Article thumbnail

Unusual Ovarian Stromal Tumor with Radiation Changes Mimicking Carcinoma

By Olga L. Bohn, Chengquan Zhao and Mirka W. Jones

Abstract

Radiation-related changes including fibrosis, nuclear enlargement, hyperchromasia and cytoplasmic vacuolization may alter the appearance of normal ovarian tissue and ovarian tumors. We describe radiation-related changes in ovarian stromal neoplasm with mixed features of sclerosing stromal tumor and fibrothecoma. The right ovarian mass was discovered in a 38 year-old woman with past history of invasive squamous cell carcinoma of the cervix treated with cone biopsy and brachytherapy. The low power architecture of cellular pseudolobules and small sheets of tumor cells with scattered hyaline plaques was consisted with the pattern of combined sclerosing stromal tumor and fibrothecoma. However, the presence of severe cytologic atypia, as well as clear cell and signet ring differentiation and arrangements of tumor cells in single files and nests, raised a possibility of primary or metastatic carcinoma. The tumor cells were positive for calretinin, vimentin, inhibin, and WT1 and negative for AE1/3, cytokeratin 7 and 20, CD99, estrogen and progesterone receptors, mammaglobin, chromogranin, and S100 protein. Based on the results of immunostains and a subsequently provided history of radiation, a diagnosis of sex cord stromal tumor with mixed fibrothecoma and sclerosing stromal differentiation was made. Radiation-related atypia and fibrosis in sex cord stromal tumor may create a pattern mimicking carcinoma and therefore, in the presence of unusual histology, the use of immunohistochemistry is recommended

Topics: Case Report
Publisher: Ivyspring International Publisher
OAI identifier: oai:pubmedcentral.nih.gov:3088862
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles

Citations

  1. Atlas of Tumor Pathology. Tumors of the Ovary and Maldeveloped Gonads, Fallopian Tube, and Broad Ligament; 3rd edition.
  2. (2001). Blaustein’s Pathology of the Female Genital Tract; 5th edition.
  3. Cancer treatment and the ovary: the effects of chemotherapy and radiation.
  4. (2009). Morphologic changes in ovarian carcinoma after neoadjuvant chemotherapy: Report of a case showing extensive clear cell changes mimicking clear cell carcinoma.
  5. Morphologic effects of chemotherapy on ovarian carcinoma.
  6. Ovarian function following radiation and chemotherapy for cancer.
  7. (2003). World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of the Breast and Female Genital Organs.