Ovarian clear cell carcinoma arising in a mucinous cystadenoma

Wani Y, Yoji Wani, Kenji Notohara, Notohara K
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2009 · doi:10.1097/PGP.0b013e3181a934b9 · PMID:19851211
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This case report describes a rare instance of ovarian clear cell carcinoma developing within a pre-existing mucinous cystadenoma in a 59-year-old woman. Histopathological and immunohistochemical analyses revealed distinct cellular populations, with clear cell components expressing hepatocyte nuclear factor-1β while the surrounding mucinous epithelium remained negative. The patient underwent salpingo-oophorectomy and showed no recurrence or metastasis during an eleven-month follow-up period. This paper is centrally about endometriosis — specifically, it notes the absence of demonstrable endometriosis as a key feature distinguishing this tumor's origin from typical clear cell carcinomas associated with the condition.

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Abstract

Here we report a rare case of ovarian clear cell carcinoma (CC) arising in a mucinous cystadenoma. A 59-year-old woman presented with a dull pain at the left inguinal area. She was found to have a left ovarian cyst measuring 4.7 cm and underwent a salpingo-oophorectomy. The unilocular cyst contained thick mucin, lacking any solid components. Histopathologically, most of the cyst wall was lined with a single layer of tall columnar cells with basophilic mucin. Within limited areas, small glands consisting of clear cytoplasm aggregated and intermingled with or partially transitioned to the mucinous glands. The clear cell components had adenofibroma-like features devoid of significant nuclear atypia or stromal invasion, including distinctive foci of CC with a hobnail appearance and hyperchromatic nuclei surrounded by desmoplastic or hyalinized stroma. Immunohistochemically, both mucinous and clear cells were positive for estrogen receptor. Hepatocyte nuclear factor-1beta and laminin were positive in all of the clear cell components, in contrast to a consistent lack of staining in the mucinous epithelium. An eleven-month follow-up revealed no recurrence or metastasis. This case was considered as an early manifestation of ovarian CC arising in a mucinous cystadenoma in the absence of demonstrable endometriosis.
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Ovarian Clear Cell Carcinoma Arising in a Mucinous Cystadenoma - Yoji Wani - Kenji Notohara Here we report a rare case of ovarian clear cell carcinoma (CC) arising in a mucinous cystadenoma. A 59-year-old woman presented with a dull pain at the left inguinal area. She was found to have a left ovarian cyst measuring 4.7 cm and underwent a salpingo-oophorectomy. The unilocular cyst contained thick mucin, lacking any solid components. Histopathologically, most of the cyst wall was lined with a single layer of tall columnar cells with basophilic mucin. Within limited areas, small glands consisting of clear cytoplasm aggregated and intermingled with or partially transitioned to the mucinous glands. The clear cell components had adenofibroma-like features devoid of significant nuclear atypia or stromal invasion, including distinctive foci of CC with a hobnail appearance and hyperchromatic nuclei surrounded by desmoplastic or hyalinized stroma. Immunohistochemically, both mucinous and clear cells were positive for estrogen receptor. Hepatocyte nuclear factor-1β and laminin were positive in all of the clear cell components, in contrast to a consistent lack of staining in the mucinous epithelium. An eleven-month follow-up revealed no recurrence or metastasis. This case was considered as an early manifestation of ovarian CC arising in a mucinous cystadenoma in the absence of demonstrable endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Cystadenoma, Mucinous Neoplasms, Multiple Primary Ovarian Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Cystadenoma, Mucinous Cystadenoma, Mucinous Cystadenoma, Mucinous Female Humans Immunohistochemistry Middle Aged Neoplasms, Multiple Primary Neoplasms, Multiple Primary Neoplasms, Multiple Primary Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms

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