Coexistence of a clear cell adenocarcinoma and an adenosarcoma with a heterologous rhabdomyosarcoma in an endometriotic cyst of the ovary: a case study

Hironao Yasuoka, Yasuoka H, Masahiko Tsujimoto, Tsujimoto M, Shigeki Fujita, Fujita S, Takashi Yamasaki, Yamasaki T, Kashihara H, Hiromi Kashihara, Yukihiro Nishio, Nishio Y, Rieko Kodama, Kodama R, Michiya Inagaki, Inagaki M, Oishi H, Hiroaki Oishi, Tokio Sanke, Sanke T, Yasushi Nakamura, Nakamura Y
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2009 · doi:10.1097/PGP.0b013e318192924d · PMID:19483627
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This case study reports a rare occurrence of clear cell adenocarcinoma and adenosarcoma with heterologous rhabdomyosarcoma components coexisting within an ovarian endometriotic cyst. Histological analysis revealed that the cyst wall was lined with endometrial-type cells, while the solid area contained the adenocarcinoma and the detached polypoid mass exhibited leaf-like patterns with benign epithelial and malignant rhabdomyosarcoma elements. X-chromosomal clonality assays indicated polyclonal origins for both the adenocarcinoma and adenosarcoma components, marking this as the first reported instance of such a complex coexistence. This paper is centrally about endometriosis — specifically detailing a malignant transformation arising from an endometriotic cyst in the ovary.

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Abstract

A rare case of a clear cell adenocarcinoma and an adenosarcoma coexisting with a heterologous rhabdomyosarcoma in an endometriotic cyst of the ovary is reported. The tumor was composed of a cystic area and a solid area arising from the cyst wall. In the cystic lesion, a detached polypoid mass was also identified. The cyst wall was lined with a single layer of endometrial-type cells, whereas the solid area was composed of a clear cell adenocarcinoma. In the detached polypoid mass, an exophytic leaf-like pattern containing benign endometrial-type cells and squamous epithelial and rhabdomyosarcoma components, which were positive for desmin and myoglobin, was observed. Using X-chromosomal clonality assay, these clear cell adenocarcinoma and adenosarcoma components showed patterns of polyclonality. To the authors' knowledge, this is the first reported case of a clear cell adenocarcinoma and an adenosarcoma coexisting with heterologous rhabdomyosarcoma in an endometriotic cyst of the ovary.
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Coexistence of a Clear Cell Adenocarcinoma and an Adenosarcoma With a Heterologous Rhabdomyosarcoma in an Endometriotic Cyst of the Ovary: A Case Study - Hironao Yasuoka - Masahiko Tsujimoto - Shigeki Fujita - Takashi Yamasaki - Hiromi Kashihara - Yukihiro Nishio - Rieko Kodama - Michiya Inagaki - Hiroaki Oishi - Tokio Sanke - Yasushi Nakamura A rare case of a clear cell adenocarcinoma and an adenosarcoma coexisting with a heterologous rhabdomyosarcoma in an endometriotic cyst of the ovary is reported. The tumor was composed of a cystic area and a solid area arising from the cyst wall. In the cystic lesion, a detached polypoid mass was also identified. The cyst wall was lined with a single layer of endometrial-type cells, whereas the solid area was composed of a clear cell adenocarcinoma. In the detached polypoid mass, an exophytic leaf-like pattern containing benign endometrial-type cells and squamous epithelial and rhabdomyosarcoma components, which were positive for desmin and myoglobin, was observed. Using X-chromosomal clonality assay, these clear cell adenocarcinoma and adenosarcoma components showed patterns of polyclonality. To the authors' knowledge, this is the first reported case of a clear cell adenocarcinoma and an adenosarcoma coexisting with heterologous rhabdomyosarcoma in an endometriotic cyst of the ovary.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Adenosarcoma Neoplasms, Multiple Primary Ovarian Cysts Ovarian Neoplasms Rhabdomyosarcoma Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenosarcoma Adenosarcoma Adenosarcoma Endometriosis Endometriosis Female Humans Immunohistochemistry Middle Aged Neoplasms, Multiple Primary Neoplasms, Multiple Primary

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