同步双侧卵巢癌伴右侧间质样腺癌和左侧高级别浆液性癌:病例报告和文献综述》(Synchronous Bilateral Ovarian Carcinomas with Right Mesonephric-like Adenocarcinoma and Left High-grade Serous Carcinoma: A Case Report and Review of the Literature)。

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY International Journal of Gynecological Pathology Pub Date : 2024-09-10 DOI:10.1097/pgp.0000000000001070
Daisy Maharjan,Katrina Collins,Tieying Hou,Brandon Umphress,Sharon E Robertson,Sheila Segura
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引用次数: 0

摘要

中肾样腺癌(MLA)是子宫体和卵巢的罕见肿瘤,而高级别浆液性癌(HGSC)则是最常见、最致命的卵巢上皮恶性肿瘤。我们报告了一例 56 岁女性的病例,她出现了双侧实性和囊性卵巢肿块。她接受了全腹子宫切除术、双侧输卵管切除术、淋巴结切除术、卵巢切除术和腹膜活检。双侧卵巢肿块的组织病理学检查显示,其中一个卵巢伴有MLA,另一个卵巢显示HGSC伴有浆液性输卵管上皮内癌。HGSC和MLA的形态、免疫分型和分子图谱均截然不同,符合不同肿瘤类型的预期:HGSC的WT-1、雌激素受体和p53(突变型)呈弥漫阳性,而GATA-3和TTF-1呈阴性;MLA的GATA-3和TTF-1呈阳性,而WT1、雌激素受体和p53(野生型)呈阴性;两种肿瘤的PAX-8均呈弥漫阳性。HGSC 发现了 TP53 c.659A>G (p.Y220C) 突变,MLA 发现了 KRAS c. 34G>T (p. G12C) 突变和 PIK3CA c. 1034A>T (p. N345I) 突变。据我们所知,这是首例同步双侧卵巢癌伴MLA和对侧卵巢HGSC的病例。
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Synchronous Bilateral Ovarian Carcinomas With Right Mesonephric-like Adenocarcinoma and Left High-grade Serous Carcinoma: A Case Report and Review of the Literature.
Mesonephric-like adenocarcinomas (MLAs) are rare neoplasms of the uterus corpus and ovary, while high-grade serous carcinoma (HGSC) is the most common and lethal epithelial ovarian malignancy. We report a case of a 56-yr-old woman who presented with bilateral solid and cystic ovarian masses. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, lymphadenectomy, omentectomy, and peritoneal biopsies. Histopathologic examination of the bilateral ovarian masses revealed 1 ovary with MLA, and the other ovary showed HGSC in association with serous tubal intraepithelial carcinoma. The morphology, immunophenotypes, and molecular profiling of the HGSC and the MLA were distinct and as expected for the different tumor types: HGSC was diffusely positive for WT-1, estrogen receptor, and p53 (mutant pattern), while negative for GATA-3 and TTF-1; MLA was positive for GATA-3 and TTF-1, while negative for WT1, estrogen receptor, and p53 (wild-type pattern); both tumors were diffusely positive for PAX-8. The HGSC revealed a TP53 c.659A>G (p.Y220C) mutation, and the MLA revealed a KRAS c. 34G>T (p. G12C) mutation and a PIK3CA c. 1034A>T (p. N345I) mutation. To the best of our knowledge, this is the first reported case of synchronous bilateral ovarian carcinomas with MLA and contralateral ovarian HGSC.
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来源期刊
CiteScore
3.90
自引率
12.50%
发文量
154
审稿时长
6-12 weeks
期刊介绍: International Journal of Gynecological Pathology is the official journal of the International Society of Gynecological Pathologists (ISGyP), and provides complete and timely coverage of advances in the understanding and management of gynecological disease. Emphasis is placed on investigations in the field of anatomic pathology. Articles devoted to experimental or animal pathology clearly relevant to an understanding of human disease are published, as are pathological and clinicopathological studies and individual case reports that offer new insights.
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