Mucinous tumors of the ovary: current thoughts on diagnosis and management

Abstract

Mucinous tumors of the ovary represent a spectrum of neoplastic disorders, including benign mucinous cystadenoma, pseudomyxoma peritonei, mucinous tumors of low malignant potential (borderline), and invasive mucinous ovarian carcinoma. These tumors are related closely to each other and are distinct from other histologic subtypes of epithelial ovarian neoplasms from a clinical, histologic, and molecular standpoint. A continuum appears to be present from benign to borderline to malignant, which is different from other types of epithelial ovarian cancer. Mutational profiles are also distinct, as KRAS mutations are common, but p53 and BRCA mutations are infrequent. These characteristics lead to specific biologic behavior and guide both clinical management and research efforts in patients with mucinous ovarian tumors.

Fig. 1

10x H&E image showing intraepithelial carcinoma with stratified atypical nuclei with increased mitoses. Cytoplasm has decreased mucin. (Credit: Elizabeth Euscher, MD)

Fig. 2

4x H&E image with expansile invasion on permanent section. (Credit: Elizabeth Euscher, MD)

Fig. 3

10x H&E image with infiltrative invasion; small clusters of cells float in irregular cleft-like spaces. (Credit: Elizabeth Euscher, MD)

Fig. 4

20x H&E image (same focus as the 10x); higher power view showing prominent nucleoli and coarse chromatin. Atypia similar to the intraepithelial carcinoma in the glands directly above the focus of invasion. (Credit: Elizabeth Euscher, MD)