Ovarian Small Cell Carcinoma of Pulmonary Type Arising in Mature Cystic Teratomas With Metastases to the Contralateral Ovary

Abstract

A bilateral small cell ovarian carcinoma pulmonary-type (SCCOPT), arising in bilateral mature cystic teratomas (MCTs) presented as stage IIIB in a 37-year-old woman. Microscopically, tumor nests were related to the dermoid protuberance and expressed pancytokeratin, EMA, CD56, chromogranin A, NSE, synaptophysin, and SOX2. SALL4 was also focally positive. CDX2, TTF1, PAX8, CK7, CK20, and several neuroendocrine gut hormones were negative. Serum NSE was elevated. This case represents a SCCOPT arising in an MCT in the right ovary with metastasis to the left one also containing a synchronous MCT. Surface implants and lymphovascular invasion suggested metastasis from the right ovarian SCCOPT and excluded a metastatic origin from usual locations of small cell carcinoma (SCC). SCCOPT is morphologically identical to SCC elsewhere, even sharing NSE serum elevation. Although the tumor was closely related to teratomatous mature tissues, a complex immunohistochemical panel failed to provide a tissue of origin.

Neuroendocrine Tumors of the Female Reproductive Tract: A Literature Review

“…In a previous study, eight of 11 SCCOPT cases were associated with surface epithelial tumors [ 59 ]. Rare cases arising in an ovarian teratoma have been reported [ 61 , 62 ]. A diagnosis of SCCOPT can be made in the absence of neuroendocrine marker positivity if the morphologic appearance is typical SCNEC.…”

Primary small cell ovarian cancer of pulmonary type: A case report

“…SCCOPT is an extremely rare and aggressive ovarian malignancy ( Reed et al, 2014 ; Rubio et al, 2015 ). Patients are being aged between 28 and 85 years but most often occurs in perimenopausal and postmenopausal women with a median age of 59 years ( Eichhorn et al, 1992 ).…”

“…They are not easily distinguished pre-operatively from common epithelial ovarian cancers and the differential diagnosis will include germ cell and granulosa/sex-cord tumors ( Reed et al, 2014 ). To our knowledge, only 22 cases in total of SCCOPT have been described in the literature with majority of these arising in mature cystic teratomas ( Eichhorn et al, 1992 ; Rubio et al, 2015 ; Ikota et al, 2012 ; Lim et al, 1998 ; Chang et al, 1992 ; Grandjean et al, 2007 ; Kurasaki et al, 2013 ; Mebis et al, 2004 ; Suzuki et al, 2007 ; Lo Re et al, 1994 ; Tsolakidis et al, 2012 ; Reckova et al, 2010 ). However, from these, only 8 cases are described as “pure” primary SCCOPT ( Eichhorn et al, 1992 ; Kurasaki et al, 2013 ; Suzuki et al, 2007 ; Lo Re et al, 1994 ; Tsolakidis et al, 2012 ; Reckova et al, 2010 ) ( Table 1 ).…”

A case of ovarian clear cell carcinoma arising from ovarian mature cystic teratoma

“…We reviewed literatures concerning epithelial ovarian cancer arising from MCT (excluding squamous cell carcinoma, mucinous carcinoma and thyroid carcinoma) from the last 20 years (Table 1 ) [ 10 – 23 ]. Table 1 shows that their adenocarcinomal histological subtypes arising from MCT are prostate-type 7adenocarcinoma [ 10 ], small cell carcinoma [ 11 , 19 ], sebaceous carcinoma [ 12 , 15 , 18 ], undifferentiated carcinoma [ 13 ], carcinoid tumor [ 14 , 20 , 22 ], signet ring mucinous adenocarcinoma [ 16 ], large cell neuroendocrine carcinoma [ 17 ], urothelial carcinoma [ 21 ], and apocrine adenocarcinoma [ 23 ]. This case is the first case report of clear cell carcinoma arising from MCT reported in English literatures.…”