Mucinous borderline tumour of the ovary

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Mucinous borderline tumour of the ovary is an ovarian tumour with a low malignant potential.

It is also known as ovarian mucinous borderline tumour and ovarian mucinous tumour of low malignant potential.[1]

General

  • Requires extensive sampling - to avoid missing an adenocarcinoma.

Note:

  • The WHO prefers borderline over low malignant potential as the descriptor for these tumours.[2]

Classification

Subdivided into:[3]

  1. Intestinal type mucinous borderline tumour of the ovary ~ 90% of cases.
  2. Endocervical type mucinous borderline tumour of the ovary ~ 10% of cases.[4]

Gross

Intestinal type mucinous borderline tumour of the ovary and endocervical type mucinous borderline tumour of the ovary:

  • Complex multiloculated mass with mucin.
  • Often large - may > 30 cm.

Microscopic

Intestinal type mucinous borderline tumour of the ovary

Features:

  • Mucinous differentiation:
    • Tall columnar cells with apical mucin - usu. resembles gastric foveolar epithelium.
  • Layering of epithelial cells (stratification).
    • Must be <= 3 cells.[5]
  • +/-Papillary infoldings.
    • Projections into the cystic space.
  • +/-Mild nuclear atypia.
  • +/-Mitoses (focally).

Notes:

  1. Resembles a villous adenoma of the colon.[6]
  2. Borderline component must be >= 10% of the tumour.[6]

DDx:

Images:

Endocervical type mucinous borderline tumour of the ovary

Features:[7]

  1. Cells with mucinous differentiation resembling endocervical epithelium:
  2. Cells with eosinophilic cytoplasm - known as "pink cells".
  3. Ciliated cells.
  • Neutrophils associated with the epithelium/mucin - common.[8]

Images:

Comparing intestinal versus endocervical

Feature Intestinal Endocervical
Primary mucin producing cell clear - well-diff. component, eosinophilic (pink) eosinophilic (pink), grey or clear
Size tall columnar (height:width >3:1) "champagne flute" stubby columnar (height:width <3:1)
Accompanying epithelial cells +/-goblet cells pink cells, ciliated cells
Other cells none neutrophils (intraepithelial) - common
Images high mag. (webpathology.com) low mag. (webpathology.com), high mag. (webpathology.com)

Molecular

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OVARY AND CYST, LEFT, OOPHORECTOMY:
- MUCINOUS BORDERLINE TUMOUR, INTESTINAL TYPE, ARISING FROM A MUCINOUS CYSTADENOMA (INTESTINAL TYPE).
- OVARIAN PARENCHYMA.

See also

References

  1. ↑ Khunamornpong, S.; Settakorn, J.; Sukpan, K.; Suprasert, P.; Siriaunkgul, S. (May 2011). "Mucinous tumor of low malignant potential (borderline or atypical proliferative tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion.". Int J Gynecol Pathol 30 (3): 218-30. doi:10.1097/PGP.0b013e3181fcf01a. PMID 21464732.
  2. ↑ Acs, G. (Jun 2005). "Serous and mucinous borderline (low malignant potential) tumors of the ovary.". Am J Clin Pathol 123 Suppl: S13-57. PMID 16100867.
  3. ↑ Rodriguez, IM.; Irving, JA.; Prat, J. (Oct 2004). "Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases.". Am J Surg Pathol 28 (10): 1311-8. PMID 15371946.
  4. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 419. ISBN 978-0443069208.
  5. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 416. ISBN 978-0443069208.
  6. ↑ 6.0 6.1 Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 416. ISBN 978-0443069208.
  7. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 420. ISBN 978-0443069208.
  8. ↑ URL: http://www.webpathology.com/image.asp?n=12&Case=526. Accessed on: 9 January 2013.
  9. ↑ Cuatrecasas, M.; Villanueva, A.; Matias-Guiu, X.; Prat, J. (Apr 1997). "K-ras mutations in mucinous ovarian tumors: a clinicopathologic and molecular study of 95 cases.". Cancer 79 (8): 1581-6. PMID 9118042.
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