Tubular Krukenberg tumor A problem in histopathologic diagnosis

Bullón, A; Arseneau, Jocelyne; Prat, Jaime; Young, Robert H.; Scully, Robert E.

doi:10.1097/00000478-198104000-00002

Cited by 70 publications

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“…They are traditionally perceived as composed of mucin-filled signet-ring cells associated with a striking proliferation of the ovarian stroma but many variations on this pattern are seen; 61,62 signet-ring cells, although sometimes scant, are still definitional but a cellular stroma is not as requiring its presence would exclude otherwise typical tumors from the Krukenberg category. These tumors originate in the stomach in the vast majority of cases.…”

Section: Krukenberg Tumormentioning

confidence: 99%

“…Small glands, some of them appearing as microcysts, are usually found, as are larger glands and, occasionally, there is a predominant tubular architecture (tubular Krukenberg tumor). 61 The stromal cells are typically spindle shaped, and their degree of cellularity is variable, ranging from that of a normocellular ovarian fibroma to that of a cellular fibroma or fibrosarcoma to, conversely, that of an edematous fibroma. Some tumors are extensively luteinized.…”

Section: Krukenberg Tumormentioning

confidence: 99%

“…Some tumors are extensively luteinized. 1,61 Krukenberg tumors must be distinguished from primary and other metastatic ovarian tumors that have mucin-rich signet-ring cells including clear cell adenocarcinoma, mucinous (goblet cell) carcinoid, and a variety of ovarian tumors that contain signet-ring-like cells filled with nonmucinous material. Ovarian clear cell adenocarcinoma may have a signet-ring cell component that simulates a Krukenberg tumor but the presence of the various distinctive patterns of clear cell carcinoma should resolve the problem.…”

Section: Krukenberg Tumormentioning

confidence: 99%

“…61 Positive mucicarmine and PAS stains with diastase digestion, the latter being more reliable, are of great value in establishing the diagnosis of a Krukenberg tumor. Occasional Krukenberg tumors may closely resemble fibromas on macroscopic examination and may have relatively few signet-ring cells.…”

Section: Krukenberg Tumormentioning

confidence: 99%

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Ovarian carcinomas, including secondary tumors: diagnostically challenging areas

Prat

2005

Mod Pathol

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The differential diagnosis of ovarian carcinomas, including secondary tumors, remains a challenging task. Mucinous carcinomas of the ovary are rare and can be easily confused with metastatic mucinous carcinomas that may present clinically as a primary ovarian tumor. Most of these originate in the gastrointestinal tract and pancreas. International Federation of Gynecology and Obstetrics (FIGO) stage is the single most important prognostic factor, and stage I carcinomas have an excellent prognosis; FIGO stage is largely related to the histologic features of the ovarian tumors. Infiltrative stromal invasion proved to be biologically more aggressive than expansile invasion. Metastatic colon cancer is frequent and often simulates ovarian endometrioid adenocarcinoma. Although immunostains for cytokeratins 7 and 20 can be helpful in the differential diagnosis, they should always be interpreted in the light of all clinical information. Occasionally, endometrioid carcinomas may exhibit a microglandular pattern simulating sex cord-stromal tumors. However, typical endometrioid glands, squamous differentiation, or an adenofibroma component are each present in 75% of these tumors whereas immunostains for calretinin and alpha-inhibin are negative. Endometrioid carcinoma of the ovary is associated in 15-20% of the cases with carcinoma of the endometrium. Most of these tumors have a favorable outcome and they most likely represent independent primary carcinomas arising as a result of a Mü llerian field effect. Although the criteria for distinguishing metastatic from independent primary carcinomas rely mainly upon conventional clinicopathologic findings, loss of heterozygosity and gene mutation analyses can be helpful. Transitional cell carcinomas are distinguished from undifferentiated carcinomas by the presence of thick, undulating papillae with smooth luminal borders, microspaces, and tumor cells with distinctive 'urothelial' appearance. Krukenberg tumors are metastatic adenocarcinomas traditionally perceived as composed of mucin-filled signet-ring cells associated with a striking proliferation of the ovarian stroma but many variations on this pattern occur.

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Section: Krukenberg Tumormentioning

confidence: 99%

Section: Krukenberg Tumormentioning

confidence: 99%

Section: Krukenberg Tumormentioning

confidence: 99%

Section: Krukenberg Tumormentioning

confidence: 99%

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Ovarian carcinomas, including secondary tumors: diagnostically challenging areas

Prat

2005

Mod Pathol

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“…The endometrium should be carefully examined especially in the case of estrogen-producing tumors. Sex cord-stromal tumors in women of reproductive age may mimic tubular Krukenberg tumors [45,61] . Granulosa and Sertoli cell tumors share the same features with endometrioid carcinomas [62][63][64][65] ( fig.…”

Section: Fsd For Distinguishing Types Of Ovarian Neoplasmsmentioning

confidence: 99%

Intraoperative Consultation in Ovarian Pathology

Akrivos

Thomakos

Sotiropoulou

et al. 2010

Gynecol Obstet Invest

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Ovarian specimens are very commonly submitted for intraoperative consultation (frozen section diagnosis) in order to confirm the presence of malignancy, to give the surgeon all the information for the histologic type of the tumor and finally determine the extent of surgery. In most cases, intraoperative consultation regarding ovarian masses accurately determines the type of malignancy. The pathologist and the gynecologist must be aware of the applications, indications and limitations of frozen section. Despite its limitations, frozen section diagnosis represents a sensitive and specific technique that can play a very important role in the management of ovarian disease.

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Ovarian endometrioid tumors mimicking sertoli and sertoli-leydig cell tumors. Sertoliform variant of endometrioid carcinoma

Roth

Liban

Czernobilsky

1982

Cancer

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We have encountered four cases of an unusual variant of well‐differentiated endometrioid carcinoma that was predominantly composed of tubules, solid or hollow, as well as cord‐like areas histologically mimicking Sertoli and Sertoli‐Leydig cell tumors. The two features most helpful in differential diagnosis were the presence of areas of tumor with the typical confluent pattern of endometrioid carcinoma, and the presence of mucin at the apical borders of the tumor cells and/or within glandular lumina. Other features that were helpful if present, but were observed only in one case each, were foci of squamous metaplasia or the presence of ciliated epithelium. In two cases, ultrastructural studies showed well developed microvilli and perinuclear microfilaments confirming the endometrioid nature of the neoplasm. The patients varied from 22–74 years in age. All tumors were confined to a single ovary, and no tumor is known to have recurred or metastasized. One of the patients died at age 80, six years following operation, presumably without evidence of recurrent neoplasm or metastases. Two other patients are living and well, one and 14 years after diagnosis. In one patient follow‐up is short. The clinicopathologic features of this variant of endometrioid carcinoma are reviewed with emphasis on differential morphologic features.

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Tubular Krukenberg tumor A problem in histopathologic diagnosis

Cited by 70 publications

References 0 publications

Ovarian carcinomas, including secondary tumors: diagnostically challenging areas

Ovarian carcinomas, including secondary tumors: diagnostically challenging areas

Intraoperative Consultation in Ovarian Pathology

Ovarian endometrioid tumors mimicking sertoli and sertoli-leydig cell tumors. Sertoliform variant of endometrioid carcinoma

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