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Diagnostic difficulties in the differentiation between an ovarian metastatic low‑grade appendiceal mucinous neoplasm and primary ovarian mucinous cancer: A case report and literature review.

作者信息

Kawecka Weronika, Adamiak-Godlewska Aneta, Lewkowicz Dorota, Urbańska Karolina, Semczuk Andrzej

机构信息

The Second Department of Gynecological Surgery and Gynecological Oncology, University Clinical Hospital no. 4, Lublin Medical University, PL-20090 Lublin, Poland.

Department of Clinical Pathomorphology, Lublin Medical University, PL-20090 Lublin, Poland.

出版信息

Oncol Lett. 2024 Aug 16;28(5):500. doi: 10.3892/ol.2024.14633. eCollection 2024 Nov.


DOI:10.3892/ol.2024.14633
PMID:39233821
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11369849/
Abstract

Low-grade appendiceal mucinous neoplasm (LAMN) is a tumor that primarily originates from the appendix and belongs to the family of appendiceal mucinous neoplasms (AMNs). In 50% of female patients, AMNs (particularly LAMNs) have a tendency to metastasize to organs in the genital tract, where the neoplasm can mimic the features of primary ovarian mucinous cancer (POMC). The present case report reviewed the difficulties in differentiating between these two types of tumors. In the present case report, a 61-year-old female patient was admitted to the Second Department of Gynecological Surgery and Gynecological Oncology, University Clinical Hospital no. 4 at Lublin Medical University (Lublin, Poland) with the diagnosis of a right ovarian mass. After performing ultrasound and computed tomography (CT) scans and laboratory analysis, the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy and resection of the Douglas peritoneum. Notably, the postoperative pathological assessment revealed LAMN with metastases to the right ovary and omentum. Immunohistochemically, cytokeratin 20 and caudal type homeobox 2 both stained positively, whereas paired box gene 8 stained negatively. After surgery, the patient received the recommended hyperthermic intraperitoneal chemotherapy at the Department of Surgical Oncology at Lublin Medical University. After 1 year, a CT scan was performed, which indicated no evidence of recurrent disease. In conclusion, observations from the present case report suggest that gynecologists should be conscious of the possibility of malignancies of gastrointestinal origin in cases of ovarian tumors instead of making direct assumptions of POMC. If the mucinous mass involves the base of the appendix or if there is a suspicion of positive margins, then cytoreductive surgery and right-sided hemicolectomy must be performed. In addition, identifying the origin of mucinous tumors in the right ovary and/or the appendix requires the histopathological examination of a panel of markers using immunohistochemistry.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/35ed36241be4/ol-28-05-14633-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/dbcc056c2d5f/ol-28-05-14633-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/fd98316663f4/ol-28-05-14633-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/9d2b828f3e16/ol-28-05-14633-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/35ed36241be4/ol-28-05-14633-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/dbcc056c2d5f/ol-28-05-14633-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/fd98316663f4/ol-28-05-14633-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/9d2b828f3e16/ol-28-05-14633-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe10/11369849/35ed36241be4/ol-28-05-14633-g03.jpg

相似文献

[1]
Diagnostic difficulties in the differentiation between an ovarian metastatic low‑grade appendiceal mucinous neoplasm and primary ovarian mucinous cancer: A case report and literature review.

Oncol Lett. 2024-8-16

[2]
[Clinicopathological analysis and surgical strategy of primary appendiceal neoplasms].

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[3]
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[5]
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[6]
SATB2 is a supportive marker for the differentiation of a primary mucinous tumor of the ovary and an ovarian metastasis of a low-grade appendiceal mucinous neoplasm (LAMN): A series of seven cases.

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[7]
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J Obstet Gynaecol Res. 2023-12

[8]
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[9]
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[10]
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引用本文的文献

[1]
Appendiceal mucinous neoplasms: Optimizing treatment strategies based on clinical, histological, and molecular features.

World J Clin Oncol. 2025-8-24

[2]
How to differentiate primary mucinous ovarian tumors from ovarian metastases originating from primary appendiceal mucinous neoplasms: a review.

Pathol Oncol Res. 2025-5-12

本文引用的文献

[1]
Confined Low Grade Appendiceal Mucinous Neoplasm With Coexisting Distant Metastasis.

In Vivo. 2024

[2]
Clinicopathological spectrums and prognosis of primary appendiceal adenocarcinoma, goblet cell adenocarcinoma, and low-grade appendiceal mucinous neoplasms.

Pathology. 2023-4

[3]
Low-grade mucinous neoplasms (LAMN) of the appendix in Germany between 2011 and 2018: a nationwide analysis based on data provided by the German Center for Cancer Registry Data (ZfKD) at the Robert Koch Institute (RKI).

Langenbecks Arch Surg. 2022-12

[4]
Immunohistochemical expression of CK20, CK7, and CDX2 in colorectal carcinoma in correlation with pathomorphological characteristics.

Folia Med (Plovdiv). 2022-4-30

[5]
Incidental diagnosis of a low-grade mucinous appendicular neoplasm: A case report.

Int J Surg Case Rep. 2021-6

[6]
Low-Grade Appendiceal Mucinous Neoplasm (LAMN) Primarily Diagnosed as an Ovarian Mucinous Tumor.

Case Rep Surg. 2021-4-22

[7]
Incidentally found mucinous epithelial tumors of the appendix with or without pseudomyxoma peritonei: diagnostic and therapeutic algorithms based on current evidence.

Acta Chir Belg. 2021-8

[8]
Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature.

World J Clin Cases. 2021-4-6

[9]
Diagnosis and Treatment of Primary Tumors of the Appendix: a Critical Review.

J Gastrointest Cancer. 2021-6

[10]
Primary mucinous ovarian tumors vs. ovarian metastases from gastrointestinal tract, pancreas and biliary tree: a review of current problematics.

Diagn Pathol. 2021-3-11

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