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]
- Intestinal type mucinous borderline tumour of the ovary ~ 90% of cases.
- 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:
- Resembles a villous adenoma of the colon.[6]
- Borderline component must be >= 10% of the tumour.[6]
- Lesions with <10% borderline component are known as mucinous cystadenoma of the ovary with focal proliferation or mucinous cystadenoma of the ovary with focal atypia.
DDx:
- Mucinous adenocarcinoma of the ovary.
- Mucinous cystadenoma of the ovary.
- Mucinous cystadenoma of the ovary with focal proliferation.
Endocervical type mucinous borderline tumour of the ovary
Features:[7]
- Cells with mucinous differentiation resembling endocervical epithelium:
- Tall columnar cells with grey apical mucin.
- Cells with eosinophilic cytoplasm - known as "pink cells".
- Ciliated cells.
- Neutrophils associated with the epithelium/mucin - common.[8]
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 |
Molecular
- KRAS mutations common ~ 73% of mucinous borderline tumours in one series.[9]
Sign out
OVARY AND CYST, LEFT, OOPHORECTOMY: - MUCINOUS BORDERLINE TUMOUR, INTESTINAL TYPE, ARISING FROM A MUCINOUS CYSTADENOMA (INTESTINAL TYPE). - OVARIAN PARENCHYMA.
See also
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 6.0 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.
- ↑ 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.
- ↑ URL: http://www.webpathology.com/image.asp?n=12&Case=526. Accessed on: 9 January 2013.
- ↑ 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.