Borderline Mucinous Cystadenoma Research Articles

Extremely high levels of CA199 antigen in borderline mucinous ovarian cystadenoma.

SynopsisA case report on a patient with a mucinous borderline ovarian cystadenoma with extremely elevated CA199 levels.

A histopathological study of ovarian lesions in a rural medical college

Ovarian lesions can present in any age of life and has a wide spectrum of presentation. They contribute to most of the pelvic masses encountered in clinical practice in reproductive age group. Histopathological examination is of prime importance in ovarian lesions as it is difficult to diagnose these lesions on basis of clinical history, radiology alone.: To analyse the spectrum of ovarian lesions and to categorize them on basis of histomorphological pattern. A total 132 cases were studied from January 2022 to December 2022. Relevant clinical details and histopathological findings were reviewed and analysed. A total of 132 cases of ovarian lesions were included in this study with age range from 20 years to 72 years. Non neoplastic cases were 71 and neoplastic cases were 61 in present study. Follicular cyst was the commonest non neoplastic lesion (48 cases) followed by haemorrhagic corpus luteal cyst (16 cases). Out of 61 neoplastic lesions, 56 were benign, 3 were borderline and 2 were malignant on histopathological examination. Mucinous cystadenoma was the commonest benign lesion and serous cystadenocarcinoma was the commonest malignant tumour in the present study. Borderline mucinous cyst adenoma was the commonest in borderline cases in our study. Unilateral presentation of ovarian lesions was found in 116 cases and bilateral in 16 cases. In present study majority of cases were of non neoplastic lesions. For accurate management of the ovarian lesions it is important to correlate clinical findings and ultrasonography findings with histopathology diagnosis.

Tumori în pandemie: chistadenom mucinos de ovar gigant.

Tumors in the pandemic era: giant ovarian mucinous cystadenoma. Mucinous cystadenoma is a benign tumor of the ovary originating from the surface epithelium of the ovary, characterized by mucin production. They represent 10-15% of ovarian tumors. The borderline variety represents 10% of mucinous cystadenomas. They can reach very large sizes. We present the case of a patient, aged 65, hospitalized at the end of pandemics with a giant abdominal cystic tumor (diameter 40 cm) with compression disorders. He had a subtotal hysterectomy for uterine fibroids at the age of 25. Laboratory tests are within normal limits except CA19-9 = 398 IU / ml. Abdomino-pelvic ultrasound shows a mid-abdominal liquid formation, inhomogeneous with septa inside that exceeds 30 cm. CT with the contrast substance highlights a multiloculated formation, developed from the left ovary to with iodophilic septa, with mass effect on anatomical elements, with overall dimensions of approx. 230/300/350 mm. With the suspicion of a giant left ovarian cyst suspected of being malignant, a median xipho-umbilical laparotomy was performed and a giant cystic tumor of the left ovary weighing 13 kg, reaching the supramesocolic floor without adhesions, with an ovarian pedicle one cm thick, was removed. Anexectomy was performed on the right side without complications. The postoperative evolution was simple. Histopathological examination determined the diagnosis of borderline mucinous cystadenoma. The epidemiology, clinical signs and imaging diagnosis and surgical treatment of these rare tumors with favorable evolution are discussed.

Coexistence of malignant ovarian Brenner tumor and borderline mucinous cystadenoma, combined with primary uterine corpus endometrioid carcinoma: A case report and literature review.

Malignant Brenner tumor (MBT) of the ovary is a rare malignant ovarian tumor, whereas uterine corpus endometrioid carcinoma (UEC) constitutes one of the most common malignant tumors of the female reproductive system. The present study reported on a case of the coexistence of ovarian MBT and borderline mucinous cystadenoma combined with primary UEC. Therefore, the present case is a synchronous primary cancer of both ovary and endometrium. Although synchronous primary cancers of the endometrium and ovary are relatively uncommon, they are not rare; however, due to the rarity of MBT, this case was considered singular. To the best of our knowledge, this was the first-ever reported case of the coexistence of an ovarian MBT and borderline mucinous cystadenoma combined with primary UEC. Based on a review of the literature associated with the present case, its clinicopathological features, immunohistochemical phenotype, differential diagnosis, molecular changes, prognosis and treatment were summarized and discussed. The aim of the present study was to improve the understanding of this rare synchronous primary cancer of the ovary and endometrium so as to avoid future misdiagnosis.

Adnexal masses detected during pregnancy: A tertiary center experience

Objective: We aimed to evaluate adnexal masses in pregnant women who were referred to the gynecologic oncology department. Material and Methods: Data of the pregnant women referred to the gynecological oncology department between November 2016 and June 2019 with suspicion of adnexal malignancy were retrieved through the hospital's electronic medical records that included patients' demographic characteristics, gestational age, ultrasonographic, and magnetic resonance imaging findings, serum tumor markers, histopathological results. Patients with a spontaneously regressed adnexal mass, benign adnexal masses, and concurrent ectopic pregnancy were excluded. Results: The mean age of the patients was 30.9±0.87 years. The mean gestational age at diagnosis was 14.05±1.36 weeks and the mean gestational age at delivery was 35.9±1.23 weeks. The mean gestational age at diagnosis was 14.05±1.36 weeks. Twenty-five patients (59.5%) underwent laparotomy while 18 patients (40.5%) managed conservatively. The histopathological results were mucinous cystadenoma in 8 (32%) patients, mature cystic teratoma in 6 (24%) patients, borderline mucinous cystadenoma in 3 (12%) patients, borderline serous cystadenoma in 2 (8%) patients, serous cystadenoma in 2 (8%) patients, Brenner’s tumor in 2 (8%) patients, theca lutein cysts in 1 (4%) patient, and fibroma in 1 (4%) patient. None of the patients has malignant neoplasm. Conclusion: Adnexal masses at pregnancy should be referred gynecologic oncology department after the 17th week of gestation.

Successful laparoscopic removal of ovarian borderline cystadenoma in patient with multiorgan hemangioma and ventriculoperitoneal shunt: a case report and literature review

As medical diagnosis and treatment level improved, patients with ventriculoperitoneal shunt (VPS) live longer and may develop conditions that need laparoscopic surgery. The safety of laparoscopy in patients with VPS continues to be challenged due to pneumoperitoneum. Here, we report a patient with medical history of VPS and hemangioma, diagnosed with ovarian borderline mucinous cystadenoma, received laparoscopic surgery in supine position and 10 mmHg pneumoperitoneum pressure, in which no clamping or externalizing catheter, no perioperative or postoperative complications. We also present a literature review and discuss the precautions needing considering during laparoscopy. For patients with VPS, laparoscopic surgery can be recognized as a potentially safe and feasible procedure.

Computed Tomography and Clinical Analysis of Ovarian Mucinous Tumors in Adolescent Patients

To investigate the clinical and computed tomography features of ovarian mucinous tumors in children and adolescents. A retrospective analysis of clinical and preoperative computed tomography (CT) data was performed in 59 patients who were 20 years or younger with ovarian mucinous tumors confirmed by histopathology. Patients' age, medical history, symptoms, tumor marker levels, and CT imaging findings were recorded. None. Identification of the clinical and CT features of ovarian mucinous tumors in pediatric and adolescent patients. There were 41 mucinous cystadenomas in 39 cases, 12 borderline mucinous cystadenomas in 11 cases, and 9 mucinous cystadenocarcinomas in 9 patients. A total of 55 tumors were multilocular (55/62, 88.7%), including fewer than 10 loculations in 23 tumors, 10-20 loculations in 17 tumors, and over 20 loculations in 15 tumors. Eleven borderline mucinous cystadenomas were multilocular (11/12, 91.7%), with over 10 loculations in 7 tumors (7/12, 58.3%). Twelve tumors appeared as multilocular cystic-solid (12/62, 19.4%), and a case of mucinous cystadenocarcinoma was predominantly solid (1/62, 1.6%). Seventeen tumors showed honeycomb sign and stained glass appearance. Six mural nodules, with sizes ranging from 1.1 to 3.5cm (average: 2.8cm), were found in borderline mucinous cystadenoma and mucinous cystadenocarcinoma. The CT findings of ovarian mucinous tumors in children are characteristic. The preoperative CT is helpful in making differential diagnoses.

The Value of Apparent Diffusion Coefficient in Differential Diagnosis of Ovarian Cystic Adenoid Tumors

Objective: To quantitatively analyze apparent diffusion coefficient (ADC) value of cystic composition and solid composition in ovarian cystadenocarcinoma, borderline cystadenoma and cystadenoma by 3.0T magnetic resonance imaging (MRI), and to investigate its diagnostic and differential diagnostic values in ovarian cystic adenoid tumors. Methods: Retrospective analysis was carried out on 28 patients with ovarian cystic adenoid tumor as confirmed by surgical and pathological examinations. Examination was performed by Siemens 3.0T MRI scanner. Tumor size, margin, composition (cystic or solid), signal characteristic and presence of ascites were observed. Combined with localization using T2WI and diffusion weighted imaging (DWI), ADC value was calculated from ADC mapping using region of interest ROI (the largest surface area of cystic and solid compositions in tumor). Statistical analysis was performed. Results: Among the 28 ovarian tumors, there were 13 cases of cystadenomas (5 serous cystadenomas and 9 mucinous cystadenomas), 4 borderline mucinous cystadenomas and 11 cystadenocarcinoma (9 serous cystadenocarcinoma and 2 mucinous cystadenocarcinoma). There was no significant intragroup difference in ADC values of cystic composition and solid composition in ovarian cystadenoma and cystadenocarcinoma respectively (P>0.05). The ADC value of solid composition between benign cystadenoma and borderline cystadenoma (P<0.05) showed statistically significantly difference. The difference in ADC value of solid composition between benign cystadenoma and cystadenocarcinoma was also statistically significant (P<0.05). There was no significant difference in ADC value of cystic composition between benign cystadenoma, borderline cystadenoma and cystadenocarcinoma (P>0.05). Conclusion: Quantitative analysis of ADC value of solid composition using 3.0T MRI has great value in differential diagnosis of benign and malignant ovarian cystic adenoid tumors. Its combination with conventional MRI method can improve the accuracy of diagnosis of ovarian cystic adenoid tumors.

Погранична муцинозна цистаденома яєчника як причина виникнення псевдоміксоми черевини (Презентація клінічного випадку)

Peritoneal pseudomixome (PMP) is a rare clinical condition characterized by a localized or generalized accumulation of gelatin-like content, associated in most cases with mucinous tumors of the digestive tract, and more rarely ovaries. Based on the presentation of the clinical case of MBP caused by ovarian border neoplasia, the effect of cytoreduction on the further course of the disease as an independent treatment method was analyzed. The clinical case presented in this article reflects a rare combination of borderline ovarian tumor with PMP. The effectiveness of performing cytoreductive surgery has been proved, which calls into question the advisability of chemotherapy in patients with tumors of a potentially low degree of malignancy. Key words: borderline mucinous cystadenoma, pseudomyxoma peritonei, debulking.

Primary Retroperitoneal Mucinous Cystic Neoplasm

Primary retroperitoneal mucinous cystic neoplasm (PRMCN) is a rare retroperitoneal tumor with female predilection. It is classified into 3 types: benign mucinous cystadenoma (MCA), borderline mucinous cystadenoma (MCAb), malignant mucinous cystadenocarcinoma (MCAc). This study retrospectively evaluates the prevalence of PRMCN among retroperitoneal neoplasms resected between June 2006 and January 2015 at a referral center. Authors' experience with PRMCN is reviewed, and a new case of PRMCN, incidentally diagnosed during pregnancy is reported. A literature review using PubMed is also presented, discussing several issues concerning clinicopathologic features, treatment options, and long-term outcome of PRMCN. A 36-year-old woman was incidentally diagnosed with a 12-cm retroperitoneal cyst discovered by ultrasound at 36 weeks of gestation. Eight months later the patient was referred to the department of surgery, the Tel Aviv Sourasky Medical Center. By that time, the patient has sensed local discomfort. Physical examination revealed a right abdomen mass with mild tenderness. Computed tomographic scan depicted the cyst, located along the right paracolic gutter, displacing the right colon medially. The patient underwent complete laparoscopic resection of a 15-cm cyst, without its disruption. The cyst was drained inside an endobag and retrieved. The patient was discharged home on postoperative day 1. The pathology was MCA. Long-term result was no evidence of disease for 9 months. The prevalence of PRMCN among resected retroperitoneal neoplasms was 1.95% (3/154 neoplasms). The treatment of choice is complete tumor resection. Surgical technique should be chosen depending on the surgeon's expertise and tumor factors affecting safe resection. Surgery timing during pregnancy should be dictated by both risk of malignancy and obstetric considerations. As for malignant PRMCN, radical surgery does not seem justified, especially in reproductive females. Adjuvant chemotherapy should probably be reserved for metastatic disease, recurrence, and tumor rupture. Long-term follow-up is lacking, although it is important to better define the prognosis of PRMCN.

Paired box gene 2 is associated with estrogen receptor α in ovarian serous tumors: Potential theory basis for targeted therapy.

It has been suggested that Paired box gene (PAX)2 is activated by estradiol via estrogen receptor (ER)α in breast and endometrial cancer. The expression of PAX2 was restricted to ovarian serous tumors and only one case was positive in borderline mucinous tumor in our previous study. In the present study, immunohistochemistry was performed to assess the expression of ERα in 58 cases of ovarian serous tumors, including 30 serous cystadenomas, 16 borderline serous cystadenomas, 12 serous carcinomas and 67 cases of ovarian mucinous tumors, including 29 mucinous cystadenoma, 23 borderline mucinous cystadenoma and 15 mucinous carcinoma, which were the same specimens with detection of PAX2 expression. The results demonstrated that ERα was expressed in 10% (3/30) of serous cystadenomas, 62.5% (10/16) borderline serous cystadenomas and 66.7% (8/12) serous carcinomas. The expression of ERα in borderline serous cystadenomas and serous carcinomas were significantly higher compared with that in serous cystadenomas (P<0.01). ERα was detected in 3.4% (1/29) mucinous cystadenoma, 26.1% (6/23) borderline mucinous cystadenoma and only 6.7% (1/15) mucinous carcinoma. Furthermore, a scatter plot of the expression of PAX2 and ERα revealed a linear correlation between them in ovarian serous tumors (P<0.0001). With few positive results, no correlation was determined in ovarian mucinous tumors. It was demonstrated that PAX2 is associated with ERα in ovarian serous tumors, and this may become a potential theory basis for targeted therapy for ovarian serous tumors. Further research is required to determine how PAX2 and ERα work together, and the role of targeted therapy in ovarian serous tumors.

Mucinous cystadenoma of the appendix presenting as an umbilical hernia: A case report.

Mucinous cystadenoma of the appendix is a rare condition that develops as a result of proliferation of mucin-secreting cells in an occluded appendix. Mucinous cystadenoma of the appendix presenting as an umbilical hernia is a rare clinical entity. The most common causes of this condition are known to be ascites, hepatitis and cirrhosis; however, the patient in the present study, was diagnosed as hepatitis- and cirrhosis-negative, with no history of chronic coughing or constipation. The aim of the present study was to report a rare case of mucinous cystadenoma of the appendix presenting as an umbilical hernia in a 66-year-old female patient. The patient had a 6-month history of a reducible mass in the umbilical region and was diagnosed with umbilical hernia. Computed tomography and ultrasonography were performed and revealed massive ascites. Ultimately, a laparoscopic appendectomy was performed and borderline mucinous appendiceal cystadenoma of low malignant potential was confirmed. In addition, the present study discussed the association between mucinous cystadenoma of the appendix and umbilical hernia, as well as the diagnostic process and treatment strategies.

Expression of Lysine-specific demethylase 1 in human epithelial ovarian cancer.

BackgroundLysine-specific demethylase 1(LSD1) is implicated in the tumorigenesis and progression in various cancers. However, the expression of LSD1 in epithelial ovarian cancer and its clinical significance has not been examined in detail.MethodsImmunohistochemical was used to detect the expression of LSD1 in normal ovarian epithelial tissues, cystadenoma, borderline cystadenoma, and cystadenocarcinoma. Next, the correlations between expression of LSD1 and clinicopathological features was assessed in 96 species of serous cystadenocarcinoma and 36 species of mucinous cystadenocarcinoma.ResultsImmunohistochemical results showed that the expression of LSD1 was gradually increased from benign cystadenoma and borderline cystadenoma to cystadenocarcinoma. The positive ratio of LSD1 expression was 50% in normal ovarian epithelial tissues, 72% in serous cystadenoma, 73% in mucinous cystadenoma, 82% in borderline serous cystadenoma, 83% in borderline mucinous cystadenoma, 94% in serous cystadenocarcinoma and 92% in mucinous cystadenocarcinoma, respectively. LSD1 expression levels were associated with International Federation of Gynecology and Obstetrics stage and lymphatic metastasis in both serous and mucinous cystadenocarcinoma samples. Kaplan-Meier curves suggested that overall survival time of patients with high LSD1 expression was significantly shorter than that of patients with low LSD1 expression. Multivariate Cox proportional hazard regression indicated that higher LSD1 expression was a significant independent predictor of poor survival of EOC patients (P = 0.016).ConclusionsThese results suggest that LSD1 may be involved in carcinogenesis and progression with promising therapeutic potential for epithelial ovarian cancer.

PAX2 and PAX8 reliably distinguishes ovarian serous tumors from mucinous tumors.

Ovarian cancer is the leading cause of cancer-related death in gynecologic malignancies and consists of different histologic types. Histopathologic examination and accurate subtype diagnosis has become increasingly important in guiding patient management and, as such, is the most important currently available ovarian carcinoma "biomarker." In this study, we examined the expression of PAX2 and PAX8 by immunohistochemistry in 58 cases of ovarian serous tumors and 68 cases of ovarian mucinous tumors. The results demonstrated that PAX2 and PAX8 were detected in 100% (30/30) and 77% (23/30) of serous cystadenomas, 100% (16/16) and 94% (15/16) of borderline serous cystadenomas, and 100% (12/12) and 83% (10/12) of serous carcinomas, respectively. However, PAX2 and PAX8 were detected in only 0% (0/29) and 0% (0/29) of mucinous cystadenoma, 4% (1/24) and 4% (1/24) of borderline mucinous cystadenoma, and 0% (0/15) and 7% (1/15) of mucinous carcinoma, respectively. Further, there is a linear correlation between PAX2 and PAX8 (R=0.745; P<0.0001). Overall, our data indicated that PAX2 correlated with PAX8, and these 2 proteins differentially expressed in ovarian serous tumors and ovarian mucinous tumors. Thus, PAX2 and PAX8 are useful biomarker in the differential diagnosis of ovarian serous and mucinous tumors.

Expression of c-myc and mutation of the KRAS gene in patients with ovarian mucinous tumors.

We examined the expression of c-myc and mutations in the KRAS gene in ovarian mucinous tumors to explore the pathogenesis of these tumors and the feasibility of targeted gene therapy. Expression of c-myc protein and mutations in the KRAS gene in 24 cases of ovarian mucinous cystadenoma, 46 cases of ovarian borderline mucinous cystadenoma, and 46 cases of ovarian mucinous cystadenocarcinoma were detected using the immunohistochemistry PV-9000 2-step method and polymerase chain reaction-restriction fragment length polymorphism. The positive expression rates of c-myc in ovarian mucinous cystadenoma, borderline mucinous cystadenoma, and cystadenocarcinoma were 0, 39.1, and 65.2%, respectively (P < 0.01), while the mutation rates in KRAS were 0, 39.1 and 13.0%, respectively. The mutation rate of the borderline group was significantly higher, while rates in the other 2 groups were similar (P > 0.05). c-myc was not correlated with clinical stage, pathological grade, or age of patients with ovarian mucinous cystadenocarcinoma or borderline mucinous cystadenoma (P > 0.05), but was correlated with tumor size (P < 0.05). Mutations in KRAS were not correlated with clinical stage or tumor size in patients with borderline mucinous cystadenoma (P > 0.05), whereas it was correlated with age (P < 0.05). In borderline mucinous cystadenoma, c-myc expression and KRAS mutations were not correlated (P > 0.05). c-myc is involved in the formation of ovarian borderline mucinous cystadenoma and mucinous cystadenocarcinoma, and the KRAS gene may contribute to the formation of borderline mucinous cystadenoma.

Giant borderline mucinous cystadenoma presenting as an acute abdomen in the early pueperium

Giant borderline mucinous cystadenoma presenting as an acute abdomen in the early pueperium

MRI in differentiating ovarian borderline from benign mucinous cystadenoma: Pathological correlation

To investigate MRI in differentiating borderline mucinous cystadenoma (MC) from benign MC of the ovary. We studied MR images of 26 benign MCs and 24 borderline MCs of the ovary. The following MRI features of tumors were evaluated and compared between two groups: laterality, shape, size, loculation, signal intensity of the fluid, thickness of the septation and the wall, and vegetations. The results of the MRI were then compared with the pathological findings. Honeycomb loculi, high signal intensity on T1WI, and low signal intensity on T2WI of the intracystic content, thickened septation or wall (≥5 mm), and vegetations (≥5 mm) were significantly more common in borderline MC than in benign MC with the sensitivity and specificity of identifying borderline MC of 50.0% and 80.8%, 41.7% and 96.2%, 45.8% and 96.2%, and 62.5% and 96.2%, respectively. The presence of any one of the following features-honeycomb loculi with a low signal intensity on T2WI, thickened septation or wall (≥5 mm), and vegetations (≥5 mm)-yielded the sensitivity, specificity, and accuracy of identifying borderline MC of 91.7%, 92.3%, and 92.0%, respectively. MRI has the ability to accurately demonstrate the morphological characteristics of ovarian MC and reliably differentiate borderline MC from benign MC.

Nodular Histiocytic Aggregates in the Greater Omentum of Patients With Ovarian Cancer

Nodular histiocytic aggregate (NHA) of the omentum is a rare benign proliferative process composed predominantly of histiocytes with scattered mesothelial cells. NHA is a differential diagnosis for neoplasms or metastatic tumors in cancer patients. To further clarify this clinical pitfall issue, the authors investigated surgical samples of the greater omentum from 96 patients with gastrointestinal malignancies and 53 patients with gynecologic neoplasms. Visible NHA of greater omentum was identified in 3 patients with ovarian neoplasms (borderline mucinous cystadenoma, low-grade papillary serous cystadenocarcinoma, and juvenile granulosa-cell tumor) but in none of the patients with gastrointestinal malignancies. Similar lesion was also identified on the cell blocks from peritoneal washings in 1 of the 3 patients. Grossly, the lesions formed small yellow-red nodules on the greater omentum, and the NHA lesion was also found diffusely on the surface of the appendix and fallopian tubes in 2 of the 3 patients. Histological study showed that typical NHA changes over an inflammatory background, which may indicate that NHA is a consequence of a chronic inflammatory process of omentum. The predominant infiltration of T lymphocytes in the NHA lesions indicates that the aggregation of histiocytes may be related to the activation of T-cell immunity. This report has first demonstrated visible NHA in the greater omentum of patients with ovarian malignancies, and awareness of this entity should be brought to clinicians to avoid misdiagnosis.

Primary squamous carcinoma of the ovary likely arising from a monodermal cystic mucinous teratoma

We present a 58-year-old woman with primary squamous carcinoma of the ovary likely arising from a monodermal cystic mucinous teratoma. Noninvolved ovary showed no Brenner tumor, endometriosis, transitional carcinoma, endometrioid adenocarcinoma, or typical multigerm layer classic mature teratoma. Moreover, no other primary site was possible because there were no prior or concomitant squamous carcinomas, or history of cervical intraepithelial neoplasia. The tumor showed strong positivity for p63 and CK5/6, reactivity that also extended from the squamous carcinoma into the basal-cell lining of the mucinous cyst of a likely monodermal teratoma. This basal-cell pattern was absent in a series of conventional benign and borderline cystic mucinous cystadenomas of the ovary, but clearly present in the mucinous cysts part of mature teratomas. We present this as a unique case of squamous carcinoma likely arising from a monodermal cystic mucinous teratoma. Moreover, we submit that the p63 and CK5/6 staining pattern may help to differentiate monodermal cystic mucinous teratoma from conventional cystic mucinous tumors.

Stage-Specific Embryonic Antigen 4 Expression in Epithelial Ovarian Carcinoma

Stage-specific embryonic antigen 4 (SSEA-4) is a widely used marker to monitor the differentiation of pluripotent embryonic stem cells. Little is known about the expression pattern of SSEA-4 in solid tumors up to now. In this study, we investigated the expression of SSEA-4 in 479 cases of various degrees of ovarian epithelial lesions by immunohistochemistry, consisting of 45 normal ovarian epithelia, 110 benign serous ovarian cystadenomas, 68 borderline serous ovarian cystadenomas, 104 invasive serous ovarian carcinomas, 64 benign serous mucinous cystadenomas, 48 borderline mucinous ovarian cystadenomas, and 40 invasive mucinous carcinomas. Moreover, the association between SSEA-4 expression and clinicopathological parameters was also evaluated. The expression of SSEA-4 was found to be increased from normal epithelium to benign cystadenoma and to borderline cystadenoma and adenocarcinoma in both serous and mucinous group. The loss or reduction of the expression of SSEA-4 was significantly correlated with more advanced tumor stage and poorer tumor cell differentiation. We therefore proposed that SSEA-4 may play a role during the oncogenesis of epithelial ovarian carcinoma and posses a tumor suppressor effect during malignancy promotion. It could be a potential therapy target in patients with epithelial ovarian carcinoma.