Ovarian Mucinous Cystadenocarcinoma Research Articles

A case report on rare co-occurrence of invasive ovarian mucinous adenocarcinoma, unilateral renal agenesis, and bicornuate uterus: is it a new triad?

BackgroundConcomitant invasive ovarian mucinous adenocarcinoma, unilateral renal agenesis and bicornuate uterus is a rare combination. Unilateral renal agenesis has been associated with genital anomalies, such as unicornuate and bicornuate uterus. Furthermore, a wealth of studies has reported the association between unicornuate uterus and ovarian anomalies, such as the absence of an ovary or ectopic ovaries, but rarely has there been a combination of the three to the best of our knowledge. The present case report is the first case presentation with a combination of the three syndromes: ovarian mucinous tumor, unilateral renal agenesis, and bicornuate uterus.Case presentationWe report the case of a 17-year-old who presented with abdominal distension. On examination, a CT scan revealed a large multicystic abdominal mass on the right side, with an absence of the right kidney while the left kidney was normal in size, appearance, and position. Intraoperatively, massive blood-stained ascitic fluid was evacuated. Additionally, a large whitish polycystic intra-abdominal mass with mucus-like materials and solid areas was attached to the midpoint of the colon and the right ovary, with visible metastasis to the omentum. The uterus was bicornuate. The mass and omentum were taken for histopathology and a diagnosis of invasive ovarian mucinous cystadenocarcinoma with metastasis to the colon and omentum was made after a pathological report.ConclusionsThe presence of these conditions in the same individual could potentially complicate medical management and fertility considerations. Thus, a need for a multidisciplinary medical team, including gynecologists, urologists, and oncologists, to address their unique needs and provide appropriate treatment and guidance. Further research and case studies are needed to better understand the possible association and implications of these rare co-occurring conditions.

Mucinous cystadenocarcinoma of ovary in 16 years old postmenarchal patient-A rare case report

Malignant epithelial ovarian tumor is a rare entity in children. Especially, mucinous ovarian cystadenocarcinoma is exceedingly rare in pediatric age group, only a limited number of cases are reported in this age group till date with less than 5 cases reported in adolescence age in the literature. We describe a case of mucinous cystadenocarcinoma in a sixteen-year old postmenarchal girl presenting with complaints of abdominal distension and irregular periods from last three months. Management of such cases is tricky as conservative approach involving sparing fertility of the patient is adopted. This case is presented for its rarity and unique presentation.

Synchronous or Metastatic Gastric and Ovarian Malignancies: A Diagnostic Challenge

Primary ovarian carcinoma is the prevailing form of cancer in the female reproductive system, leading to a substantial number of cancer-related fatalities globally. One of the major obstacles encountered in diagnosing this condition is distinguishing between primary gastrointestinal tumors and tumors that have metastasized from the ovaries, since they may exhibit similar histological characteristics. This case report underscores the difficulties involved in determining whether multiple tumors originate primarily or are a result of metastasis. We report a case of a 65-year-old female who presented with abdominal pain and was found to have a large multiloculated cystic mass in the right ovary and a poorly detected left ovary on ultrasound and CT scan. Her serum CA125 level was elevated. She underwent exploratory laparotomy and frozen section analysis of the right ovarian and gastric tumors. The histopathological diagnosis was mucinous cystadenocarcinoma of the ovary and well differentiated adenocarcinoma of the stomach. She also underwent hysterectomy with left salpingo-oophorectomy, which revealed mucinous cystadenocarcinoma of the left ovary. Immunohistochemical staining for specific markers, including CK7, CK20, CDX2, and PAX8, was conducted to identify the origin of the adenocarcinoma. The results revealed that both ovarian and gastric tumors showed a positive expression for CK7, while CK20 was negative in the gastric tumor but positive in the ovarian tumor. Furthermore, both CDX2 and PAX8 were negative in both the gastric and ovarian tumors. These findings provide valuable insights into the differential diagnosis and help to distinguish the possible sources of the adenocarcinoma. This case emphasizes the significance of histopathological examination and immunohistochemistry profiling in accurately diagnosing and determining the primary tumor site. Recognizing the primary tumor and its immunohistochemistry profile aids in guiding treatment strategies and predicting patient prognosis, leading to improved management and outcomes. Keywords Ovarian carcinoma, Gastric carcinoma, Immunohistochemistry

Mucinous cystadenocarcinoma of the breast harbours TRPS1 expressions and PIK3CA alterations.

Breast mucinous cystadenocarcinoma (BMCA) is a rare tumour recently recognised as a distinct entity by the World Health Organisation Tumour Classification Series. BMCA is a triple-negative tumour that lacks specific immunohistochemical markers; therefore, distinguishing it from mimickers such as ovarian and pancreatic cystadenocarcinomas requires careful clinicopathological correlation. Due to its rarity, little is known about the molecular alterations that underlie BMCA. In this study, we used immunohistochemical staining methods to investigate TRPS1 (trichorhinophalangeal syndrome type 1) expression in BMCA and compare it to expression in ovarian and pancreatic mucinous cystadenocarcinomas. We also collected tumour samples from three BMCA patients for molecular analysis by MALDI-TOF mass spectrometry, real-time polymerase chain reaction, whole exome sequencing and fluorescence in-situ hybridisation. TRPS1 immunoreactivity was found only in BMCA tumour cells and not in the ovarian and pancreatic counterparts. One of the three BMCA tumours also showed a PIK3CA hot-spot mutation, which was confirmed by whole genome next-generation sequencing (NGS). No KRAS, NRAS, BRAF or AKT mutations were found. To our knowledge, this is the first demonstration of TRPS1 expression in BMCA patients and the first identification of a PIK3CA hotspot mutation in these tumours. These findings provide insights into the molecular mechanisms underlying BMCA tumorigenesis and suggest a potential drug target for this rare and poorly understood cancer.

Mucinous cystadenocarcinoma of the ovary in a 14-year-old girl: a case report and literature review

BackgroundOvarian epithelial tumors are common in adults, and their peak incidence of onset is over 40 years of age. In children, most ovarian tumors are germ cell-derived, whereas epithelial tumors are rare and mostly benign.Case presentationThis report describes a case of a 14-year-old Chinese girl with ovarian mucinous cystadenocarcinoma. She was admitted with a small amount of bloody vaginal discharge during the past month. Magnetic resonance imaging of the abdomen and pelvis showed a large solid cystic mass lesion in the left ovary. Tumor marker levels were within normal limits ( CA-125: 22.3 U/mL, HE4: 28.5 pmol/L, HCG: < 1.20 mIU/ml, AFP: 3.3 ng/ml, CEA: 2.2 ng/ml, CA19-9: < 2.0 U/mL). Laparoscopic exploration revealed a large left ovarian tumor. The patient underwent left salpingo-oophorectomy, and showed no significant issues during follow-up, as well as no evidence of recurrence or metastasis.ConclusionsWe report the first pediatric case of ovarian mucinous cystadenocarcinoma in China. Given the scarcity of reports addressing the clinical management of this condition, the present study provides a useful contribution to its further understanding in light of developing future treatment strategies.

Ovarian mucinous cystadenocarcinoma in an 11-year-old girl

Epithelial ovarian tumors are extremely rare in the pediatric age group. Mucinous cystadenocarcinoma in children, a rare form of epithelial tumor, is a malignant cystic ovarian neoplasm. To our knowledge, there are only five cases of mucinous cystadenocarcinoma reported in the English-language in the pediatric age. Here we present a case of an 11-year- old girl with a giant ovarian mucinous cystadenocarcinoma.

A case of Pseudomyxoma Peritonei of an unexpected origin

BackgroundPseudomyxoma peritonei (PMP) is a complex and partially understood disease defined by mucin deposits in the peritoneal cavity, mostly of appendiceal origin caused by the rupture of a mucocele often containing Low or High grade Appendiceal Mucinous Neoplasm (LAMN/HAMN). Other origins include primitive ovarian mucinous cystadenoma or cystadenocarcinoma almost always with an associated teratoma, but to our knowledge no case of ovarian teratomatous appendiceal-like mucocele with LAMN has been reported as a cause of PMP.Case presentationA 25-year old female with infertility was diagnosed with an isolated left ovarian tumor in a context of PMP. Histological examination revealed an ovarian teratoma containing an appendiceal-like structure with mucocele and LAMN, without any associated lesion of the appendix on full histological analysis. Molecular characterization of the ovarian lesion showed co-KRAS and GNAS mutations, as described in PMP of appendiceal origin, while only KRAS mutations are reported in primitive ovarian mucinous tumor.ConclusionsDetection of co-KRAS and GNAS mutations in our case of ovarian teratomatous appendiceal-like mucocele with LAMN shows that when PMP derives from a mucinous ovarian lesion (with histological proof of none-appendiceal involvement), it is probably of a digestive teratomatous origin, emphasizing the need to actively search for tetatomatous signs in a context of ovarian PMP.

Role of Transabdominal Ultrasound in Characterization of the Ovarian Mass

The use of grey-scale ultrasound morphology to characterize a pelvic mass may also be called ‘pattern recognition’. The grey-scale ultrasound image provides as much information as that obtained by the surgeon or pathologist when they cut a surgical specimen to see what it looks like inside. Aim of our study is to characterize the ovarian mass by ultrasound. The study was conducted in Department of Radiology and Imaging, College of Medical Sciences, Bharatpur. Patients with suspected ovarian mass in Gynecology OPD were included in our study. A prospective cross-sectional study was conducted on 60 patients in college of medical science, Bharatpur, over the period of one year (from November 2019 to October 2020). Present study showed benign ovarian (90.0%) pathology are the most commonly encountered ovarian mass. Ovarian mass is most common in adult female of age 15-30 years and malignant ovarian mass was most common among the age group of 30-60 years. Among benign pathology of ovary simple follicular cysts are most common (39.0%), followed by hemorrhagic cyst (31.0%), dermoid cyst (17.0%), chocolate cyst (9.0%) and ectopic pregnancy (4.0%). Among the malignant ovarian mass serous cystadenocarcinoma and mucinous cystadenocarcinoma showed similar frequency (33.0% each) and followed by immature teratoma and krukenberg tumor (17.0% each). Ultrasound parameters like size, septal thickness, solid component and spectral doppler (RI ans PI) are very helpful for determination of malignant pathology. In this study the sensitivity and specificity of size parameter is least (40.3% and 60.2%) and highest in solid component and spectral Doppler parameter (PI) being (82.0% and 92.0%). Combined study of grey scaleand spectral Doppler study plays crucial role in characterization of ovarian mass to differentiate between benign and malignant pathology.

Hereditary mucinous ovarian cancer complicated with omental metastasis: A case report

Approximately 80% ovarian tumorsare benign, and these arise mostly in young adult females. Malignant tumors are more prevalent in ageing women, between the ages of 45-65 years. Mucinous ovarian cancer represents about 5% of epithelial ovarian cancers (EOC).We have reported a case of mucinous cystadenocarcinoma in 35-year-old lady with metastasis to omentum.Imaging (radiograph &amp; CT scan) studies showed a large right sided pelvic mass with probable origin in the right ovary. Cancer antigen-125 was elevated, while carcinoembrionic antigen and alphafetoprotein were normal. Mutational profiles shown distinct finding, as KRAS mutations positive nevertheless p53 and BRCA mutations are absent. She had undergone total abdominal hysterectomy with bilateral salphingo-oopherectomy along with pelvic dissection for removal of lymph nodes at the age of 35. She was given advice for radiotherapy with 3 cycles of chemotherapy with cisplatin and paclitaxel. To the best of our knowledge, this is the one of the littlecase of ovarian mucinous cystadenocarcinoma being reported at a relatively young age, and the first case being reported from Bangladesh.&#x0D; J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 83-88

Fertility-sparing Surgery (FSS) in Epithelial Ovarian Cancer (EOC): A Case Report

Background: Epithelial ovarian cancer is the most common and lethal ovarian cancer. Now a days Fertility preservation is an important issue because of the constant shifting of childbearing age towards higher ages. The increasing incidence of epithelial ovarian cancer in women with active childbearing potential constitutes a therapeutic dilemma. Fertility sparing techniques are being increasingly incorporated in the therapeutic strategies in early stages of the disease. Established organ-preserving techniques in early stage epithelial ovarian cancer includes preservation of the contralateral ovary and uterus.&#x0D; Aim: To report the case of a Epithelial Ovarian Cancer, who had conservative surgery followed by chemotherapy with a good fertility outcome.&#x0D; Case presentation: A 31-year-old nulliparous woman with a right sided ovarian mucinous cystadenocarcinoma was treated by right adnexectomy and omentectomy followed by chemotherapy. A 3years follow-up showed no signs of relapse, and she completed a fullterm natural pregnancy which was delivered by caesarean section.&#x0D; Conclusion: Fertility sparing surgery in early stage Epithelial Ovarian Cancer has good prognosis. However, due to the rarity of the disease in early stages, the fertility outcome of this group of patients has not been established.&#x0D; Bangladesh J Obstet Gynaecol, 2020; Vol. 35(1): 46-48

Breast mucinous cystadenocarcinoma – case report

Introduction: Mucinous cystadenocarcinoma (MCC) is a rare primary breast tumor, first described in 1998. It was removed from the WHO classification in 2012, due to lack of consensus about its definition. To our knowledge, only 25 cases have been published in the literature. Objective: Case report and discussion of a case of breast MCC diagnosed in Centro de Doenças da Mama in Curitiba. Case report: Premenopausal 51 year-old patient, complaining of pain and nodule in the left breast. Physical examination showed a palpable nodule of approximately 2 cm, in the UOQ of the left breast. The ultrasound showed a 2.3 cm nodule, BI-RADS 5, submitted to core-needle biopsy with diagnosis of carcinoma with mucinous differentiation, positive for estrogen receptor (ER). The PET-Scan did not show extramammary site capture. Conserving surgery and sentinel lymph node were performed, with breast reconstruction using the geometric compensation technique. Macroscopy showed a cystic and solid mass, of mucinous content, measuring 4.0x3.5 cm. The histological status was suggestive of MCC, with 2 negative sentinel lymph nodes. The IQ showed mammaglobin expression, CK7 and ER, negative expression of c-erbB-2, CK20 and CK5/6. The patient was submitted to radiotherapy and hormone therapy. Discussion: The primary breast MCC needs to be distinguished from ovarian and pancreatic metastasis. The IQ for CK7 and CK20 can be useful, considering that the pancreatic and ovarian MCC have concomitant expression of CK7 and CK20; the breast MCC expresses only CK7. In the 26 cases described in the literature, including this study, mean age was 62 years (41‒96), and the tumor size was variable (0.8–19 cm). Only 4 cases presented positive lymph nodes. Most described cases did not express ER. The reported cases were associated with good prognosis. Conclusion: A consensus on the histological nomenclature and longer follow-up time are necessary to better understand this variant.

Extremely large epithelial ovarian cancer associated with pregnancy: A case report.

Ovarian malignancies are rare in pregnancy; however, the incidence of abnormal adnexal masses diagnosed during pregnancy is increasing. The most common masses are ovarian cysts, and only 3-6% of those are malignant. The majority of ovarian masses are diagnosed at an early stage by routine ultrasound examinations. Malignant germ cell tumors are the most common ovarian malignancies associated with pregnancy, while the incidence of epithelial ovarian cancer is only 1:12,000-1:50,000 of pregnancies. The diagnosis and management of ovarian cancer during pregnancy remain unclear due to the rare occurrence and scant data on this condition. We herein report the case of 23-year-old woman with an extremely large ovarian papillary mucinous cystadenocarcinoma diagnosed during pregnancy, identified on ultrasound and magnetic resonance imaging, and treated by surgical resection followed by adjuvant chemotherapy with carboplatin and paclitaxel.

Fertility preservation and refreezing of transplanted ovarian tissue—a potential new way of managing patients with low risk of malignant cell recurrence

To report the first successful refreezing of ovarian tissue recovered more than 3years after transplantation in a woman previously treated for early-stage ovarian cancer. Evaluation of cryopreserved and grafted ovarian tissue. University hospital. A 23-year-old woman diagnosed with stage 1C ovarian mucinous cystadenocarcinoma. The patient underwent ovarian tissue cryopreservation for fertility preservation and subsequent heterotopic transplantation for fertility restoration 9years after freezing. After a successful IVF twin pregnancy, grafted tissue was laparoscopically removed for safety reasons. The recovered tissue was refrozen. Live birth and histologic evaluation of the distribution of pre-antral follicle stages. The previously grafted ovarian tissue was successfully refrozen, presenting follicular survival 4weeks after xenografting. The follicular distribution in the recovered grafts showed a shift toward growing-stage follicles compared with the fresh tissue. The patient subsequently entered menopause, and histologic evaluation revealed a total of five follicles in two remaining grafts which had supported ovarian function a few months earlier. This is the second case of delivery following heterotopic grafting as well as the second case of successful transplantation of ovarian tissue from a patient with early-stage ovarian cancer. The recovered grafts showed that a lower number of functional follicles than previously estimated can actually support ovarian function. Removing and refreezing grafted tissue could be a new way of handling not only cancer patients with a risk of malignant cell recurrence, but also certain groups of patients with genetic conditions.

The status of Her2 amplification and Kras mutations in mucinous ovarian carcinoma

Jayson GC et al. remarked in Lancet that nearly 100% of mucinous ovarian cancer cases have Kras mutation as well as a high frequency of Her2 amplification. Using the Abbott PathVysion Her2 DNA Probe Kit and Kras mutant-enriched PCR Kits (FemtoPath®), 21 samples of primary ovarian mucinous cystadenocarcinomas from Taiwanese patients were examined to determine the status of Her2 amplification and Kras mutations. Our results showed the Her2 amplification rates were 33.33%, while the Kras mutation rates were 61.90%. We present here our results in order to enlighten the readership that the ~100% Kras mutant frequency and the high Her2 amplification rate reported by Jayson et al. may be too exaggerated to be applicable into all populations. Additionally, we report another 2 novel Kras mutations (A11V, V14I).

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.

Huge Mucinous Cystadenocarcinoma with Mucocele of Appendix in a Postmenopausal Woman: Extremely Rare Case Report with Review of Literature

Ovarian tumour is not a single entity, but a complex wide spectrum of neoplasms involving a variety of histological tissues. The most common are the epithelial tumours forming 80% of all tumours. 80% are benign tumours, 10% borderline malignant and 8-10% malignant. Mucinous tumours represent about 8-10% of the epithelial tumours, they may reach enormous size filling the entire abdominal cavity. While mucinous cystadenomas themselves are not infrequent, majority of them (80%) are benign while only 10% of them are borderline and another 10% are malignant. Mucinous tumours of ovary are part of the surface epithelial-stromal tumor group of ovarian neoplasms, and account for approximately 36% of all ovarian tumors. Pseudomyxoma peritonei may present as a result of an ovarian mucinous tumor, however this is a rare cause of this condition, which is a rare condition. A more common cause of pseudomyxoma peritonei is a mucin-producing tumor of the appendix. Here we report a case of 72 years postmenopausal, posthysterectomy patient with huge ovarian mucinous cystadenocarcinoma associated with pseudomyxoma peritoni and mucocele of appendix. Exploratory laparotomy with excision of ovarian tumour and appendix was done. Histopathology report was mucinous cystadenocarcinoma of ovary with metastasis in appendix with fibrosis and calcification. Patient received adjuvent chemotherapy cycles and discahrged in healthy condition.

Mucinous Cystadenocarcinoma of Ovary in Preadolescence: An Ordinary Tumor but at an Unexpected Age

Malignant epithelial ovarian tumors are common in adult women, but are rare in childhood. Especially, mucinous ovarian cystadenocarcinoma are extremely rare in pediatric age group, only a limited number of cases are reported in this age group till date with no case reported in preadolescence age in the literature. We describe a case of mucinous cystadenocarcinoma in eleven year old premenarchal girl presenting with symptoms of abdominal distension and respiratory distress from last three months.

Anaesthetic management in resection of huge ovarian tumour

Giant ovarian tumours are rare in this era of contemporary medical practice and awareness among patients to seek the medical care at the earliest. Mucinous tumours are among the largest known tumours found in the human body, about 80% of which are benign, 10% borderline and 10% malignant. They are usually common between third and fifth decade of life. We describe the anaesthetic management of a giant ovarian mucinous cyst adenocarcinoma in a 55 year old female.

Synchronous occult metastasising duodenal carcinoid and ovarian mucinous cystadenocarcinoma – multiple primary malignancies in the same patient

Gastrointestinal carcinoid tumors are uncommon neuroendocrine tumours that may be associated with synchronous or metachronous primary tumours of other histological type, most frequently colorectal adenocarcinomas. Primary ovarian mucinous adenocarcinomas have been reported to coincide with few other ovarian tumours and minority of these tumours may occur in association with Lynch syndrome. However association of duodenal carcinoid with ovarian mucinous adenocarcinoma is distinctly unusual and, to our knowledge, has not been previously described. We report a case of occult metastasising duodenal atypical carcinoid that was incidentally detected during surgical intervention performed for left ovarian mucinous cystadenocarcinoma in a middle aged female. The carcinoid tumour was Stage IIIB with regional nodal metastasis and the ovarian tumour was Stage IA with low grade histology.

Melioidosis Presenting as Pseudomyxoma Peritonei: Yet Another Pretense of the Great Mimicker: An Unreported Entity

Melioidosis, a lethal infectious disease caused by Burkholderia pseudomallei, an important human pathogen in tropical regions, is notorious for its diverse clinical presentations. We report a case of a 55-year-old woman with a history of total abdominal hysterectomy with bilateral salpingo-oophorectomy for ovarian mucinous cystadenocarcinoma five years back, who presented with complaints of chest pain, abdominal distention, and breathlessness for one week. Ultrasound-guided aspiration of the peritoneal free fluid revealed a thick gelatinous material consistent with pseudomyxoma peritonei. Cytologic analysis of the aspirate was negative for malignant cells, but bacterial culture proved positive for Burkholderia pseudomallei. She was started on ceftazidime, and she improved symptomatically and was discharged on oral doxycycline and chloramphenicol after three weeks of intravenous antibiotic therapy. This case is being reported to emphasize an unusual presentation of melioidosis and the significance of timely appropriate antibiotic therapy.