Ovarian Mucinous Tumor with Mural Nodules of Anaplastic Carcinoma: A Clinicopathological Analysis of Three Cases Report and Review of Related Literature

Abstract

\n Background:Anaplastic carcinoma mural nodules presenting in ovarian mucinous cystic tumors are very rare. Here, we reported clinicopathological, immunohistochemical and molecular features of 3 such cases, and reviewed the related literature.Case presentation:The expression of pan-cytokeratin (CK) in the mural nodules of all three patients supported the diagnosis of mural nodules of anaplastic carcinoma. Immunohistochemical staining showed wild-type expression of p53 in the mural nodules and mucinous epithelium of Cases 2 and 3, while Case 1 was negative for the p53 mutation. The synchronous expression of p53 in epithelia and mural nodules suggested that mural nodules might be homologous with mucinous adenocarcinoma and might be the result of dedifferentiation of mucinous adenocarcinoma. In the sarcomatoid region of Case 1, p53 was wild-type in spindle cells and multinucleated giant cells in the background. In Case 3, a broad-based serrated adenoma of the appendix was also found. Therefore, exons of tumor-related genes were detected by high-throughput next-generation sequencing (NGS). Missense mutations of PIK3CA and PTEN were found, but no germline mutations were detected.Conclusions:In young patients with sarcomalike mural nodule (SLMNs) morphology, pathological analysis is recommended to avoid overlooking the existence of malignant mural nodules. Serrated lesions occurred in the appendix and ovarian mucinous tumor simultaneously, but no germline mutations were detected by NGS, indicating this was a sporadic case.