Seromucinous ovarian tumors and endometriosis in reproductive-aged wo
Endometriosis affects up to 15% of reproductive-aged women. Consideration of this nosological entity in a new aspect is impelled by the evidence that 0.5–1% of cases develops endometriosis-associated ovarian neoplasms that are more represented by the endometrioid and clear-cell subtypes of tumors. This category also includes seromucinous ovarian tumors (SMOTs). Objective. To investigate the morphological and immunohistochemical (IHC) features of SMOTs in reproductive-aged women, including pregnant ones. Subjects and methods. Ovarian tumor samples from 15 patients who had been operated on in 2012-2016 were analyzed comprehensively at the National Medical Research Center of Obstetrics, Gynecology, and Perinatology: IHC examination was conducted using the biomarkers of estrogen and progesterone receptors and Ki-67. Results. Borderline SMOTs were characterized by papillary growths on the inner surface (in one case) and on the outer surface, with an adhesive process with the serous surface of the corpus uteri (FIGO Stage 1c), and mixed epithelial structures; leukocyte infiltration was observed in 4 cases. The epithelium of seromucinous carcinoma (n = 1) was similar to that of serous, endocervical, and endometrial types at the same time. All the samples exhibited a low Ki-67 expression and high positive receptor immunoreactivity. Endometriosis diagnosed in nine women was accompanied by benign seromucinous cystadenomas (n = 4), borderline tumors (n = 4), and carcinoma (n = 1). Conclusion. Most of the examined SMOTs showed the areas, covered with the endometrioid epithelium, with adjacent endometrial stroma, which indicated the development of carcinoma in the presence of endometrioid cyst. The revealed facts suggest that endometriosis plays an etiological role in developing SMOTs. When detected, most neoplasms are localized (limited to ovarian tissue, FIGO stage 1a) and characterized by a favorable prognosis as a whole.Shamarakova M.V., Adamyan L.V., Asaturova A.V., Ezhova L.S., Zaitsev N.V., Yurova M.V., Martirosyan Ya.O.
Keywords
borderline ovarian tumors
reproductive age
seromucinous ovarian tumors
endometriosis-associated tumors
References
1. Франк Г.А., Москвина Л.В., Андреева Ю.Ю. Новая классификация опухолей яичника. Архив патологии. 2015; 77(4): 40-50. [Frank G.A., Moskvina L.V., Andreeva Yu.Yu. A new classification of ovarian tumors. Archive of pathology. 2015; 77(4): 40-50. (in Russian)]
2. Matias-Guiu X., Stewart C.J.R. Endometriosis-associated ovarian neoplasia. Pathology. 2018; 50(2): 190-204.
3. Vercellini P., Vigano P., Somigliana E., Fedele L. Endometriosis: pathogenesis and treatment. Nat. Rev. Endocrinol. 2014; 10(5): 261-75.
4. Edwards R.P., Huang X., Vlad A.M. Chronic inflammation in endometriosis and endometriosis-associated ovarian cancer: New roles for the “old” complement pathway. Oncoimmunology. 2015; 4(5): e1002732.
5. Brilhante A.V., Augusto K.L., Portela M.C., Sucupira L.C., Oliveira L.A., Pouchaim A.J. et al. Endometriosis and ovarian cancer: an integrative review (endometriosis and ovarian cancer). Asian Pac. J. Cancer Prev. 2017; 18(1): 11-6.
6. Saraswat L., Ayansina D., Cooper K.G., Bhattacharya S., Horne A.W., Bhattacharya S. Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study. BJOG. 2018; 125(1): 64-72.
7. Mikami Y. Endometriosis-related ovarian neoplasms: pathogenesis and histopathologic features. Diagn. Histopathol. 2014; 20(9): 357-63.
8. Davis M., Rauh-Hain J.A., Andrade C., Boruta D.M. 2nd, Schorge J.O., Horowitz N.S. et al. Comparison of clinical outcomes of patients with clear cell and endometrioid ovarian cancer associated with endometriosis to papillary serous carcinoma of the ovary. Gynecol. Oncol. 2014;132(3): 760-6.
9. Anglesio M.S., Papadopoulos N., Ayhan A., Nazeran T.M., Noë M., Horlings H.M. et al. Cancer-associated mutations in endometriosis without cancer. N. Engl. J. Med. 2017; 376(19): 1835-48.
10. Chene G., Ouellet V., Rahimi K., Barres V., Provencher D., Mes-Masson A.M. The ARID1A pathway in ovarian clear cell and endometrioid carcinoma, contiguous endometriosis, and benign endometriosis. Int. J. Gynaecol. Obstet. 2015; 130(1): 27-30.
11. Rutgers J.K.L. Mullerian mucinous/mixed epithelial (seromucinous) ovarian tumors. AJSP: Rev. Rep. 2016; 21(5): 206-13.
12. Miyamoto M., Takano M., Aoyama T., Soyama H., Yoshikawa T., Tsuda H., Furuya K. Seromucinous component in endometrioid endometrial carcinoma as a histological predictor of prognosis. J. Gynecol. Oncol. 2018; 29(2): e20.
13. Kurman R.J., Shih Ie.M. Seromucinous tumors of the ovary. What's in a name? Int. J. Gynecol. Pathol. 2016; 35(1): 78-81.
14. Pearce C.L., Templeman C., Rossing M.A., Lee A., Near A.M., Webb P.M. et al. Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case — control studies. Lancet Oncol. 2012; 13(4): 385-94.
15. Wu C.H., Mao T.-L., Vang R. et al. Endocervical-type mucinous borderline tumors are related to endometrioid tumors based on mutation and loss of expression of ARID1A. International Journal of Gynecological Pathology. 2012; 31(4): 297-303.
16. Nakamura E., Sato Y., Moriguchi S., Yamashita A. Ovarian seromucinous borderline tumor and clear cell carcinoma: an unusual combination. Case Rep. Obstet. Gynecol. 2015; 2015: 690891.
17. Massicot R., Rousseau V., Darwish A.A., Sauvat F. et al. Serous and seromucinous infantile ovarian cystadenomas – a study of 42 cases. Eur. J. Obstet. Gynecol. Reprod. Biol. 2009; 142(1): 64-7.
18. Taskinen S., Fagerholm R., Lohi J., Taskinen M. Pediatric ovarian neoplastic tumors: incidence, age at presentation, tumor markers and outcome. Acta Obstet. Gynecol. Scand. 2015; 94(4): 425-9.
19. Shappell H.W., Riopel M.A., Smith Sehdev A.E., Ronnett B.M. et al. Diagnostic criteria and behavior of ovarian seromucinous (endocervical-type mucinous and mixed cell-type) tumors: atypical proliferative (borderline) tumors, intraepithelial, microinvasive, and invasive carcinomas. Am. J. Surg. Pathol. 2002; 26(12): 1529-41.
20. Karpathiou G., Chauleur C., Corsini T., Venet M., Habougit C., Honeyman F. et al. Seromucinous ovarian tumor A comparison with the rest of ovarian epithelial tumors. Ann. Diagn. Pathol. 2017; 27: 28-33.
21. Rambau P.F., McIntyre J.B., Taylor J., Lee S., Ogilvie T., Sienko A. et al. Morphologic reproducibility, genotyping, and immunohistochemical profiling do not support a category of seromucinous carcinoma of the ovary. Am. J. Surg. Pathol. 2017; 41(5): 685-95.
22. Taylor J., McCluggage W.G. Ovarian seromucinous carcinoma: report of a series of a newly categorized and uncommon neoplasm. Am. J. Surg. Pathol. 2015; 39(7): 983-92.
23. McCluggage W.G. Ovarian borderline tumours: a review with comparison of serous and mucinous types. Diagn. Histopathol. 2014; 20(9): 333-50.
24. Dubé V., Roy M., Plante M., Renaud M.C. et al. Mucinous ovarian tumors of Mullerian-type: an analysis of 17 cases including borderline tumors and intraepithelial, microinvasive, and invasive carcinomas. Int. J. Gynecol. Pathol. 2005; 24(2): 138-46.
Received 16.02.2018
Accepted 02.03.2018
About the Authors
Marina V. Shamarakova, MD, pathologist, Center of family planning and reproduction.117209, Russia, Moscow, Sevastopolskiy Prospect 24А. Tel.: +74957182088. E-mail: mshamarakova@yandex.ru. orcid.org/0000-0002-0972-4350
Leila V. Adamyan, professor, academician of RAMS, head specialist in obstetrics and gynecology, deputy director, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: l_ezhova@oparina4.ru. orcid.org/0000-0002-9804-8349
Alexandra V. Asaturova, MD, pathologist, senior scientific assistant, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: a_asaturova@oparina4.ru. orcid.org/0000-0001-8739-5209
Larisa S. Ezhova, MD, pathologist, senior scientific assistant, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: l_ezhova@oparina4.ru. orcid.org/0000-0002-9804-8349
Nikon V. Zaitsev, MD, pathologist, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov.
117997, Russia, Moscow, Ac. Oparina str. 4
Mariia V. Yurova, medical student of the International School «Medicine of Future», I.M. Sechenov First Moscow State Medical University (Sechenov University).
119991, Russia, Moscow, Trubetskaya str. 8/2. Tel.: +74992480553. E-mail: yurova.m.vl@gmail.com
Yana O. Martirosyan, medical student of the I.M. Sechenov First Moscow State Medical University (Sechenov University).
119991, Russia, Moscow, Trubetskaya str. 8/2. Tel.: +79251249999. E-mail: marti-yana@yandex.ru
For citations: Shamarakova M.V., Adamyan L.V., Asaturova A.V., Ezhova L.S., Zaitsev N.V., Yurova M.V., Martirosyan Ya.O. Seromucinous ovarian tumors and endometriosis in reproductive-aged women. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (7): 84-91. (in Russian)
https://dx.doi.org/10.18565/aig.2018.7.84-91
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