Immunophenotype and K-RAS mutation in mucinous ovarian adenocarcinoma with mural nodule of high-grade sarcoma: case report.
Ovarian mucinous tumors with mural nodules are rare. The mural nodules are microscopically divergent neoplasms of varying sizes that may be benign (eg, sarcoma-like and carcinosarcoma-like), or malignant (eg, anaplastic carcinoma and sarcoma). The K-RAS gene mutation in ovarian mucinous neoplasms with mural nodules has not been previously reported. This is a case report of a 25-year-old female diagnosed with ovarian invasive mucinous adenocarcinoma with mural nodule of high-grade sarcoma. The mucinous tumor component demonstrated a K-RAS codon 12/13 mutation (p.G12V, c.35 G>T), whereas the sarcomatous component demonstrated a K-RAS codon 12/13 mutation (p.G12D, c.35 G>A). Although both tumor components revealed a mutation in codon 12 of K-RAS, they were of different nucleotide substitutions, indicating that these 2 tumor components were of different clonal origins. However, the fact that the 2 mutations identified in the tumor components are the most common mutations reported in mucinous tumors of the ovary, raises the possibility that sarcomatous mural nodules simply represent a form of dedifferentiation in mucinous tumors.
Departments of Pathology, Microbiology and Immunology (M.M.D., O.F.), Vanderbilt University Medical Center, Nashville, Tennessee Magee-Womens Hospital of University of Pittsburgh Medical Center (A.K., A.K.S.), Pittsburgh, Pennsylvania.
Mohamed M
MM
Desouki
Oluwole
O
Fadare
Anisa
A
Kanbour
Amal
A
Kanbour-Shakir
D002288:Adenocarcinoma, Mucinous / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D005260:Female; D011905:Genes, ras / Q000235:genetics*; D006801:Humans; D016130:Immunophenotyping; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D012509:Sarcoma / Q000235:genetics / Q000378:metabolism / Q000473:pathology*