Change in MIB-1 staining between primary and recurrent epithelial ovarian cancer

In recent articles, MIB-1 staining has been shown to relate to length of survival of patients with epithelial ovarian malignancies. We report a case showing the difference in MIB-1 between the primary and recurrent tumor.

A 63 year old female had a total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy, partial omentectomy, and a staging procedure which achieved optimal debulking of a clear cell adenocarcinoma of the ovary. Final pathology revealed Stage IIIc disease because of one positive left iliac node. All other specimens except for the ovaries were negative for malignancy. The proliferation index of the tumor based on MIB-1 monoclonal antibody staining was 4.10%. The patient then was treated with 6 courses of carboplatin and cyclophosphamide. After a microscopically positive second look laparotomy, the patient received 4800 cGy of external beam radiation to the pelvic and paraaortic lymph node bearing areas. Fifteen months after the original diagnosis, a suspicious vaginal mass was biopsied and found to be recurrent clear cell adenocarcinoma consistent with an ovarian primary. MIB-1 monoclonal antibody staining of the recurrent cancer gave a proliferation index of 38.73%. The patients is still alive with a CA-125 which has plateaued between 60 U/ml and 70 U/ml, fourteen months after recurrence.

The proliferation index by MIB-1 staining may be affected by treatment for ovarian epithelial malignancies.