Ovarian microcystic stromal tumor with significant bizarre nuclei

Abstract

Rationale: Ovarian microcystic stromal tumor is a relatively rare tumor type, which is characterized by morphology with microcyst structure, solid cellular areas, and hyalinized fibrous stroma. The most reported tumors were stage I with good prognosis. Patient concerns: We report a case of a 33-year-old woman with primary ovarian microcystic stromal tumor with significant bizarre nuclei. We describe the clinical, histopathological, and immunohistochemical findings and review the English literatures. So far, as we know, the patient presented here is a rare case of ovarian microcystic stromal tumor with prominent bizarre nuclei accounting for about 50% of the tumor cells. Diagnoses: She was diagnosed with ovarian microcystic stromal tumor with significant bizarre nuclei. Interventions: The right ovarian tumor was resected laparoscopically on October 19, 2018. Outcomes: Up to now, the patient is free of disease at 19 months of follow-up. Lessons: This is a rare case of ovarian microcystic stromal tumor with obvious bizarre nuclei. This report will contribute to expand the morphological spectrum of ovarian microcystic stromal tumor.

Ovarian Microcystic Stromal Tumor With Intraovarian Recurrence and Peritoneal and Omental Spread: A Case Report With Morphological, Immunohistochemical, and Molecular Analysis

“…Interestingly, both our case and the previous recurrent case were among the very few patients who received ovarian cystectomy/tumor resection (n=4 including ours), and recurrence occurred 4 and 9 years after surgery, respectively 3,8,10 . Two other patients who underwent cystectomy/tumor resection were without recurrence, though notably with a much shorter follow up period of 4 and 19 months respectively 3,10 .…”

“…Focal atypia was observed in about 60% of MCST cases, and 1 previous case showed severe atypia involving 50% area of the tumor; none of these cases recurred, with follow up periods ranged from 4 months to 12.5 years (1,3,(10)(11)(12). Meanwhile, neither the case with initial omental involvement nor the previous recurrent case had significant atypia (8,9).…”

“…Tumor cells are often arranged in solid sheets and variably sized microcystic spaces with a myxoid background, and hyalinized fibrotic stroma is also common. Focal atypia with pleomorphic, large bizarre nuclei were seen in about 60% of cases 1 , with 1 case reported to contain a large area of atypical cells 3 . MCSTs demonstrate a unique immunophenotype with negative sex-cord stromal markers such as inhibin, calretinin, estrogen receptor, progesterone receptor, and cytokeratin, and are positive for CD10, WT-1, and most characteristically nuclear β-catenin.…”

Primary testicular microcystic stromal tumor: two case reports with a broad morphological spectrum and frequency of predilection site

“…When the Wnt pathway is dysregulated, the cytoplasmic β-catenin protein is not degraded by the degradation complex (Axin, GSK-3β, and APC), causing β-catenin accumulation, translocating to the nucleus and acts as a transcription factor to stimulate the overexpression of downstream genes, such as cyclin D1 and c-MYC [15]. Such results explained the aberrant staining of β-catenin and cyclin D1 in all cases including those either CTNNB1 or APC mutation [12].…”

Microcystic Stromal Tumor with Predominant Bizarre Nuclei of Ovary in a Pregnant Woman

“…MST with diffuse bizarre cells, as seen in this case, may potentially lead to overlooking of MST features and overestimation of the malignant potential of the tumor. Predominant bizarre nuclei have not been reported in MST; however, in a report by He et al, bizarre nuclei were present in up to 50% of tumor with an uneventful follow-up outcome [ 6 ]. Bizarre cells in MST may represent degenerative changes similar to those seen in other sex cord-stromal tumors and their presence does not appear to affect prognosis [ 2 , 7 ].…”