Ovarian serous carcinoma associated with a distinct "corded and hyalinized" pattern.
The "corded and hyalinized" pattern, described in endometrioid carcinoma, has not been previously reported in association with serous carcinoma. We describe a unique case of serous neoplasm of low malignant potential with low-grade serous carcinoma combined with a distinct pattern of high-grade carcinoma characterized by cords of epithelioid and spindled cells enmeshed in a hyalinized, collagenous stroma. This pattern was the predominant architecture in the patient's recurrence and caused a diagnostic challenge, as the splenic recurrence was initially diagnosed as a second primary high-grade spindle cell neoplasm. Both ovarian and splenic tumors displayed positive immunohistochemical staining for cytokeratin 7, cytokeratin 8/18, estrogen receptor, and paired box gene 8 (PAX-8) in the conventional serous carcinoma and the corded and hyalinized component, confirming the diagnosis of recurrent carcinoma. The behavior in this unique case of serous carcinoma associated with a distinct corded and hyalinized pattern was more aggressive than low-grade serous carcinoma, but more favorable than malignant mixed mullerian tumor.
Departments of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. jsestrella@mdanderson.org
Jeannelyn S
JS
Estrella
Judith K
JK
Wolf
Michael T
MT
Deavers
D000328:Adult; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D018200:Mixed Tumor, Mullerian / Q000473:pathology; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology*; D000072636:PAX8 Transcription Factor; D051761:Paired Box Transcription Factors / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D013160:Splenic Neoplasms / Q000378:metabolism / Q000473:pathology / Q000556:secondary
D000072636:PAX8 Transcription Factor; C083325:PAX8 protein, human; D051761:Paired Box Transcription Factors; D011960:Receptors, Estrogen; D007633:Keratins