Transitional cell carcinoma of the ovary

Five patients with transitional cell carcinoma of the ovary constituted 1.0% of all patients with primary ovarian carcinoma (5/494) managed in the study period (1984-93). The average age at diagnosis was 59.2 years. All the patients presented with a pelvic mass. The average size of the primary tumoral mass at surgery was 5.2 cm. Only one patient had grossly bilateral involvement. All of the patients were subjected to a primary surgical staging procedure. One patient had stage IIA, two had stage IIB, one had stage IIIC and one had stage IVB disease. Four patients were treated with adjuvant multiagent chemotherapy consisting of cisplatinum and cyclophosphamide for 6 cycles. The other patient received monthly melphalan for 10 courses. Three of the patients were subjected to a second-look procedure. Of them, one with stage IIA disease was found to be negative for tumor after melphelan chemotherapy. This patient is still alive. While the patient with stage IIB disease was found to be tumor-free, the patient with stage IIIC disease had macroscopic tumor at second-look. The other patients with stage IIB and IVB disease were lost to follow-up after 6 months. Four of the patients had grade 3 disease. While epithelim membrane antigen was positive in tumors, intermediate filaments such as vimentin and desmin could not be demonstrated in any. Absence of stromal calcification and CEA immunohistochemical staining, which are common in Brenner tumors, as well as the presence in almost all cases of high grade disease in advanced stages appear to support the establishment of transitional cell carcinoma of the ovary as a separate entity.