Ovarian mucinous cystadenocarcinoma producing alpha-fetoprotein

Common epithelial ovarian tumors associated with alpha-fetoprotein (AFP) production are rare. A case of ovarian mucinous cystadenocarcinoma producing both AFP and carcinoembryonic antigen (CEA) is presented. A 53-year-old postmenopausal woman with right adnexal tumor underwent total hysterectomy and right salpingo-oophorectomy. Preoperative serum CEA and AFP levels were elevated to 660 and 1,120 ng/ml, respectively, and both decreased to their normal ranges after surgery. Histologically, the right ovarian tumor was diagnosed as a mucinous cystadenocarcinoma, composed of both intestinal-type cells and endocervical-type cells. Intestinal-type cells were identified ultrastructurally, with cells resembling neuroendocrine cells as well as gobletlike cells with many mucinous granules. Yolk sac or teratomatous components were not identified. By the immunoperoxidase technique, CEA was positive in well to moderately differentiated mucinous cells lining lumina, whereas AFP-positive cells were intermingled with CEA-positive cells in moderately differentiated epithelia.