Prominent Papillary Growth Pattern and Severe Nuclear Pleomorphism Induced by Neoadjuvant Chemotherapy in Ovarian Mucinous Carcinoma: Potential for Misdiagnosis as High-grade Serous Carcinoma
Prominent Papillary Growth Pattern and Severe Nuclear Pleomorphism Induced by Neoadjuvant Chemotherapy in Ovarian Mucinous Carcinoma: Potential for Misdiagnosis as High-grade Serous Carcinoma
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DOI：
10.21873/anticanres.14918
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发表时间：
2021-03-01
影响因子：
2
通讯作者：
Kim, Hyun-Soo
中科院分区：
文献类型：
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作者：
Kwon, Hee Jung;Song, Sang Yong;Kim, Hyun-Soo
背景/目的：除卵巢高级别浆液性癌（HGSC）以外的组织学亚型中，很少有新辅助化疗（NAC）引起的组织学变化的报道。病例报告：我们报告了一名 49 岁女性，其肿瘤在间隔减灭手术 (IDS) 标本中表现出明显的乳头状生长模式和由于 NAC 导致的严重核多形性。在最初的显微镜检查中，卵巢 HGSC 是最有可能的候选者；然而，免疫染色结果与 HGSC 不兼容。我们检测到类似粘液性囊腺瘤和交界性肿瘤的区域，最终诊断该病例为卵巢粘液癌。结论：虽然该肿瘤在组织学上与HGSC相似，但其临床特征与晚期HGSC不同。对于病理学家来说，识别 NAC 引起的组织学变化、了解诊断模拟和陷阱，并通过考虑患者既往病史、临床特征、术前影像学表现和组织学特征来识别正确的组织学亚型非常重要。
Background/Aim: Histological changes induced by neoadjuvant chemotherapy (NAC) have rarely been reported in histological subtypes other than ovarian high-grade serous carcinoma (HGSC). Case Report: We report a 49-year-old woman whose tumors in interval debulking surgery (IDS) specimen exhibited prominent papillary growth pattern and severe nuclear pleomorphism due to NAC. In the initial microscopic examination, ovarian HGSC was the most likely candidate; however, immunostaining results were not compatible with HGSC. We detected areas resembling mucinous cystadenoma and borderline tumor, and finally diagnosed this case as ovarian mucinous carcinoma. Conclusion: Although the tumor mimicked histologically HGSC, its clinical features differed from those of advanced-stage HGSC. It is important for pathologists to recognize NAC-induced histological changes, be aware of the diagnostic mimics and pitfalls, and to identify the correct histological subtype by considering the patient's previous history, clinical features, preoperative imaging findings, and histological features.