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Solid pseudopapillary neoplasm, pancreas type, presenting as a primary ovarian neoplasm
Lisa M Stoll1, Ram Parvataneni, Michael W Johnson
1Department of Pathology, University of California Los Angeles, Los Angeles, CA 90095, USA.
Human Pathology
|April 27, 2012
Summary
Solid pseudopapillary neoplasm (SPN) is a rare ovarian tumor. This case report details a fourth instance of primary ovarian SPN in a 48-year-old woman, highlighting its distinct characteristics.
Area of Science:
- Gynecologic Oncology
- Pathology
- Surgical Oncology
Background:
- Solid pseudopapillary neoplasm (SPN) is typically a low-grade malignant tumor originating in the pancreas.
- Recent literature indicates SPN can rarely present as a primary ovarian tumor.
Purpose of the Study:
- To report a fourth case of primary ovarian solid pseudopapillary neoplasm.
- To describe the clinicopathologic features and immunohistochemical profile of this rare ovarian neoplasm.
Main Methods:
- Case presentation of a 48-year-old woman with an 8-cm left ovarian mass.
- Surgical resection via left salpingo-oophorectomy.
- Detailed microscopic examination and immunohistochemical analysis (pancytokeratin, progesterone receptor, CD57, β-catenin, Ki-67, synaptophysin, inhibin, E-cadherin).
Main Results:
- The ovarian mass exhibited a predominantly cystic neoplasm with solid nests of epithelioid to plasmacytoid cells, pseudopapillary structures, hemorrhage, and degenerative changes.
- Tumor cells showed focal positivity for pancytokeratin, progesterone receptor, and CD57, with diffuse nuclear β-catenin expression. Ki-67 proliferation index was 5%-10%.
- Immunohistochemical stains for synaptophysin, inhibin, and E-cadherin were negative. No pancreatic lesions were identified clinically or radiologically.
Conclusions:
- This case represents a rare instance of primary ovarian solid pseudopapillary neoplasm.
- Further prolonged clinical follow-up is essential to ascertain the long-term behavior and prognosis of this rare ovarian tumor.
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