Unusual Ovarian Tumors With Endometrioid Proliferations Co-Expressing Estrogen Receptor and CDX-2 Arising in Cystadenofibromatous Background: Report of 3 Cases

Emily R. McMullen-Tabry, Andrew P. Sciallis, Aaron M. Udager, Stephanie L. Skala
In: International Journal of Gynecological Pathology · 2022 · vol. 42(1) , pp. 93–100 · doi:10.1097/pgp.0000000000000862 · PMID:35149615 · W4211130375
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This report details three ovarian tumors with endometrioid proliferations co-expressing estrogen receptor and CDX-2, found to harbor CTNNB1 mutations, and sometimes ATM and PIK3CA mutations, within a cystadenofibromatous background.

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Abstract

This report describes 3 cases of ovarian tumors with unusual glandular proliferations co-expressing estrogen receptor and CDX-2 by immunohistochemistry set in cystadenofibromatous background. Targeted next-generation sequencing was performed on the cyst lining epithelium and glandular proliferations for all cases; CTNNB1 mutations were detected in the glandular proliferations of all neoplasms. The cyst lining of case 1 demonstrated a different CTNNB1 mutation from the matched glandular proliferation. No mutations were detected in the cyst lining from case 2. The cyst lining and glandular proliferation for case 3 harbored identical ATM and PIK3CA mutations with an additional CTNNB1 mutation in the glandular proliferation. To our knowledge, this is the first reported series of endometrioid proliferations with co-expression of estrogen receptor and CDX-2 in cystadenofibromatous background.

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