Retiform uterine tumours resembling ovarian sex cord tumours. A comparative immunohistochemical study with retiform structures of the female genital tract.
OBJECTIVE
To analyse both the clinicopathological and immunohistochemical findings in six cases of uterine tumours resembling ovarian sex cord tumours with a predominant epithelial retiform component resembling the rete ovarii (RUTROSCT) and to compare their immunophenotype with tissues containing retiform structures such as the normal rete ovarii, retiform Wolffian adnexal tumour (RWAT) and ovarian retiform areas of Sertoli-Leydig cell tumours (ORSLCT).


RESULTS
Six RUTROSCTs were analysed. The average age of patients was 65 years, and all tumours behaved in a benign fashion. Four were intracavitary and two intramural. Two cases were misdiagnosed as malignant in endometrial biopsy specimens and one in the hysterectomy specimen. Histologically they had a tubulopapillary or glomeruloid formation; a sex-cord-like or endometrial stromal component was absent or comprised at most 30% of the tumour. RUTROCST showed consistent positivity for CAM5.2, cytokeratin (CK) 7, vimentin, calretinin, progesterone receptor and apical CD10. CD56 and alpha-inhibin were positive in half of the cases. Epithelial membrane antigen, desmin, smooth muscle actin and calponin were negative. Comparatively, rete ovarii and RWAT had a similar positivity for CK7, CD56, CD10 and calretinin. ORSLCT differed in its conspicuous positivity to CD56, CD10, alpha-inhibin and calretinin, but absent CK7 expression.


CONCLUSIONS
RUTROSCTs have benign behaviour but may be confused with various uterine adenocarcinomas or metastases. Correct diagnosis should avoid overtreatment. The immunophenotype of retiform areas is similar to that of adult rete ovarii and RWAT with minor divergence from ORSLCT.
Nogales
Francisco F
FF
Medical University of Targu Mures, Romania. fnogales@ugr.es
Stolnicu
Simona
S
Harilal
Kadappayil R
KR
Mooney
Eoghan
E
García-Galvis
Olga F
OF
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D019002:CD56 Antigen / Q000378:metabolism; D064032:Calbindin 2; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007265:Inhibins / Q000378:metabolism; D053552:Keratin-7 / Q000378:metabolism; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D015260:Neprilysin / Q000378:metabolism; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology*; D064030:S100 Calcium Binding Protein G / Q000378:metabolism; D018310:Sertoli-Leydig Cell Tumor / Q000378:metabolism / Q000473:pathology; D018312:Sex Cord-Gonadal Stromal Tumors / Q000378:metabolism* / Q000473:pathology*; D014594:Uterine Neoplasms / Q000378:metabolism* / Q000473:pathology*
D014408:Biomarkers, Tumor; C576764:CALB2 protein, human; D019002:CD56 Antigen; D064032:Calbindin 2; D053552:Keratin-7; D018396:Mucin-1; D064030:S100 Calcium Binding Protein G; C094377:inhibin-alpha subunit; D007265:Inhibins; D015260:Neprilysin