For intraoperative consultation of mucinous adenocarcinoma involving the ovary, it would be useful to have approaching methods in addition to the traditional limited microscopic findings in order to determine the nature of the tumors. Mucinous adenocarcinomas involving the ovaries were evaluated in 91 cases of metastatic mucinous adenocarcinomas and 19 cases of primary mucinous adenocarcinomas using both an original algorithm (unilateral > or =10 cm tumors were considered primary and unilateral <10 cm tumors or bilateral tumors were considered metastatic) and a modified cut-off size algorithm. With 10 cm, 13 cm, and 15 cm size cut-offs, the algorithm correctly classified primary and metastatic tumors in 82.7%, 87.3%, and 89.1% of cases and in 80.6%, 84.9%, and 87.1% of signet ring cell carcinoma (SRC) excluded cases. In total cases and SRC excluded cases, 98.0% and 97.2% of bilateral tumors were metastatic and 100% and 100% of unilateral tumors <10 cm were metastatic, respectively. In total cases and SRC excluded cases, 68.4% and 68.4% of unilateral tumors > or =15 cm were primary, respectively. The diagnostic algorithm using size and laterality, in addition to clinical history, preoperative image findings, and operative findings, is a useful adjunct tool for differentiation of metastatic mucinous adenocarcinomas from primary mucinous adenocarcinomas of the ovary.
Adenocarcinoma, Mucinous/*classification/pathology/secondary ; Adolescent ; Adult ; Aged ; *Algorithms ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Neoplasms/*classification/mortality/pathology

Female ; Genital Neoplasms, Female ; classification ; pathology ; Humans ; Ovarian Neoplasms ; pathology ; Papillomavirus Infections ; Precancerous Conditions ; pathology ; Uterine Cervical Neoplasms ; pathology ; virology ; World Health Organization

No abstract available.
Fallopian Tube Neoplasms/classification/*pathology ; Female ; Gynecology/organization & administration/standards ; Humans ; International Agencies ; Neoplasm Staging/methods/*standards ; Obstetrics/organization & administration/standards ; Ovarian Neoplasms/classification/*pathology ; Peritoneal Neoplasms/classification/*pathology ; *Practice Guidelines as Topic

OBJECTIVETo compare the sonographic findings with pathological features of ovarian thecoma, and to analyze the relationship between them.

METHODSThe sonograms of 45 ovarian thecoma cases were reviewed retrospectively and categorized into three subtypes as sound attenuation pattern, homogeneous hypoechoic pattern and solid and cystic mixed pattern. The pathological findings were classified as theca cell-predominant, fibroblast-predominant and mixed thecoma according to the cellular composition of the tumors. Hyaline degeneration and luteinization of the tumors were recorded. The pathologic findings of each subtype based on sonography were compared.

RESULTSOf the 45 patients, there were 34 (75.6%) solid ovarian lesions, 15 (33.3%) of those showed a sound-attenuation pattern with an anterior hypoechoic zone and posterior acoustic attenuation in sonography, the other 19 (42.2%) cases had homogeneous hypoechoic pattern with no posterior acoustic attenuation, and the remaining 11 (24.4%) cases presented as a solid and cystic mixed pattern. There were no significant differences in pathological cellular composition among the three sonographic subtypes. Five solid tumors containing hyaline degeneration and one with luteinization were found to have posterior acoustic attenuation. The solid and cystic mixed thecomas showed cystic degeneration and hemorrhage.

CONCLUSIONSolid ovarian thecomas usually have typical sonographic features, which may be associated with degeneration but not with cellular composition within the tumor.

Adult ; Aged ; Aged, 80 and over ; CA-125 Antigen ; blood ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; blood ; classification ; diagnostic imaging ; pathology ; Retrospective Studies ; Thecoma ; blood ; classification ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color ; methods ; Young Adult

Animals ; Biomarkers, Tumor ; genetics ; metabolism ; Cell Nucleus Division ; Cystadenocarcinoma, Serous ; classification ; genetics ; metabolism ; pathology ; Female ; Humans ; Mutation ; Neoplasm Grading ; Ovarian Neoplasms ; classification ; genetics ; metabolism ; pathology ; Proto-Oncogene Proteins B-raf ; genetics ; metabolism ; Tumor Suppressor Protein p53 ; genetics ; metabolism

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Carcinoma, Endometrioid ; metabolism ; pathology ; Carcinoma, Transitional Cell ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Neoplasms, Glandular and Epithelial ; classification ; metabolism ; pathology ; Ovarian Neoplasms ; classification ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; metabolism ; WT1 Proteins ; metabolism

OBJECTIVETo evaluate the two-tier system for the grading of ovarian serous carcinomas, and to analyze Pax2, p53, Ki-67 protein expression and their prognostic values for low- and high-grade ovarian serous carcinomas.

METHODSA total of 38 cases of low-grade and 100 cases of high-grade ovarian serous carcinomas were selected based on the two-tier grading system. Immunohistochemistry was used to detect Pax2, p53 and Ki-67 protein expression in all cases. Correlation of the two-tier system with immunohistochemical results and prognostic parameters were performed.

RESULTS(1) The overall survival, disease-free survival and 5-year survival rates were significantly higher in the low-grade serous carcinoma cases than in the high-grade cases (P < 0.05). (2) Significant differences in protein expressions were found between the low- and high-grade serous carcinomas. The high-grade serous carcinomas had a significantly higher expression level of p53 (55.0% vs 13.2%, P < 0.05) and Ki-67 (42.1% vs 13.7%, P < 0.05), while low-grade carcinomas had a significantly higher expression level of Pax2 (65.8% vs 13.0%, P < 0.05). (3) Pax2 positive cases had a significantly better overall survival and 5-year survival rates than Pax2 negative cases (P < 0.05). The expressions of p53 and Ki-67 were found to have little correlation with overall survival and disease-free survival (P > 0.05).

CONCLUSIONSThe two-tier system for the grading of ovarian serous carcinomas has a good prognostic value. There are significantly differences in expressions of Pax2, p53 and Ki-67 between low- and high-grade ovarian serous carcinomas. Compared with p53 and Ki-67, Pax2 is likely a better prognostic indicator for ovarian serous carcinoma.

CA-125 Antigen ; metabolism ; Cystadenocarcinoma, Serous ; classification ; metabolism ; mortality ; pathology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Membrane Proteins ; metabolism ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Ovarian Neoplasms ; classification ; metabolism ; mortality ; pathology ; Ovary ; pathology ; PAX2 Transcription Factor ; metabolism ; Survival Rate ; Tumor Suppressor Protein p53 ; metabolism