Mucinous Borderline Tumor Associated with Mesonephric-like Proliferation: Further Evidence for a Possible New Origin of Ovarian Mucinous Neoplasms
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Information
2.2. Immunohistochemistry
2.3. DNA Extraction and PCR-Based Sanger Sequencing
3. Results
4. Review of Published Cases of Ovarian Combined MBT/APMT and MLP/MLA
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Kurman, R.J.; Shih, I.-M. The Dualistic Model of Ovarian Carcinogenesis: Revisited, Revised, and Expanded. Am. J. Pathol. 2016, 186, 733–747. [Google Scholar]
- Kurman, R.J.; Carcangiu, M.L.; Herrington, C.S.; Young, R.H. WHO Classification of Tumors of Female Reproductive Organs; IARC: Lyon, France, 2014. [Google Scholar]
- WHO. Classification of Tumours Editorial Board. In WHO Classification of Tumours: Female Genital Tumours, 5th ed.; International Agency for Research on Cancer: Lyon, France, 2020. [Google Scholar]
- Roma, A.A.; Masand, R.P. Different staining patterns of ovarian Brenner tumor and the associated mucinous tumor. Ann. Diagn. Pathol. 2015, 19, 29–32. [Google Scholar]
- Halimi, S.A.; Maeda, D.; Ushiku-Shinozaki, A.; Goto, A.; Oda, K.; Osuga, Y.; Fujii, T.; Ushiku, T.; Fukayama, M. Comprehensive immunohistochemical analysis of the gastrointestinal and Mullerian phenotypes of 139 ovarian mucinous cystadenomas. Hum. Pathol. 2021, 109, 21–30. [Google Scholar]
- Wang, Y.; Wu, R.C.; Shwartz, L.E.; Haley, L.; Lin, M.T.; Shih, I.-M.; Kurman, R.J. Clonality analysis of combined Brenner and mucinous tumours of the ovary reveals their monoclonal origin. J. Pathol. 2015, 237, 146–151. [Google Scholar]
- Vang, R.; Gown, A.M.; Barry, T.S.; Wheeler, D.T.; Ronnett, B.M. Ovarian atypical proliferative (borderline) mucinous tumors: Gastrointestinal and seromucinous (endocervical-like) types are immunophenotypically distinctive. Int. J. Gynecol. Pathol. 2006, 25, 83–89. [Google Scholar]
- Simons, M.; Simmer, F.; Bulten, J.; Ligtenberg, M.J.; Hollema, H.; van Vliet, S.; de Voer, R.M.; Kamping, E.J.; van Essen, D.F.; Ylstra, B.; et al. Two types of primary mucinous ovarian tumors can be distinguished based on their origin. Mod. Pathol. 2020, 33, 722–733. [Google Scholar]
- Vang, R.; Gown, A.M.; Zhao, C.; Barry, T.S.; Isacson, C.; Richardson, M.S.; Ronnett, B.M. Ovarian mucinous tumors associated with mature cystic teratomas: Morphologic and immunohistochemical analysis identifies a subset of potential teratomatous origin that shares features of lower gastrointestinal tract mucinous tumors more commonly encountered as secondary tumors in the ovary. Am. J. Surg. Pathol. 2007, 31, 854–869. [Google Scholar]
- Kerr, S.E.; Flotte, A.B.; McFalls, M.J.; Vrana, J.A.; Halling, K.C.; Bell, D.A. Matching maternal isodisomy in mucinous carcinomas and associated ovarian teratomas provides evidence of germ cell derivation for some mucinous ovarian tumors. Am. J. Surg. Pathol. 2013, 37, 1229–1235. [Google Scholar]
- Fujii, K.; Yamashita, Y.; Yamamoto, T.; Takahashi, K.; Hashimoto, K.; Miyata, T.; Kawai, K.; Kikkawa, F.; Toyokuni, S.; Nagasaka, T. Ovarian mucinous tumors arising from mature cystic teratomas--a molecular genetic approach for understanding the cellular origin. Hum. Pathol. 2014, 45, 717–724. [Google Scholar]
- Ronnett, B.M.; Seidman, J.D. Mucinous tumors arising in ovarian mature cystic teratomas: Relationship to the clinical syndrome of pseudomyxoma peritonei. Am. J. Surg. Pathol. 2003, 27, 650–657. [Google Scholar]
- McFarland, M.; Quick, C.M.; McCluggage, W.G. Hormone receptor-negative, thyroid transcription factor 1-positive uterine and ovarian adenocarcinomas: Report of a series of mesonephric-like adenocarcinomas. Histopathology 2016, 68, 1013–1020. [Google Scholar]
- da Silva, E.M.; Fix, D.J.; Sebastiao, A.P.M.; Selenica, P.; Ferrando, L.; Kim, S.H.; Stylianou, A.; Da Cruz Paula, A.; Pareja, F.; Smith, E.S.; et al. Mesonephric and mesonephric-like carcinomas of the female genital tract: Molecular characterization including cases with mixed histology and matched metastases. Mod. Pathol. 2021, 34, 1570–1587. [Google Scholar]
- Deolet, E.; Arora, I.; Van Dorpe, J.; Van der Meulen, J.; Desai, S.; Van Roy, N.; Kaur, B.; Van de Vijver, K.; McCluggage, W.G. Extrauterine Mesonephric-like Neoplasms: Expanding the Morphologic Spectrum. Am. J. Surg. Pathol. 2022, 46, 124–133. [Google Scholar]
- Dundr, P.; Gregová, M.; Němejcová, K.; Bártů, M.; Hájková, N.; Hojný, J.; Stružinská, I.; Fischerová, D. Ovarian mesonephric-like adenocarcinoma arising in serous borderline tumor: A case report with complex morphological and molecular analysis. Diagn. Pathol. 2020, 15, 91. [Google Scholar]
- McCluggage, W.G.; Vosmikova, H.; Laco, J. Ovarian Combined Low-grade Serous and Mesonephric-like Adenocarcinoma: Further Evidence for A Mullerian Origin of Mesonephric-like Adenocarcinoma. Int. J. Gynecol. Pathol. 2020, 39, 84–92. [Google Scholar]
- Chapel, D.B.; Joseph, N.M.; Krausz, T.; Lastra, R.R. An Ovarian Adenocarcinoma With Combined Low-grade Serous and Mesonephric Morphologies Suggests a Mullerian Origin for Some Mesonephric Carcinomas. Int. J. Gynecol. Pathol. 2018, 37, 448–459. [Google Scholar]
- Kolin, D.L.; Costigan, D.C.; Dong, F.; Nucci, M.R.; Howitt, B.E. A Combined Morphologic and Molecular Approach to Retrospectively Identify KRAS-Mutated Mesonephric-like Adenocarcinomas of the Endometrium. Am. J. Surg. Pathol. 2019, 43, 389–398. [Google Scholar]
- Nilforoushan, N.; Liu, L.; Cheang, G.; Sui, A.C.; Andersen, J.; Finkelman, B.S.; Liu, Y.; Nasseri-Nik, N.; Vang, R.; Ronnett, B.M.; et al. Mucinous Tumor Coexisting With Mesonephric-like Proliferation/Tumor in the Ovary: A Novel Association. Am. J. Surg. Pathol. 2022, 46, 1095–1105. [Google Scholar]
- Nilforoushan, N.; Liu, L.; Finkelman, B.S.; Andersen, J.; Liu, Y.; James, J.; Hung, C.F.; Wu, T.C.; Vang, R.; Xing, D. Ovarian Combined Serous Borderline Tumor/Low-grade Serous Carcinoma and Mesonephric-like Lesion: Report of 2 Cases with New Observations. Int. J. Gynecol. Pathol. 2022; early online. [Google Scholar]
- Vang, R.; Gown, A.M.; Barry, T.S.; Wheeler, D.T.; Yemelyanova, A.; Seidman, J.D.; Ronnett, B.M. Cytokeratins 7 and 20 in primary and secondary mucinous tumors of the ovary: Analysis of coordinate immunohistochemical expression profiles and staining distribution in 179 cases. Am. J. Surg. Pathol. 2006, 30, 1130–1139. [Google Scholar]
- Vang, R.; Gown, A.M.; Wu, L.S.; Barry, T.S.; Wheeler, D.T.; Yemelyanova, A.; Seidman, J.D.; Ronnett, B.M. Immunohistochemical expression of CDX2 in primary ovarian mucinous tumors and metastatic mucinous carcinomas involving the ovary: Comparison with CK20 and correlation with coordinate expression of CK7. Mod. Pathol. 2006, 19, 1421–1428. [Google Scholar]
- Seidman, J.D.; Khedmati, F. Exploring the histogenesis of ovarian mucinous and transitional cell (Brenner) neoplasms and their relationship with Walthard cell nests: A study of 120 tumors. Arch. Pathol. Lab. Med. 2008, 132, 1753–1760. [Google Scholar]
- Balasa, R.W.; Adcock, L.L.; Prem, K.A.; Dehner, L.P. The Brenner tumor: A clinicopathologic review. Obstet. Gynecol. 1977, 50, 120–128. [Google Scholar]
- Shevchuk, M.M.; Fenoglio, C.M.; Richart, R.M. Histogenesis of Brenner tumors, I: Histology and ultrastructure. Cancer 1980, 46, 2607–2616. [Google Scholar]
- Roma, A.A.; Masand, R.P. Ovarian Brenner tumors and Walthard nests: A histologic and immunohistochemical study. Hum. Pathol. 2014, 45, 2417–2422. [Google Scholar]
- Chu, P.G.; Chung, L.; Weiss, L.M.; Lau, S.K. Determining the site of origin of mucinous adenocarcinoma: An immunohistochemical study of 175 cases. Am. J. Surg. Pathol. 2011, 35, 1830–1836. [Google Scholar]
- Pors, J.; Segura, S.; Chiu, D.S.; Almadani, N.; Ren, H.; Fix, D.J.; Howitt, B.E.; Kolin, D.; McCluggage, W.G.; Mirkovic, J.; et al. Clinicopathologic Characteristics of Mesonephric Adenocarcinomas and Mesonephric-like Adenocarcinomas in the Gynecologic Tract: A Multi-institutional Study. Am. J. Surg. Pathol. 2021, 45, 498–506. [Google Scholar]
Case | Age (years) | Tumor Site | Tumor Size (cm) | Mucinous Component | Mesonephric Component | Mucinous Component (Pax8) | Mesonephric Component (Pax8) | Mucinous Component (Gata3) | Mesonephric Component (Gata3) |
---|---|---|---|---|---|---|---|---|---|
1 Nilforoushan et al. [20] | 56 | Left ovary | 12 | MBT/APMT | MLH in a background of MLP | Negative | Positive | Negative | Positive |
2 Nilforoushan et al. [20] | 67 | Right ovary | 28 | MBT/APMT | Microscopic foci of MLP | Focally positive | Positive | Negative | Positive |
3 Nilforoushan et al. [20] | 58 | Left ovary | 12 | Mucinous cystadenofibroma | MLA in a background of MLP | Focally positive | Positive | Negative | Positive |
4 Nilforoushan et al. [20] | 55 | Left ovary | 13 | MBT/APMT | MLA in a background of MLP | Negative | Positive | Negative | Positive |
5 da Silva et al. [14] | 52 | Right ovary | 18.5 | MBT/APMT | MLA | Positive | Positive | Negative | Positive |
6 da Silva et al. [14] | 60 | Right ovary | 10 | MBT/APMT | MLA | Weakly positive | Positive | Weakly positive | Positive |
7 This study | 58 | Left ovary | 11 | MBT/APMT | MLH in a background of MLP | Weakly positive | Positive | Negative | Positive |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Zhang, J.; Dong, Y.; Zhou, X.; Finkelman, B.S.; Xing, D. Mucinous Borderline Tumor Associated with Mesonephric-like Proliferation: Further Evidence for a Possible New Origin of Ovarian Mucinous Neoplasms. Diagnostics 2022, 12, 1901. https://doi.org/10.3390/diagnostics12081901
Zhang J, Dong Y, Zhou X, Finkelman BS, Xing D. Mucinous Borderline Tumor Associated with Mesonephric-like Proliferation: Further Evidence for a Possible New Origin of Ovarian Mucinous Neoplasms. Diagnostics. 2022; 12(8):1901. https://doi.org/10.3390/diagnostics12081901
Chicago/Turabian StyleZhang, Jie, Yuling Dong, Xiaoqiu Zhou, Brian S. Finkelman, and Deyin Xing. 2022. "Mucinous Borderline Tumor Associated with Mesonephric-like Proliferation: Further Evidence for a Possible New Origin of Ovarian Mucinous Neoplasms" Diagnostics 12, no. 8: 1901. https://doi.org/10.3390/diagnostics12081901