Ovarian Microcystic Stromal Tumor: A Case Report and Literature Review

Abstract

Background: Microcystic stromal tumor is a recently described subtype of ovarian tumor characterized by microcystic pattern and diffuse immunoreactivity for CD10, vimentin, and β-catenin and negative for EMA. However, its diagnostic criterion and standard treatment remain unclear. Case presentation: We report a rare case of a left side microcystic stromal tumor with diameter about 7 cm in a 25-year-old female and summarize all cases of MCST reported in this study. The present patient underwent left ovarian tumor resection. Generally, the tumor was solid and cystic mixed. Immunohistochemically, the tumor was expressed CD10, WT1, cyclin D1 and vimentin, and nuclear immunoreactivity for β-catenin but negative for α-inhibin, calretinin, CK AE1/AE3, PLAP, SALL-4, CK7, P53, EMA, CD99, AFP, desmin, CgA, E-cadherin, and melanA. Conclusion: Unilateral ovary, solid-cystic, and a larger than 4-8 cm pelvic mass without serious abdominal pain are its clinical features. The immunophenotype of vimentin+/CD10+/WT-1+/β-catenin+(nuclei)/cyclin D1+ is supportive of diagnosis. For these patients, unilateral oophorectomy dissection could be selected.

A Constellation of Rare Gynecological Malignancies and Familial Adenomatous Polyposis Gastrointestinal Adenocarcinoma: A Case Report

“…Our case did not have excessive hormonal manifestations, and this is in keeping with the majority of reported MST’s 3. MST’s have been reported as being exclusively unilateral masses 2,3; however, our case is unique as it is the first presented case of bilateral ovaries with MST.…”

“…These tumors were positive for β-catenin, CD10, Vimentin, WT1 and cyclin D1, and stained negative for sexcord stromal markers inhibin and calretinin. Importantly, the bilateral MST's showed nuclear positivity for β-catenin as demonstrated in prior reports (3,6). As previous research has demonstrated, this MST is likely a result of chromosomal (5q21.22) germline mutation of the APC gene that can also lead to FAP associated colorectal polyps and colonic adenocarcinoma (4,5,10,11).…”

“…A review of existing MST literature identified one prior case that presented with endometrial disease and was subsequently found to have MST 3,4. This patient was diagnosed with grade 1 endometrioid adenocarcinoma on endometrial biopsy, and after hysterectomy and bilateral salpingo-oophorectomy was found to have right ovarian MST and the endometrioid adenocarcinoma was FIGO stage IA 4.…”

“…It is classified as a tumor of sex-cord stromal origin with distinct histologic and immunohistochemical findings (1). Histologically, these tumors have been consistently identified by microcysts, solid cellular regions and hyalinized fibrous stroma, and often have moderate finely granular eosinophilic cytoplasm and possibly foci of bizarre nuclei (1)(2)(3)(4)(5)(6). A recent review of all published cases indicated that generally these tumors have strongly positive immunoreactivity for vimentin, β-catenin, CD10, and WT-1 (3,6).…”

Primary testicular microcystic stromal tumor: two case reports with a broad morphological spectrum and frequency of predilection site

“…Usually, MCST was diffusely positive for β-catenin (nucleus and cytoplasm), CD10, cyclin D1, and CD99, but almost all tumors were typically negative markers of sex-cord stromal cells (inhibin, calretinin), epithelial cells (CK7, EMA) and germ cell tumors (SALL4, AFP) [13]. Similar to our case, CK was focally and weakly positive in one quarter of cases [14].…”