Journal of Pathology and Translational Medicine

Case Reports

Ovarian Large Cell Neuroendocrine Carcinoma Associated with Endocervical-like Mucinous Borderline Tumor: A Case Report and Literature Review.: Jun Mo Kim, Hyeong Chan Shin, Mi Jin Kim; Korean J Pathol. 2011;45(5):523-528.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.5.523

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Ovarian large cell neuroendocrine carcinoma is a rare tumor that is usually associated with surface epithelial tumors. Mucinous tumors are most common surface epithelial component identified in reported cases. Ovarian mucinous tumor associated with large cell neuroendocrine carcinoma is almost always an intestinal type. However, large cell neuroendocrine carcinoma associated with pure mucinous borderline tumor of endocervical-like type has not been described previously. The present case report describes a large cell neuroendocrine carcinoma associated with endocervical-like mucinous borderline tumor of the ovary in a 35-year-old woman. The tumor was confirmed by histopathology and immunohistochemistry. A review of the pertinent literature is included.

Citations

Citations to this article as recorded by

The puzzle of gynecologic neuroendocrine carcinomas: State of the art and future directions
Giuseppe Caruso, Carolina Maria Sassu, Federica Tomao, Violante Di Donato, Giorgia Perniola, Margherita Fischetti, Pierluigi Benedetti Panici, Innocenza Palaia
Critical Reviews in Oncology/Hematology.2021; 162: 103344. CrossRef
Pathological features, clinical presentations and prognostic factors of ovarian large cell neuroendocrine carcinoma: a case report and review of published literature
Xiaohang Yang, Junyu Chen, Ruiying Dong
Journal of Ovarian Research.2019;[Epub] CrossRef
Primary pure large cell neuroendocrine carcinoma of the ovary
Chen-Hsien Lin, Yu-Chieh Lin, Mu-Hsien Yu, Her-Young Su
Taiwanese Journal of Obstetrics and Gynecology.2014; 53(3): 413. CrossRef
Pure Large Cell Neuroendocrine Carcinoma of Ovary: A Rare Clinical Entity and Review of Literature
P. N. Shakuntala, K. Uma Devi, K. Shobha, U. D. Bafna, M. Geetashree
Case Reports in Oncological Medicine.2012; 2012: 1. CrossRef

Sarcoma-like Mural Nodule in Ovarian Mucinous Cystadenocarcinoma: A case report.: Suk Hee Lee, Min Hee Jung, Byung Yuk Lee, Jong Min Chae; Korean J Pathol. 1996;30(9):854-857.

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Abstract PDF: We describe an ovarian mucinous cystadenocarcinoma with a sarcoma-like mural nodule. In the literature, rare cases of ovarian mucinous tumors have been described which contain foci of undifferentiated carcinoma, sarcoma, and sarcoma-like nodules. The distinction between these lesions is important because of poorer prognosis of true sarcoma and anaplastic carcinoma than sarcoma-like mural nodules. This case shows different results of immunohistochemical stain for anaplastic carcinoma.

Original Article

Mucinous Tumors of the Appendix Associated with Mucinous Tumors of the Ovary and Pseudomyxoma Peritonei: A Clinicopathologic Analysis of 5 Cases Supporting an Appendiceal Origin.: Eung Seok Lee, Han Kyeom Kim, In Sun Kim; Korean J Pathol. 1998;32(2):131-137.

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Abstract PDF: Pseudomyxoma peritonei often have synchronous appendiceal and ovarian mucinous tumors. There has been considerable debate as to whether the ovarian tumors are secondary to the appendiceal tumor or they are independent primary ovarian tumors. It is important to reveal the primary site for treatment and prognosis of a patient. Five cases of synchronous mucinous tumors of the ovary and appendix were studied. Four cases had pseudomyxoma peritonei and pseudomyxoma ovarii. The ovarian tumors were bilateral in two cases, right in two, and left in one. The ovarian tumors were four mucinous cystadenoma of borderine malignancy and one mucinous cystadenocarcinoma, and the appendiceal tumors consisted of four mucinous tumors of borderline malignancy and one mucinous adenocarcinoma. The histology of the ovarian and appendiceal tumors was similar. Rupture of the tumor was seen in all appendiceal tumors and two ovarian tumors. It has been reported that cytokeratin 7 is a useful marker for distinguishing primary ovarian neoplasms from metastases of intestinal origin. All ovarian and appendiceal tumors showed positive reaction for broad-spectrum cytokeratin, but negative for cytokeratin 7. Based on the clinicopathologic and immunohistochemical features, it should be considered that the appendiceal tumors are primary and ovarian tumors are secondary in the synchronous presentation of the ovarian and appendiceal mucinous tumors.

Case Reports

Combined Mucinous Tumor and Carcinoid of Appendix Associated with Mucinous Tumor of Ovary and Pseudomyxoma Peritonei: A case report .: Hye Jeong Choi, Mi Jin Kim; Korean J Pathol. 1999;33(11):1094-1096.

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Abstract PDF: We report a case of mucinous cystadenoma of uncertain malignant potential and carcinoid of appendix associated with bilateral mucinous cystadenoma of ovary and pseudomyxoma peritonei. The patient was a 46-year-old female. She suffered from dyspnea and lower abdominal palpable masses for several months. Ultrasonogram showed multilocular huge ovarian cysts. Appendectomy, transabdominal hysterectomy, bilateral salphingo-oophorectomy and biopsy of omentum were performed. The bilateral ovaries measured 16 11 cm and 7X5 cm in size, respectively. The both ovaries showed multilocular cysts filled with thick mucus material. The ovarian cysts were covered by a single layer of columnar epithelium with focal proliferation. Mucus materials dissected through the ovarian stroma (pseudomyxoma ovarii). The tip of appendix was dilated and covered by mucus material. The cut surface showed a cyst and a yellowish solid mass proximal to the cyst. Microscopically, the appendiceal cyst was lined by stratified columnar epithelium with moderate cytologic atypia. Mucus material dissected through the wall. In the proximal portion of the appendix, a classic carcinoid with focal tubular form was present in submucosa and muscle layer. The omentum was covered by thick mucus material. Microscopically, the omentum showed mucinous epithelium and mucus material (pseudomyxoma peritonei).

Fine Needle Aspiration Cytology of the Intraductal Papillary Mucinous Tumor of the Pancreas: A Case Report.: In Gu Do, Jae Hoon Park, Youn Wha Kim, Ju Hie Lee, Moon Ho Yang, Sung Wha Hong, Yong Koo Park; Korean J Cytopathol. 2003;14(2):91-95.

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Abstract PDF: Intraductal papillary mucinous tumor of the pancreas is characterized by intraductal papillary proliferation of mucin-producing epithelial cells with or without excessive mucin secretion. According to the degree of epithelial dysplasia, intraductal papillary mucinous tumor is classified into adenoma, borderline tumor, and carcinoma. We recently experienced a case of fine needle aspiration cytology of the intraductal papillary mucinous adenoma in a 69-year-old male. The fine needle aspiration cytology yielded flat sheets of columnar, mucin containing epithelial cells in the background of dense mucin containing degenerated cellular material and histiocytes.

Original Articles

Clinicopathological Analysis of Growth Patterns of Malignant Intraductal Papillary Mucinous Tumors of the Pancreas: Unusual Growth Pattern of Fistulous Extension.: Kee Taek Jang, Ghee Young Kwon, Geunghwan Ahn; Korean J Pathol. 2007;41(1):38-43.

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Abstract PDF: BACKGROUND
Usually, a malignant intraductal papillary mucinous tumor (IPMT) of the pancreas shows invasive carcinoma. Recently, IPMT with an unusual growth pattern of a fistulous extension was reported. However, little is known about malignant IPMTs with a different growth pattern of invasion and fistulous extension.
METHODS
Malignant IPMTs were classified into invasive (colloid or tubular type) carcinomas and the fistulous extension type according to their growth patterns. Their clinicopathological characteristics were compared.
RESULTS
Among a total of 68 cases of IPMT, there were 16 cases with malignant IPMT; eight, six and two of the colloid, tubular, and fistulous extension types, respectively. The immunohistochemical (IHC) expression of MUC1 was found in seven out of eight colloid and five out of six tubular types, but there was no IHC expression of MUC1 in the fistulous extension type. The IHC expression of MUC2 was noted in one of the eight colloid, one of the six tubular and in both cases with the fistulous extension type. There was no difference in the tumor recurrence rates bet- ween the different growth patterns.
CONCLUSIONS
IPMT with the fistulous extension type has a peculiar extension pattern consisting of multiple fistulous tracts without a mass. Although most of the epithelium in the fistulous tract show moderate to severe dysplasia, only the fistulous extension should be considered to be an unusual growth pattern of malignant IPMT. The clinical significance of this unusual type of IPMT remains to be determined.

Prevalence and Clinicopathologic Features of Mucinous Cystic Tumor and Intraductal Papillary Mucinous Tumor of Pancreas in Korea.: Jin Hee Sohn, Kyung Me Kim, Seoung Wan Chae, Woo Ho Kim, Woo Sung Moon, Young Nyun Park, Chul Gun Park, Eun sil Yu, Hee Kyung Jang, Hee Jin Jang, Jong Jae Jung, Jin Sook Jung, So Young Jin, Jong Sang Choi, Dae Young Kang; Korean J Pathol. 2003;37(4):270-278.

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Abstract PDF: BACKGROUND
Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasmsremain the subject of controversy.
METHODS
The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 casesof MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1.
RESULTS
IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoralnormal or atrophic parenchyma. On the other hand, MCT was located largely in thetail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD(7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions weresignificantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressedonly in the invasive carcinoma among cases of MCT and IPMT.
CONCLUSIONS
The tumorlocation, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastictissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.

Evaluation of DNA Ploidy and Other Morphometric Parameters of Ovarian Mucinous Tumors.: Yun Mee Kim, Sang Woo Juhng, Joo Yong Yoo, Kyu Hyuk Cho; Korean J Pathol. 1991;25(5):397-406.

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Abstract: Biological behavior of malignant tumors has been assessed by morphological grading, clinical staging, and estimating other tumor markers. Recently DNA ploidy measured by flow cytometry and image analyser has been suggested as an additional useful indicator of the tumor behavior. In order to extract useful tumor cell-specific information in ovarian mucinous tumors, DNA contents and other morphologic parameters were measured by image analysis and DNA ploidy was also measured by flow cytometry. In all cases of cystadenoma, DNA diploidies were observed. In borderline malignancy, DNA diploidies were chiefly observed except one case of polyploidy. In true malignancy, DNA aneuploidies were observed except one case of polyploidy and two cases of diploidies by image analysis, and except four cases of diploides and one cas of polyploidy by flow cytometry. The statistical significance were observed in DNA ploidy pattern by image analysis. In nuclear areas, perimeters and major axis, statistical significance were not observed. These results suggest that DNA ploidy pattern are more or less independent parameter as an additional useful indicator of the histological grade of malignancy and that image analysis are better than flow cytometry in detecting DNA aneuploidy.

Morphometric Study on Mucinous Tumors of the Ovary.: Joo Seub Keum, Jung Dal Lee; Korean J Pathol. 1991;25(4):305-317.

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Abstract PDF: Mucinous tumors of the ovary are the most common tumors arising from the common epithelium of the ovary in Korean. Distinguishing the tumor with borderline malignancy from mucinous cystadenocarcinoma is very important in determining proper therapeutic modalities and prognosis. Authors have undertaken morphometric analysis of various parameters from both borderline lesions and carcinomas of mucinous nature of the ovary. In each, five cases of the borderline and malignant tumors were subjected to be evaluated. Various cytologic and histologic parameters were analyzed using Kontron IBAS-I. 1) The most helpful parameter-for differentiation between borderline and malignant mucinous tumors is cell concentration (sensitivity 80%, specificity 80%). The discrimination value is more than 35 cells per 100 micrometer of the basement membrane length. If the cellular concentration is higher than the discriminating value, that indicates malignancy. 2) Tumor cell height, though it is other parameter of stratification, is not helpful for differentiation of the two lesions. 3) Cytologic atypia, either in size or in form, can not be a criterion distinguishing the borderline from malignancy. 4) Papillary growths can not be a criterion of either borderline and malignant lesions. 5) The degree of irregularity at tumor-stroma interface is not helpful for differentiation between borderline and malignancy.

Peanut Agglutinin Binding Activity in Overian Malignant Mucinous Tumors.: Hyung Geun Song, Chul Woo Kim; Korean J Pathol. 1987;21(4):249-256.

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Abstract PDF: The positive binding activity of lectin, peanut agglutinin (PNA), against the mucinous malignancies of the ovary was studied in order to clarify biologic differences among those lesions using immunoperoxidase method (ABC). A total of 23 cases were included in this study and they were classified as 10 cases of mucinous cystadenocarcinoma, 9 mucinous tumors of borderline malignancy and 4 pseudomyxoma peritonei, histologically. Nine of 10 cystadenocarcinomas and all cases of pseuomyxoma peritonei showed more than moderate degree of positive binding activity (>2+) with PNA in the neoplastic epithelial cells. In the cases of borderline malignancy, only 3 of 9 revealed as much similar binding pattern with PNA as cystadenocarcinoma group, in contrast, minimal degree of positivity (1+) was noted in the remainder. These findings may suggest heterogeneity in the biochemical characteristics among the cases of borderline lesion. And it is proposed that the higher PNA binding cases in ovarian mucinous borderline malignancy require extensive sampling by multiple sections and further careful follow-up study.

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