Clinicopathological features of ovarian borderline seromucinous tumor / 中国医师进修杂志

ABSTRACT

Objective To investigate the clinicopathological features of ovarian borderline seromucinous tumor. Methods The clinical data of 22 ovarian borderline seromucinous tumor from April 2015 to March 2018 were retrospectively analyzed. The clinicopathological features were summarized by immunohistochemical staining with EnVision method. Results The age of patients was 23 to 66 years, with an average age of 39.2 years and a median age of 36 years. In the 22 patients, 14 patients were found by physical examination, 7 patients had abdominal discomfort or irregular vaginal bleeding, 4 patients had a history of dysmenorrheal, and 5 patients had cancer antigen 125 and/ or carcinoembryonic antigen elevation. Ultrasonography revealed mass in the adnexal region. The average diameter of these tumors was 7.2 cm. The tumors were cystic or cystic solid property and contained viscid or hemorrhagic fluid, with endogenous or exogenous papilla. Microscopically, these tumors showed complex papillary architecture and the larger papillae tended to have edematous stroma containing neutrophils. The epithelium lining the papillae was typically stratified and mostly composed of endocervical-type mucinous or serous epithelium, but endometrioid epithelium was not unusual. Eleven patients had endometriosis, and 2 cases occurred peritoneal or omental tumor implantation respectively. Immunohistochemistry showed that the estrogen receptor (ER), progesterone receptor (PR), paired box gene (PAX) 8 and cytokeratin (CK) 7 were positive in different degrees, and the CK20 and tail-type homeobox gene (CDX) 2 were negative in all patients. Twenty patients were International Federation of Gynecology and Obstetrics (FIGO)Ⅰstage without recurrence or metastasis in 3 to 36 months (average 13.6 months)′ follow-up. Conclusions Most patients with the ovarian borderline seromucinous tumor are young without specific clinical symptoms. Tumor is associated with endometriosis and maybe has characteristic histological changes. Attention should be paid to the differentiation from borderline serous and mucinous tumor before the final diagnosis. Most patients with ovarian borderline seromucinous tumor are FIGO Ⅰ stage and have the good prognosis. The clinical treatment is referred to the treatment of borderline endometrioid tumors.