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Zeng H, Zhang M, Xie Y, Wang M, Dai J, Zhu X, Zeng Y, Xu N, Huang P, Zhao J, Sun G, Zeng H, Shen P. Primary renal mucinous adenocarcinoma masquerading as a giant renal cyst: a case report. Front Oncol 2023; 13:1129680. [PMID: 37223683 PMCID: PMC10200912 DOI: 10.3389/fonc.2023.1129680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
Mucinous adenocarcinoma of the kidney is rarely reported in the literature. We present a previously unreported mucinous adenocarcinoma arising from the renal parenchyma. A 55-year-old male patient with no complaints showed a large cystic hypodense lesion in the upper left kidney on contrast-enhanced computed tomography (CT) scan. A left renal cyst was initially considered, and a partial nephrectomy (PN) was performed. During the operation, a large amount of jelly-like mucus and bean-curd-like necrotic tissue was found in the focus. The pathological diagnosis was mucinous adenocarcinoma, and further systemic examination revealed no clinical evidence of primary disease elsewhere. Then the patient underwent left radical nephrectomy (RN), and the cystic lesion was found in the renal parenchyma, while neither the collecting system nor the ureters were involved. Postoperative sequential chemotherapy and radiotherapy were administered, and no signs of disease recurrence were observed over 30 months of follow-up. Based on a literature review, we summarize the lesion with rarity and the associated dilemma in preoperative diagnosis and treatment. Given the high degree of malignancy, a careful history analysis accompanied by dynamic observation of imaging and tumor markers is recommended for the diagnosis of the disease. Comprehensive treatment based on surgery may improve its clinical outcomes.
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Affiliation(s)
- Hong Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mengni Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yandong Xie
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Minghao Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jindong Dai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xudong Zhu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuhao Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Nanwei Xu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peng Huang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinge Zhao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guangxi Sun
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Pengfei Shen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Raj MS, Pittala K, Wallace SJ, Wojcik Jr. R. Abdominal Wall Reconstruction After Extirpation of a 140-Pound Primary Ovarian Mucinous Adenocarcinoma. Cureus 2023; 15:e35542. [PMID: 37007307 PMCID: PMC10056769 DOI: 10.7759/cureus.35542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
Ovarian cancer is a feared diagnosis for women and clinicians alike. Ovarian mucinous adenocarcinoma is a unique subset of ovarian cancer. As a primary tumor, massive ovarian masses, and more specifically mucinous adenocarcinomas, have been infrequently reported in the medical literature. Team approaches to massive tumor extirpations are essential, as patients often require the expertise of various subspecialists including, but not limited to, gynecologic-oncologists, general surgeons, and plastic and reconstructive surgeons. Here we present a case of a 71-year-old woman with a massive, incapacitating pelvic mass, later found to be a primary ovarian mucinous adenocarcinoma. Once medically optimized, a multi-service team approach was utilized for tumor extirpation and abdominal wall reconstruction. Involved surgical services included Gynecologic-Oncology, General Surgery, and Plastic and Reconstructive Surgery. Exploratory laparotomy for tumor extirpation, hysterectomy, bilateral salpingo-oophorectomy, omentectomy, peritoneal stripping, bilateral inguinal lymphadenectomy, and appendectomy was performed. Extensively thin, devascularized, and attenuated abdominal wall fascia that was adherent to the tumor was removed. The abdominal wall defect was reconstructed and reinforced with inlay and overlays of biologic monofilament mesh. Inverted-T of the vertical and horizontal skin components was performed in a tailor-tacking fashion, assuring the maintenance and protection of the abdominal skin flap vascularity through utilizing the Huger Zones of perfusion. Pathology revealed a stage IA grade 2 mucinous adenocarcinoma of the ovary without evidence of metastasis. No adjuvant therapies were required. The tumor's weight was 140 pounds, and its dimensions were 63 x 41 x 40 cm. It is our hope that presenting this experience will raise awareness of this spectrum of diseases and allow for earlier diagnoses and treatments, as well as exemplify the virtues of a team-based approach in the successful extirpation and subsequent reconstruction of the abdominal wall and skin.
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Ovarian Cancer Dissemination-A Cell Biologist's Perspective. Cancers (Basel) 2019; 11:cancers11121957. [PMID: 31817625 PMCID: PMC6966436 DOI: 10.3390/cancers11121957] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/04/2019] [Indexed: 12/16/2022] Open
Abstract
Epithelial ovarian cancer (EOC) comprises multiple disease states representing a variety of distinct tumors that, irrespective of tissue of origin, genetic aberrations and pathological features, share common patterns of dissemination to the peritoneal cavity. EOC peritoneal dissemination is a stepwise process that includes the formation of malignant outgrowths that detach and establish widespread peritoneal metastases through adhesion to serosal membranes. The cell biology associated with outgrowth formation, detachment, and de novo adhesion is at the nexus of diverse genetic backgrounds that characterize the disease. Development of treatment for metastatic disease will require detailed characterization of cellular processes involved in each step of EOC peritoneal dissemination. This article offers a review of the literature that relates to the current stage of knowledge about distinct steps of EOC peritoneal dissemination, with emphasis on the cell biology aspects of the process.
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Lin W, Cao D, Shen K. Prognostic significance of preoperative serum CEA in primary mucinous ovarian carcinoma: a retrospective cohort study. Cancer Manag Res 2018; 10:6913-6920. [PMID: 30588097 PMCID: PMC6300373 DOI: 10.2147/cmar.s186258] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the prognostic significance of preoperative serum carcinoembryonic antigen (CEA) in primary mucinous ovarian carcinoma (MOC). Patients and methods We reviewed 57 patients with primary MOC, in whom preoperative serum CEA had been measured. All patients were treated at Peking Union Medical College Hospital between June 1996 and September 2016. Results Preoperative serum CEA was elevated (>5.0 ng/mL) in 10 patients (17.5%), with a median serum CEA of 9.6 ng/mL (5.4–111.7 ng/mL). CEA was significantly associated with preoperative serum cancer antigen 125 (P=0.002), surgical debulking status (P=0.015), and tumor stage (P=0.001). Univariate analysis showed that patients with elevated CEA had significantly worse overall survival (OS) than patients with normal CEA (5-year OS: 50.8% vs 91.9%, respectively; P=0.013), but there was no significant difference in progression-free survival between the two groups (P=0.307). Multivariate analysis further demonstrated that advanced stage was an independent prognostic predictor for OS (P=0.002, HR: 15.925, 95% CI: 2.745–92.404). Conclusion Elevated preoperative serum CEA was strongly correlated with advanced stage in primary MOC, which may indicate a poorer prognosis. Further investigation of the intrinsic relationship between CEA and primary MOC is now required.
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Affiliation(s)
- Wei Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China,
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China,
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China,
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Firat Cuylan Z, Karabuk E, Oz M, Turan AT, Meydanli MM, Taskin S, Sari ME, Sahin H, Ulukent SC, Akbayir O, Gungorduk K, Gungor T, Kose MF, Ayhan A. Comparison of stage III mucinous and serous ovarian cancer: a case-control study. J Ovarian Res 2018; 11:91. [PMID: 30376858 PMCID: PMC6208168 DOI: 10.1186/s13048-018-0464-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/22/2018] [Indexed: 11/12/2022] Open
Abstract
Background The purpose of this case-control study was to compare the prognoses of women with stage III mucinous ovarian carcinoma (MOC) who received maximal or optimal cytoreduction followed by paclitaxel plus carboplatin chemotherapy to those of women with stage III serous epithelial ovarian cancer (EOC) treated in the similar manner. Methods We performed a multicenter, retrospective review to identify patients with stage III MOC at seven gynecologic oncology departments in Turkey. Eighty-one women with MOC were included. Each case was matched to two women with stage III serous EOC in terms of age, tumor grade, substage of disease, and extent of residual disease. Survival estimates were measured using Kaplan-Meier plots. Variables predictive of outcome were analyzed using Cox regression models. Results With a median follow-up of 54 months, the median progression-free survival (PFS) for women with stage III MOC was 18.0 months (95% CI; 13.8–22.1, SE: 2.13) compared to 29.0 months (95% CI; 24.04–33.95, SE: 2.52) in the serous group (p = 0.19). The 5-year overall survival rate of the MOC group was significantly lower than that of the serous EOC group (44.9% vs. 66.3%, respectively; p < 0.001). For the entire cohort, presence of multiple peritoneal implants (Hazard ratio [HR] 2.39; 95% confidence interval [CI], 1.38–4.14, p = 0.002) and mucinous histology (HR 2.28; 95% CI, 1.53–3.40, p < 0.001) were identified as independent predictors of decreased OS. Conclusion Patients with MOC seem to be 2.3 times more likely to die of their tumors when compared to women with serous EOC.
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Affiliation(s)
- Zeliha Firat Cuylan
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Emine Karabuk
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Acibadem University, Istanbul, Turkey
| | - Murat Oz
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
| | - Ahmet Taner Turan
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mehmet M Meydanli
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Salih Taskin
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, AnkaraUniversity, Ankara, Turkey
| | - Mustafa Erkan Sari
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Hanifi Sahin
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Suat C Ulukent
- Department of General Surgery, Kanuni Sultan Suleyman Teaching and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Ozgur Akbayir
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Kemal Gungorduk
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Tayfun Gungor
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mehmet F Kose
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Acibadem University, Istanbul, Turkey
| | - Ali Ayhan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, BaskentUniversity, Ankara, Turkey
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Bassiouny D, Ismiil N, Dubé V, Han G, Cesari M, Lu FI, Slodkowska E, Parra-Herran C, Chiu HF, Naeim M, Li N, Khalifa M, Nofech-Mozes S. Comprehensive Clinicopathologic and Updated Immunohistochemical Characterization of Primary Ovarian Mucinous Carcinoma. Int J Surg Pathol 2018; 26:306-317. [PMID: 29338553 DOI: 10.1177/1066896917752861] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The distinction of primary mucinous ovarian carcinoma (PMOC) from other primaries or secondaries is essential for selecting therapeutic options and prognostication. We aimed to characterize the immunohistochemical profile of 36 PMOCs using an extended immunohistochemical panel, with clinicopathologic features and outcome. PAX8 was negative in 30 (83.3%), and SATB2 was negative in 32/35. HNF1B, AMACR, and napsin-A were detected in 33 (91.7%), 35 (97.2%), and 0 (0%), respectively. MMR proteins and ARID1A were retained in 100%; PTEN was lost in 4 (11.1%). P53 was aberrant in 10 (27.8%); none overexpressed p16. HER2 was positive in 6/35 (17.1%). Most PMOCs had a favorable outcome. However, recurrence is usually fatal. The typical tumor profile was CK7+, CK20+/-, CDX2+/-, PAX8-, ER-, PgR-, and SATB2-. HER2 positivity suggests a possible target for therapy in advanced disease.
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Affiliation(s)
- Dina Bassiouny
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada.,3 Mansoura University, Mansoura, Egypt
| | - Nadia Ismiil
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Valerie Dubé
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Guangming Han
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Matthew Cesari
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Fang-I Lu
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Elzbieta Slodkowska
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Carlos Parra-Herran
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Hak Fai Chiu
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Magda Naeim
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Nim Li
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mahmoud Khalifa
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Sharon Nofech-Mozes
- 1 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
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