Journal of Pathology and Translational Medicine

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.

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 Report

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.

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).

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