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Microinvasion in low malignant potential tumors of the ovary
R Nayar1, S Siriaunkgul, K M Robbins
1Department of Pathology, George Washington University Medical Center, DC 20037, USA.
Abstract:
The presence of microinvasion (Mi) has not previously been investigated in nonserous low malignant potential (LMP) tumors of the ovary. In serous LMP tumors (SLMP), Mi has not worsened the prognosis compared with usual SLMP in previous reports. In a retrospective clinicopathologic review of 126 cases of serous and mucinous LMP (MLMP) tumors of the ovary, the authors identified 14 cases with Mi: seven of 72 SLMP, four of 44 mucinous intestinal LMP (MILMP), and three of 10 mucinous müllerian LMP (MMLMP). Tumors with Mi resembled usual LMP histologically except for small foci (up to 0.2 cm) in the stroma consisting predominantly of single cells or small clusters of cells, sometimes in a cribriform pattern. In SLMP-Mi, the cells had eosinophilic cytoplasm, and the stromal reaction was minimal/absent. In MILMP-Mi and MMLMP-Mi, nuclear staining was paler; the stroma often showed a fibrous reaction or edema, especially in MILMP-Mi. All 14 patients had follow-up (2.2 to 18.6 years) and were without evidence of disease. Careful screening of both mucinous and serous ovarian LMP can show Mi. Mi foci should be distinguished from true stromal invasion, pseudoinvasion, endothelial cells, decidual cells and histiocytes, and pseudomyxoma in mucinous LMP. Mi does not seem to worsen prognosis in MLMP and SLMP tumors of the ovary.
Insights
Microinvasion (Mi) in ovarian tumors, including serous and mucinous low malignant potential (LMP) types, was studied. Findings indicate that microinvasion does not appear to negatively impact the prognosis for these ovarian LMP tumors.
Area of Science:
- Gynecologic pathology
- Ovarian tumor classification
- Oncologic research
Background:
- Microinvasion (Mi) has not been previously studied in nonserous low malignant potential (LMP) ovarian tumors.
- Previous studies on serous LMP (SLMP) suggest Mi does not worsen prognosis.
- Ovarian LMP tumors require careful pathological assessment.
Purpose of the Study:
- To investigate the presence and prognostic significance of microinvasion (Mi) in nonserous LMP ovarian tumors.
- To compare findings in serous LMP (SLMP) and mucinous LMP (MLMP) tumors.
- To establish diagnostic criteria for Mi in ovarian LMP.
Main Methods:
- Retrospective clinicopathologic review of 126 ovarian LMP cases.
- Histopathological analysis to identify microinvasion (Mi) foci.
- Clinical follow-up data collection for prognostic assessment.
Main Results:
- Microinvasion (Mi) was identified in 14 of 126 LMP cases (SLMP, MILMP, MMLMP).
- Mi foci were characterized by small clusters of cells in the stroma, distinct from invasive patterns.
- All 14 patients with Mi remained disease-free during follow-up (2.2-18.6 years).
Conclusions:
- Microinvasion (Mi) can be present in both serous and mucinous LMP ovarian tumors.
- Mi foci require careful differentiation from other stromal alterations.
- Microinvasion does not appear to adversely affect the prognosis of ovarian LMP tumors.