Ovarian mucinous and seromucinous neoplasms: problematic aspects and modern diagnostic approach

Abstract

Ovarian mucinous and seromucinous neoplasms: problematic aspects and modern diagnostic approachThe morphological spectrum of primary ovarian mucinous and seromucinous tumours is broad, and presents an array of diagnostic challenges, many unique to these tumour types. This reflects the heterogeneous nature of these lesions, their varied histogenesis and evolving classification systems over recent decades, with further modification to the seromucinous category incorporated in the recently published 5th edition of the World Health Organisation (WHO) Classification of female genital tumours. In this review we provide an update on the classification of these neoplasms and discuss their histogenesis and diverse morphology, focusing on areas which are diagnostically problematic. We also cover tumour grading, differential diagnosis, immunohistochemistry, the recent elucidation of the molecular underpinnings of ovarian mucinous neoplasia and discuss the gross and intra-operative handling of these tumours. A number of diagnostic issues remain unresolved, highlighting the importance of further research on this front, as well as a multidisciplinary approach in the care of patients with ovarian mucinous and seromucinous neoplasia.

A 62-Year-Old Woman With a Large Abdominal Mass

“…1 Mucinous ovarian tumors are typically unilateral, multicystic, and large, with a mean size of 10 cm if benign; 16 cm if borderline, and 20 cm if malignant. 2 Mucinous ovarian carcinoma accounts for 2% to 3% of epithelioid ovarian cancers. 2,3 Compared with more common types of ovarian cancer, mucinous ovarian carcinoma presents at a younger age (median, 49 vs 62 years) and earlier stage.…”

“…2 Mucinous ovarian carcinoma accounts for 2% to 3% of epithelioid ovarian cancers. 2,3 Compared with more common types of ovarian cancer, mucinous ovarian carcinoma presents at a younger age (median, 49 vs 62 years) and earlier stage. 3,4 At diagnosis, 74% to 85% of patients with mucinous ovarian carcinoma have stage I disease.…”

Microscopic Sertoliform Sex Cord Proliferations: A Rare Incidental Finding Associated With Endometriosis and Ovarian Epithelial Neoplasia

“…Although morphologically indistinguishable from AGCT, these lesions were not grossly visible and, given the absence of FOXL2 mutation, were regarded as benign and non-neoplastic. The pathogenesis of these sex cord proliferations is, however, uncertain and they may be somewhat analogous to the reactive stromal luteinisation often seen in ovarian tumors, particularly mucinous neoplasms (24).…”

A rare case of pseudomyxoma peritonei caused by borderline mucinous tumor arising from primary mature cystic ovarian teratoma

“…According to the World Health Organization (WHO), primary ovarian mucinous tumors can be classified into benign (mucinous cystadenoma and mucinous adenofibroma), borderline (mucinous borderline tumor) and malignant (mucinous carcinoma) [4]. In addition, teratoma-derived ovarian tumors can be classified by terminology based on appendiceal or lower gastrointestinal morphology and immunophenotype.…”