Ackroyd Sarah A, Goetsch Lauren, Brown Jennifer, Houck Karen, Wang Congli, Hernandez Enrique
Temple University Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, 3401 North Broad Street, Philadelphia, PA 19140, United States of America.
Fox Chase Cancer Center, Division of Gynecologic Oncology, 333 Cottman Avenue, Philadelphia, PA 19111, United States of America.
Gynecol Oncol Rep. 2019 Mar 27;28:109-115. doi: 10.1016/j.gore.2019.03.012. eCollection 2019 May.
True primary mucinous ovarian carcinomas are rarer than originally thought and their clinical behavior and treatment response are different than more common epithelial ovarian carcinomas. Secondary ovarian neoplasms often mimic the clinical and histological features of mucinous ovarian cancer making their diagnosis, and therefore treatment, more difficult. Misdiagnosis can have a significant impact on both treatment and prognosis. The majority of these secondary ovarian neoplasms arise from the gastrointestinal tract, with mucinous histology often of pancreaticobiliary origin. Our study objective was to review current evidence distinguishing pancreaticobiliary ovarian metastasis from primary mucinous ovarian carcinoma. We utilized a PubMed search using MeSH terms and selected articles were reviewed, synthesized and summarized. Thirty-nine articles were included in the review. The clinical, gross, histological and immunohistochemical features distinguishing primary mucinous ovarian carcinomas from pancreaticobiliary ovarian metastasis were identified. Compared to primary mucinous ovarian carcinoma, metastatic pancreaticobiliary tumors are more often bilateral, <10 cm, have irregular external surface and surface implants, display an infiltrative pattern of invasion and stain for MUC1 and CK17. Primary ovarian mucinous tumors rarely (<3%) have signet ring cells or involvement of the hilum. Metastatic mucinous tumors mimic their primary mucinous ovarian counterparts and their clinical and histopathological features overlap in many ways. However, these metastatic tumors have features that can help differentiate them from primary mucinous carcinoma. With a high index of suspicion and knowledge of the reviewed features, distinguishing these tumors will continue to become easier.
真正的原发性黏液性卵巢癌比最初认为的更为罕见，其临床行为和治疗反应与更常见的上皮性卵巢癌不同。继发性卵巢肿瘤常模仿黏液性卵巢癌的临床和组织学特征，这使得它们的诊断以及因此而来的治疗变得更加困难。误诊会对治疗和预后产生重大影响。这些继发性卵巢肿瘤大多数起源于胃肠道，其黏液性组织学通常源于胰胆管。我们的研究目的是回顾目前区分胰胆管卵巢转移瘤与原发性黏液性卵巢癌的证据。我们使用医学主题词在PubMed上进行搜索，并对所选文章进行了综述、综合和总结。该综述纳入了39篇文章。确定了区分原发性黏液性卵巢癌与胰胆管卵巢转移瘤的临床、大体、组织学和免疫组化特征。与原发性黏液性卵巢癌相比，转移性胰胆管肿瘤更常为双侧性，直径<10厘米，外表面不规则且有表面种植，表现为浸润性生长模式，并对MUC1和CK17染色。原发性卵巢黏液性肿瘤很少（<3%）有印戒细胞或累及卵巢门。转移性黏液性肿瘤与其原发性黏液性卵巢对应物相似，其临床和组织病理学特征在许多方面重叠。然而，这些转移性肿瘤具有一些有助于将它们与原发性黏液性癌区分开来的特征。有了高度的怀疑指数和对所综述特征的了解，区分这些肿瘤将继续变得更容易。
