Ovarian mixed-epithelial papillary cystadenomas of borderline malignancy of mullerian type: A clinicopathologic analysis

Rutgers, Joanne L.; Scully, Robert E.

doi:10.1002/1097-0142(19880201)61:3<546::aid-cncr2820610321>3.0.co;2-i

Cited by 98 publications

(85 citation statements)

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“…Our study also attempted to evaluate relationships of endometriosis with borderline ovarian tumors, of interest given previous findings of concurrent endometriosis and borderline ovarian tumors (11,(41)(42)(43)(44). We were limited in our ability to evaluate associations given small numbers of subjects.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Benign Gynecologic Diseases to Subsequent Risk of Ovarian and Uterine Tumors

Brinton

Sakoda

Sherman

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

155

116

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Objective: Although endometriosis and uterine leiomyomas are common conditions, the extent to which either is associated with certain types of malignancies remains uncertain. Methods: Using record linkage techniques, we assessed the relationships between hospital and outpatient admissions for endometriosis or leiomyomas and the development of ovarian and uterine cancers in Denmark between 1978 and 1998. Based on a population-based cohort exceeding 99,000 women, including 2,491 ovarian cancers, 860 borderline ovarian tumors, and 1,398 uterine cancers, we derived relative risks (RR) and 95% confidence intervals (95% CI) associated with overall and histology-specific tumor risks after adjustment for calendar time and reproductive characteristics. Results: Endometriosis seemed to predispose to the development of ovarian cancer, with the association restricted to endometrioid or clear cell malignancies. Five or more years after the diagnosis of endometriosis, the RRs (95% CIs) were 2.53 (1.19-5.38) for endometrioid (7 exposed cases) and 3.37 (1.24-9.14) for clear cell (4 exposed cases) malignancies. Uterine leiomyomas were associated with increases in the risk of uterine malignancies, particularly sarcomas, where the RRs (95% CIs) were 20.80 (11.32-38.22) for women with 1 to 4 years of follow-up (11 exposed cases) and 5.70 (2.27-14.32) for those with more extended follow-up (5 exposed cases). Conclusion: In combination with clinical, pathologic, and molecular data, our results support that some endometriotic lesions may predispose to clear cell and endometrioid ovarian cancers. Uterine leiomyomas also showed a strong connection with subsequent uterine sarcomas, although it was difficult to decipher whether this reflected detection bias, shared risk factors, or an etiologic relationship. (Cancer Epidemiol Biomarkers Prev 2005;14(12):2929 -35)

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Section: Discussionmentioning

confidence: 99%

Relationship of Benign Gynecologic Diseases to Subsequent Risk of Ovarian and Uterine Tumors

Brinton

Sakoda

Sherman

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

155

116

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“…Tumors in which one or more other mullerian cell types account for more than 10% of the lining have been placed in a separate, closely related category of mixed-epithelial papillary borderline tumors. 23 The criteria proposed by Hart and NorrisZ0 and later expanded by Hart" are useful in distinguishing mucinous borderline tumors from low-grade carcinomas in general. However, one of their criteria for carcinoma, stratification of atypical cells to four or more layers, cannot be applied to MMBT, which commonly exhibit stratification up to 20 layers of polygonal cells with eosinophilic cytoplasm; these cells are often located at the tips of papillae and have only mild to moderate nuclear atypicality; we consider them to be indifferent in type as similar cells may be seen in serous papillary borderline tumors.…”

Section: Discussionmentioning

confidence: 99%

Ovarian mullerian mucinous papillary cystadenomas of borderline malignancy.A clinicopathologic analysis

Rutgers

Scully

1988

Cancer

Self Cite

190

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Ovarian mucinous cystadenomas of borderline malignancy that contain foci of intestinal differentiation are well recognized. Borderline tumors lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors, however, have not been described in the literature. We have studied 30 tumors of this type. The patients averaged 34 years of age. Forty percent of the tumors were synchronously bilateral and 30% were associated with endometriosis. Four tumors were complicated by peritoneal implants, one by both peritoneal implants and lymph node metastasis and one by lymph node metastasis alone. No patient had pseudomyxoma peritonei. Follow-up information was available on all the patients for a mean interval of 3.7 years. In two cases tumors developed in the conserved contralateral ovary; no deaths occurred. These tumors have important clinical and pathologic differences from mucinous borderline tumors with intestinal differentiation, but have many similarities to mixed-epithelial borderline tumors of Mullerian type.

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“…Borderline tumors of mixed Mü llerian epithelial cell types also have a frequent association with ovarian endometriosis. 110 Hyperplasia in endometrosis as a precursor lesion Because carcinoma of the endometrium often arises on a background of hyperplasia with cytologic and architectural atypicality, one might expect that a proportion of carcinomas arising in endometriosis would have similar precursors. Hyperplasia with varying degrees of architectural and cytologic atypia resembling that seen in the endometrium occurs in 2-7% of cases of ovarian endometriosis or ovarian endometriotic cysts without coexisting carcinoma and in 67-100% of endometriosis associated with coexisting carcinoma (Figure 6).…”

Section: Morphologic Datamentioning

confidence: 99%

Origins and molecular pathology of ovarian cancer

2005

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Epithelial ovarian cancer comprises the majority of malignant ovarian tumors in adult women. These neoplasms are classified into distinct morphologic categories based on the appearance of the epithelium into tumors of serous, mucinous, endometrioid, clear cell, transitional, squamous, mixed and undifferentiated type. Current data indicate that each of these histologic subtypes is associated with distinct morphologic and molecular genetic alterations: high-grade serous and possibly endometrioid carcinomas most probably arise from surface epithelial inclusion glands with TP53 mutations and dysfunction of BRCA1 and/or BRCA2; low-grade serous carcinomas probably arise in a stepwise fashion in an adenoma-borderline tumor-carcinoma sequence from typical to micropapillary borderline tumors to low-grade invasive serous carcinoma via activation of the RAS-RAF signaling pathway secondary to mutations in KRAS and BRAF; mucinous carcinomas arise via an adenoma-borderline tumor-carcinoma sequence with mutations in KRAS; low-grade endometrioid carcinomas arise from endometriosis via mutations in CTNNB1 (the gene encoding b-catenin) and PTEN. Although the morphologic data strongly support an origin of clear cell carcinoma from endometriosis, there is limited data on the genetic alterations in these uncommon tumors. Thus it is likely that most low-grade, relatively indolent ovarian carcinomas of serous, mucinous and endometrioid type arise from pre-existing cystadenomas or endometriosis whereas most high-grade serous carcinomas arise without an easily identifiable precursor lesion. Modern Pathology (2005) 18, S19-S32. doi:10.1038/modpathol.3800306Keywords: ovarian cancer; ovarian borderline tumors; histogenesis; molecular pathology Epithelial ovarian cancer comprises the majority of malignant ovarian tumors in adult women. These neoplasms are classified into distinct morphologic categories based on the appearance of the epithelium into tumors of serous, mucinous, endometrioid, clear cell, transitional, squamous, mixed and undifferentiated type. 1,2 Two types of ovarian surface epithelial lesions have been described as possible precursors of these carcinomas: lesions that appear in situ in surface epithelium or surface epithelial inclusion glands (SEIG); and preexisting benign epithelial ovarian tumors and endometriosis. The morphologic and genetic data implicating each as a precursor lesion of the major histologic subtypes of ovarian carcinoma are discussed. Surface epithelium and surface epithelial inclusion glands as precursor lesions Morphologic DataTwo types of morphologic data are available regarding the malignant potential of ovarian surface epithelium and inclusion glands, alterations in these structures and studies on microscopic ovarian carcinoma.Surface epithelium and surface epithelial inclusion glands Despite the widespread acceptance of the origin of surface epithelial cancers from the ovarian surface epithelium and its inclusion glands, only rarely have putative precursor lesions been described at these sites. Two...

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Ovarian mixed-epithelial papillary cystadenomas of borderline malignancy of mullerian type: A clinicopathologic analysis

Cited by 98 publications

References 27 publications

Relationship of Benign Gynecologic Diseases to Subsequent Risk of Ovarian and Uterine Tumors

Relationship of Benign Gynecologic Diseases to Subsequent Risk of Ovarian and Uterine Tumors

Ovarian mullerian mucinous papillary cystadenomas of borderline malignancy.A clinicopathologic analysis

Origins and molecular pathology of ovarian cancer

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