Composite Large-Cell Neuroendocrine Carcinoma and Surface Epithelial-Stromal Neoplasm of the Ovary

Chen, Karl T. K.

doi:10.1177/106689690000800214

Cited by 47 publications

(48 citation statements)

References 13 publications

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“…Case 3 showed extremely rapid progression with pelvic mass formation, liver metastasis and pelvic lymphadenopathy within only 2 weeks after primary surgery; moreover, TC chemotherapy was not effective in this patient. Similar cases have been previously reported (4,5,8) and provide evidence that ovarian LCNEC is a malignant neoplasm with aggressive behavior.…”

Section: Discussionsupporting

confidence: 61%

“…However, in 2 cases with serous adenocarcinoma, both DraganovaTacheva et al (17) and Choi et al (13) concluded that each LCNEC component and serous adenocarcinoma component had different origins, meaning they arose independently, on the basis of the immunohistochemical pattern or microsatellite instability (MSI) analysis. Notably, neuroendocrine markers, such as chromogranin, synaptophysin and NSE, were detected in the epithelial component as well as in the LCNEC component in the same patient by immunohistochemistry (4,5,(7)(8)(9)17). These results are shown in Table II.…”

Section: Discussionmentioning

confidence: 99%

“…Then, for all 33 available LCNEC cases, we summarized the clinicopathological findings, such as patient age, FIGO stage, tumor marker values, operation and intra-abdominal findings, chemotherapy regimens and outcomes (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The Kaplan-Meier overall survival rate was estimated by analyzing the survival time data reported in the literature with STAT view software for Windows.…”

Section: Methodsmentioning

confidence: 99%

“…The epithelial components in 29 cases of ovarian LCNEC, excluding the 4 pure type LCNEC cases, were as follows: 17 cases (56.7%) were mucinous tumors (benign, borderline malignancy and malignancy), 8 cases (26.7%) were endometrioid adenocarcinomas, 3 cases (10%) were mature cystic teratomas, 2 cases (6.7%) were adenocarcinomas, not otherwise specified, 2 cases (6.7%) were serous adenocarcinomas and 1 case (3.3%) was a benign ovarian cyst (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In the 21 cases described for which the patients had undergone surgical treatment, 16 (76.2%) cases had complete surgery, 4 (19.0%) had optimal surgery and 1 (4.8%) had suboptimal surgery.…”

Section: Clinicopathological Features Of Lcnec -Literature Reviewmentioning

confidence: 99%

“…This cancer is also generally accompanied by surface epithelial-stromal tumors, and the LCNEC components metastasize relatively early, resulting in poor prognosis (1). To date, only 29 cases of ovarian LCNEC have been reported (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Thus, we describe our 4 recently encountered cases and evaluate the clinicopathological features of ovarian LCNEC from 33 primary cases, including previously reported cases.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of ovarian large-cell neuroendocrine carcinoma: Four case reports and review of the literature

Oshita

Yamazaki²,

Akimoto³

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The objective of the present study was to present 4 recently encountered ovarian large-cell neuroendocrine carcinoma (LCNEC) cases, and to evaluate their clinicopathological features in the context of the previously reported 29 LCNEC cases. First, we described the clinical features of 4 recently encountered cases. Routine H&E staining and immunohistochemistry for CD56, synaptophysin and chromogranin A were performed on sections of both the LCNEC and epithelial carcinoma components. Clinical data for the total of 33 LCNEC cases were summarized, and the Kaplan-Meier survival curve was estimated. Our cases were observed in women aged 42-81 years. One case is clinically classified as FIGO stage IV with multiple metastases, and the others are classified as FIGO stages Ic, IIc and IIIb by post-surgical findings. Pathological features, assessed by H&E staining, were similar to lung LCNEC, and at least one neuroendocrine marker was positive staining in both LCNEC and the epithelial component. One case was pure type LCNEC and the others were mixed carcinoma. Paclitaxel/carboplatin chemotherapy was performed for all cases and 3 of the 4 treatments were effective. The prognoses of our cases were as follows: 1 in stage Ic died from the disease after only 2 months, but the others survived, with or without recurrence, for 32-64 months, whereas the total 5-year survival of the 33 LCNEC cases was 34.9%. In summary, our 3 LCNEC cases revealed ordinary chemo-sensitivity, resulting in a better prognosis than those previously described, apart from 1 case which exhibited aggressive behavior. For the future, a retrospective survey to elucidate the prognostic factors and prospective clinical studies to evaluate the efficacy of treatment modalities of ovarian LCNEC are necessary, particularly for aggressive LCNEC cases. IntroductionThe World Health Organization (WHO) defines large-cell neuroendocrine carcinoma (LCNEC) as a tumor with a large nucleus and a tendency to have neuroendocrine differentiation, and it defines ovarian LCNECs as miscellaneous tumors (1). In Japan, the term LCNEC was described for the first time in The General Rules for Clinical and Pathological Management of Ovarian Tumors by the Japan Society of Obstetrics and Gynecology and the Japanese Society of Pathology in December 2009. Until these classifications were established, LCNEC had been classified as anaplastic or poorly differentiated carcinoma and was synonymous with undifferentiated carcinoma of the non-small cell neuroendocrine type (1,2). According to the WHO classification of lung cancer (3), the pathological structures by H&E staining reveal a characteristic organization, such as round nest and sheet-like formation with frequently central coagulative necrosis, and rosette-like formation of tumor cells is often observed everywhere. The nucleus is large with granular or coarse chromatin, a prominent nucleolus and moderate or abundant cytoplasm. Additionally, neuroendocrine differentiation by immunohistochemical analysis, such as chromogranin A, sy...

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Clinicopathological Features Of Lcnec -Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical features of ovarian large-cell neuroendocrine carcinoma: Four case reports and review of the literature

Oshita

Yamazaki²,

Akimoto³

et al. 2011

Experimental and Therapeutic Medicine

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Undifferentiated, Mixed and Other Tumours of the Ovary

Chapel

2023

Essentials of Diagnostic Gynecological Pathology

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Prognostic impact of neuroendocrine differentiation in high-grade serous ovarian carcinoma

et al. 2014

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Neuroendocrine differentiation in high-grade serous ovarian carcinomas has only rarely been described. However, in our consultancy experience, we have been pointed at a case of neuroendocrine relapse in a patient with high-grade serous ovarian carcinoma where retrospectively, a minor neuroendocrine component in the primary tumor could be detected. Hypothesizing that immunohistochemical evidence of neuroendocrine differentiation might be more frequent in ovarian carcinoma than suspected by morphology, we immunophenotyped the tissue microarrays (TMAs) of a cohort of 178 high-grade serous carcinomas for chromogranin and synaptophysin expression. Synaptophysin expression was found in 12 (6.7 %) out of 172 patients, and chromogranin A expression was seen in 36 (20.7 %) out of 174 patients. Kaplan-Meier analysis revealed that carcinomas with synaptophysin expression of >20 % of positive cells (n = 4) had a significantly shorter survival time than those with 0-20 % of positive cells (p < 0.0001). Synaptophysin expression remained a significant prognostic factor in multivariate analysis (HR = 10.82, 95 % confidence interval 3.10-37.71, p < 0.0001), independently of age, FIGO stage, and residual tumor after surgery. A trend toward shorter survival was seen in patients with tumors that expressed chromogranin, irrespective of the amount of positive cells (p = 0.173). A neuroendocrine differentiation is important to keep in mind when a neuroendocrine tumor of unknown primary is detected in regional or temporal connection with an ovarian carcinoma. A minor neuroendocrine component in ovarian high-grade serous carcinomas might imply a dismal prognosis.

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Composite Large-Cell Neuroendocrine Carcinoma and Surface Epithelial-Stromal Neoplasm of the Ovary

Cited by 47 publications

References 13 publications

Clinical features of ovarian large-cell neuroendocrine carcinoma: Four case reports and review of the literature

Clinical features of ovarian large-cell neuroendocrine carcinoma: Four case reports and review of the literature

Undifferentiated, Mixed and Other Tumours of the Ovary

Prognostic impact of neuroendocrine differentiation in high-grade serous ovarian carcinoma

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