Seromucinous ovarian tumors and endometriosis in reproductive-aged wo

Abstract

Endometriosis affects up to 15% of reproductive-aged women. Consideration of this nosological entity in a new aspect is impelled by the evidence that 0.5-1% of cases are complicated by endometriosis-associated ovarian neoplasms represented mainly by the endometrioid and clear-cell subtypes of tumors. This category also includes seromucinous ovarian tumors (SMOTs). Objective. To investigate the morphological and immunohistochemical (IHC) features of SMOTs in reproductiveaged women, including pregnant ones. Subjects and methods. Ovarian tumor samples from 15 patients who had been operated on in 2012-2016 were analyzed comprehensively at the National Medical Research Center of Obstetrics, Gynecology, and Perinatology: IHC examination was conducted using the biomarkers of estrogen and progesterone receptors and Ki-67. Results. Borderline SMOTs were characterized by papillary growths on the inner surface (in one case) and on the outer surface, with an adhesive process with the serous surface of the corpus uteri (FIGO Stage 1c), and mixed epithelial structures; leukocyte infiltration was observed in four cases. The epithelium of seromucinous carcinoma (n = 1) was similar to that of serous, endocervical, and endometrial types at the same time. All the samples exhibited low Ki-67 expression and high positive receptor immunoreactivity. Endometriosis diagnosed in nine women was accompanied by benign seromucinous cystadenomas (n = 4), borderline tumors (n = 4), and carcinoma (n = 1). Conclusion. Most of the examined SMOTs showed the areas, covered with the endometrioid epithelium, with adjacent endometrial stroma, which indicated the development of carcinoma in the presence of endometrioid cyst. The revealed facts suggest that endometriosis plays an etiological role in developing SMOTs. When detected, most neoplasms are localized (limited to ovarian tissue, FIGO stage 1a) and characterized by a favorable prognosis as a whole.

Ovarian seromucinous cystadenomas and adenofibromas: first report of a case series

“…This figure is lower, but comparable to that identified in the studies of Han et al 18 . and Shamarkova et al ., 19 where endometriosis was found in eight of 15 (53%) and in four of seven (57%) benign ovarian seromucinous neoplasms, respectively (discussed below): details of the site of endometriosis were not provided in either study. Seidman and Krishnan studied 49 patients (88 ovaries) with ovarian mucinous‐lined epithelial inclusions exhibiting a spectrum of morphological appearances, ranging from fully mucinous to mixed serous and mucinous to serous with intracytoplasmic mucin 20 .…”

“…There is minimal literature regarding benign ovarian seromucinous neoplasms; this is mainly in the form of case reports or brief mention in studies of ovarian neoplasms in general, and in many of these detailed pathological descriptions are not available. 18,19,[21][22][23][24][25][26][27][28][29][30][31] Regarding studies of benign seromucinous neoplasms since the 2014 WHO publication, there have been two publications by Shamarkova et al 19 and Han et al, 18 which included seromucinous neoplasms in general. Neither of these studies described the pathological features in detail, and in fact in one of these studies the focus was on the radiological appearances.…”