Abstract
Traditionally, epithelial ovarian, tubal, and peritoneal cancers have been viewed as separate entities with disparate origins, pathogenesis, clinical features, and outcomes. Additionally, previous classification systems for ovarian cancer have proposed two primary histologic groups that encompass the standard histologic subtypes. Recent data suggest that these groupings no longer accurately reflect our knowledge surrounding these cancers. In this review, we propose that epithelial ovarian, tubal, and peritoneal carcinomas represent a spectrum of disease that originates in the Mullerian compartment. We will discuss the incidence, classification, origin, molecular determinants, and pathologic analysis of these cancers that support the conclusion they should be collectively referred to as adenocarcinomas of Mullerian origin. As our understanding of the molecular and pathologic profiling of adenocarcinomas of Mullerian origin advances, we anticipate treatment paradigms will shift towards genomic driven therapeutic interventions.
Highlights
Adenocarcinoma of Mullerian origin was first described by Dr Swerdlow in 1959 [1]
We describe common histopathologic and immunophenotype findings for adenocarcinomas of Mullerian origin stratified by the various subtypes
While the dualistic Type I and II model of epithelial ovarian cancer suggests two main categories, it is unclear if this model can be extended to adenocarcinomas of Mullerian origin
Summary
Adenocarcinoma of Mullerian origin was first described by Dr Swerdlow in 1959 [1]. The original manuscript entitled, “Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary,” described a patient with a malignant left-sided pelvic mass. Dr Swerdlow theorized that while ovarian or tubal carcinoma was unlikely, the tumor probably developed from tissue with a similar embryological origin as the ovary (the pelvic peritoneum, fallopian tubes, or uterus). He concluded that the cancer arose from the pelvic peritoneum [1]. Recent data regarding the genetics and histopathology of epithelial ovarian cancer (EOC) has improved our understanding of ovarian carcinogenesis These results and current hypotheses indicate that epithelial ovarian, peritoneal, and tubal cancers are not distinct entities but represent a spectrum of disease that originates in the Mullerian compartment. IC2: Capsule ruptured before surgery or tumor on ovarian or fallopian tube surface
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