title: Primary broad ligament cystadenocarcinoma with mucinous component: a case report with immunohistochemical study.
abstract: Primary cystadenocarcinoma that arises in the broad ligament is extremely rare, especially when it is mucinous. We report the case of a 59-year-old woman with a cystic mass of the right broad ligament who underwent a complete excision of the mass (7 x 7 x 3 cm) with hysterectomy, right salpingo-oophorectomy, omentectomy, appendicectomy, and peritoneal biopsies. Pathologic examination showed a low-grade cystadenocarcinoma with a mucinous component limited to the broad ligament. Despite the chemotherapy (cisplatinum and cyclophosphamide) performed, early tumor recurrence occurred after approximately 6 months. Our observation revealed an abundant mucin production with pools of mucin similar to those of pseudomyxoma peritonei and an inflammatory infiltrate with prominent lipid phagocytosis. Immunohistochemical analysis demonstrated a strong and diffuse positivity for both cytokeratin 7 and epithelial membrane antigen. A less extensive staining with carcinoembryonic antigen and a focal unequivocal positivity with cytokeratin 20, particularly in mucin-secreting cells, were also observed. This finding could indicate a metaplastic process toward colonic phenotype similar to primary ovarian tumors.
authors.affiliation: Department of Pathology, Institut Salah Azaiez, Tunis, Tunisia. karima.mrad@rns.tn <karima.mrad@rns.tn>
authors.forename: Karima
authors.initials: K
authors.lastname: Mrad
authors.forename: Maha
authors.initials: M
authors.lastname: Driss
authors.forename: Salma
authors.initials: S
authors.lastname: Abdelmoula
authors.forename: Samia
authors.initials: S
authors.lastname: Sassi
authors.forename: Monia
authors.initials: M
authors.lastname: Hechiche
authors.forename: Khaled
authors.initials: K
authors.lastname: Ben Romdhane
mesh_terms: D001956:Broad Ligament / Q000737:chemistry / Q000473:pathology*; D018282:Cystadenocarcinoma, Mucinous / Q000737:chemistry / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D053552:Keratin-7; D007633:Keratins / Q000276:immunology; D008875:Middle Aged; D018396:Mucin-1 / Q000276:immunology; D014565:Urogenital Neoplasms / Q000175:diagnosis*
chemical_list: C507497:KRT7 protein, human; D053552:Keratin-7; D018396:Mucin-1; D007633:Keratins