Mucinous ovarian tumours

Immunohistochemistry is of limited value in differentiating primary mucinous ovarian tumours from metastases. The coordinate expression of CK7/CK20 is of limited value.

Reliance must therefore be placed on morphological features.

Features favouring a primary ovarian mucinous tumour:

• size greater than 10 cm
  

• grossly smooth surface
  

• benign, or borderline appearing areas
  

• expansive invasive pattern of invasion
  

• microscopic cysts (> 2mm)
  

• complex papillae
  

• necrotic luminal debris
  

• presence of a teratoma or Brenner tumour
  

• presence of a "mural nodule"

Features favouring a mucinous tumour metastatic to ovary:

• bilaterality
  

• microscopic surface involvement by epithelial tumours
  

• hilar involvement
  

• nodular growth pattern
  

• infiltrative pattern of invasion
  

• small glands/tubules
  

• single cell infiltration
  

• signet ring cells
  

• "dirty" necrosis

References

Lee, K.R. and Young, R.H. The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases. Am J Surg Pathol 2003;27:281-92.

This page last revised 17.3.2003.

©SMUHT/PW Bishop