Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
In Vivo. 2021 Nov-Dec;35(6):3613-3622. doi: 10.21873/invivo.12667.
BACKGROUND/AIM: We describe a rare case of ovarian mesonephric-like adenocarcinoma (MLA) involving the fimbria and mimicking serous tubal intraepithelial carcinoma (STIC).
A 47-year-old woman presented with a 4.4-cm left ovarian mass. Histologically, the ovarian tumor showed papillary and solid architecture, severe nuclear pleomorphism, and increased mitotic activity. Some microscopic foci where the tumor cells spread horizontally along the fimbrial surface epithelium were noted, compatible with STIC. We initially considered the ovarian tumor to be high-grade serous carcinoma accompanied by a fimbrial STIC. However, immunostaining revealed nuclear immunoreactivity for paired box 2 and GATA-binding protein 3, but lacked expression of Wilms tumor 1. A thorough slide review and additional immunostaining revealed architectural diversity, densely eosinophilic intraluminal secretions, and lack of hormone receptor expression, supporting the diagnosis of MLA.
Microscopic intraepithelial metastases of the MLA to the fimbria mimic STIC. We recommend ancillary tests, such as immunostaining, in patients with ovarian tumors whenever possible, particularly for those with differential diagnosis of MLA and high-grade serous carcinoma.
背景/目的：我们描述了一例罕见的卵巢中肾样腺癌（MLA）累及输卵管伞部并模拟输卵管上皮内癌（STIC）的病例。
一名 47 岁女性因左卵巢 4.4cm 肿块就诊。组织学上，卵巢肿瘤呈乳头状和实性结构，核异型性明显，有丝分裂活性增加。显微镜下观察到肿瘤细胞沿输卵管伞部表面上皮水平扩散的微小病灶，符合 STIC。我们最初认为卵巢肿瘤为高级别浆液性癌伴输卵管伞部 STIC。然而，免疫组化显示配对盒 2 和 GATA 结合蛋白 3 的核免疫反应性，但缺乏 Wilms 瘤 1 的表达。全面的切片复习和额外的免疫组化显示出结构多样性、密集的嗜酸性腔内分泌物以及缺乏激素受体表达，支持 MLA 的诊断。
MLA 的微观上皮内转移至输卵管伞部模拟 STIC。我们建议在可能的情况下对卵巢肿瘤患者进行辅助检查，如免疫组化，特别是对于那些需要鉴别诊断 MLA 和高级别浆液性癌的患者。
