title: Wolffian tumor of the ovary with a prominent spindle cell component: report of a case with brief discussion of unusual problems in differential diagnosis, and literature review.
abstract: An 87-year-old woman underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrioid adenocarcinoma. At operation, a 4.5-cm partially solid and partially cystic right ovarian mass was identified. Frozen section showed a cytologically bland spindle cell proliferation reminiscent of cellular fibroma. Extensive sampling of the ovarian mass revealed a focus with the classic sieve-like pattern of a Wolffian adnexal tumor that merged with the fibroma-like appearance. The uterus showed well-differentiated, superficially invasive endometrioid adenocarcinoma arising in a background of atypical complex hyperplasia. Given the recent reports implying a therapeutic value for Gleevec (Novartis, Stein, Switzerland) (STI-571) in the treatment of Wolffian tumor of the ovary, paraffin immunostain for CD117 (c-kit) was performed that yielded negative results. Without further therapy, the patient was alive without disease 7 months after surgery. This case demonstrates the heterogeneity of Wolffian tumor of the ovary and shows how crucial sampling is in arriving at the correct diagnosis.
authors.affiliation: Department of Pathology, Monmouth Medical Center, Long Branch, New Jersey 07740, USA.
authors.lastname: Fanghong Li
authors.forename: Arpad
authors.initials: A
authors.lastname: Szallasi
authors.forename: Robert H
authors.initials: RH
authors.lastname: Young
mesh_terms: D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D018269:Carcinoma, Endometrioid / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005350:Fibroma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D010051:Ovarian Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor