Algorithmic Approach to Primary and Metastatic Mucinous Ovarian Tumors

Abstract

Objective: The aim of this study was to investigate the importance of immunohistochemical findings and tumor size and laterality in addition to the histopathological features in the diagnosis of primary and metastatic mucinous tumors of the ovary. Material and Methods: Two hundred and twenty two mucinous ovarian tumors diagnosed between 2001 and 2012 were retrospectively reviewed in our hospital pathology archive. The cases were evaluated for age, lateralization, tumor size and immunohistochemistry. Results: Of the 222 cases included in the study, 195 were diagnosed as primary mucinous tumor and 27 as metastatic mucinous tumor. The distribution of the primary cases was cystadenomas in 135/195, mucinous carcinomas in 31/195 and borderline tumors in 29/195 cases. The mean age of the patients was 48.7 years (range 14y-72y). When laterality was evaluated, borderline tumors (29/29) and mucinous carcinomas (27/31) had a higher incidence in a single ovary but this rate was lower in metastatic tumors (13/27). When tumor size was evaluated, it was found that tumor size was lower in metastatic lesions while the size of the primary tumors was larger. Conclusion: Mucinous tumors are an important group where the differentiation of metastasis and primary lesion should be performed. Most of the metastatic tumors mimic the primary ovarian tumor, but we think that tumor size and laterality are important for the differentiation between metastasis and primary while immunohistochemistry may be useful in increasing the diagnostic accuracy.