Anaplastic spindle cell carcinoma, arising in a background of an ovarian mucinous cystic tumor: a case report with clinical follow up, review of the literature

Anaplastic carcinoma (AC) of spindle cell type is an exceedingly rare ovarian malignant neoplasm. The histo-genesis of these tumors is still controversial. Although it was first thought to carry an invariably unfavorable prognosis, recent data indicates that this does not apply to stage Ia tumors. To date, there have been less than ten cases of anaplastic spindle cell carcinoma reported in the medical literature. Furthermore, our case is the first time this tumor has been described in a 40-year-old female with malignant spindle cells merging with conventional high grade adeno-carcinoma. The differential diagnosis of spindle cell proliferation in the ovary will be discussed and their distinction using a panel of immunohistochemical stains. This report demonstrated that the findings of malignant spindle cell proliferation does not imply this entity to be carcinosarcoma. The distinction of AC from true sarcomas is important because of the poorer prognosis of the later compared with the quite favorable behavior of AC. However, such existence necessitates a careful tissue sampling for the logical distinction between AC and carcinosarcoma, which is critical for planning further management and ultimately the predictor of prognosis.