Immunohistochemical study of ovarian psammocarcinoma: Report of a rare case

Abstract

Psammocarcinoma is a rare variant of serous carcinoma of the ovaries and has a favourable prognosis resembling that of serous borderline tumors [1]. A 60-year-old woman had a pelvic mass 20weeks size. Magnetic resonance imaging (MRI) showed bilateral ovarian cysts with suspicious peritoneal deposits (Figure. 1A). Carbohydrate antigen 125 level was 1300 U/mL. Peritoneal fluid cytology showed large cell groups with high nucleocytoplasmic ratio, irregular nuclear borders, and indistinct nucleoli. A single psammoma body (PB) was detected (Figure 1B). A diagnosis of ovarian carcinoma was offered. Intraoperatively, bilateral large cystic ovarian masses were seen with thickened omentum and multiple subdiaphragmatic deposits. A biopsy of the omental deposits showed tumor composed of small cuboidal to round cells arranged in a papillary, cribriform pattern. The cells showed minimal pleomorphism and scant mitotic figures. Abundant PBs were scattered throughout the fibrous stroma and in the tips of the papillae (Figure 1C). A diagnosis of metastatic deposits of ovarian psammocarcinoma, International Federation of Gynecology and Obstetrics (FIGO) Stage IIIc was given. Cytokeratin 7 and epithelial membrane antigen showed strong immunoreactivity in tumor cells (Figure 1D and 1E) and none for cytokeratin 20, calretinin, and desmin. Immunoreactivity for estrogen receptors was seen in 75% of tumor cells (Figure 1F). The patient was given tamoxifen and chemotherapy. Patients with psammocarcinoma range in age from 36 years to 76 years (mean age 57 years) [1]. Psammocarcinoma shows: (1)