature, diagnostic criteria, and behavior

Cited by 149 publications

References 57 publications

Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

Immunohistochemistry for estrogen and progesterone receptors in the distinction of primary and metastatic mucinous tumors in the ovary: an analysis of 124 cases

Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer

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