GPR: 2021 - Week 17

From MGH Learn Pathology

Clinical history

42 year old female with 31 cm complex pelvic mass


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Mucinous cystadenoma
  • Benign mucinous neoplasm (accounts for ~80% of mucinous ovarian neoplasms).
  • Can reach very large sizes, occasionally larger than 30 cm.
  • Composed of either unilocular or multilocular smooth lined cysts filled with thick, tenacious fluid.
  • Important to open all cystic compartments to ensure no complex, solid areas are present.
 

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Mucinous carcinoma

  • Account for < 15% of all mucinous ovarian neoplasms and < 10% all epithelial ovarian neoplasms.
  • May not show a significantly elevated CA125.
  • Predominantly unilateral.
  • Usually show a complex solid and cystic component.
 

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Mucinous cystadenofibroma

  • Along with mucinous cystadenoma, comprise the category of benign mucinous neoplasms.
  • Rare, with estimated incidence of approximately 1.7% of benign ovarian neoplasms.
  • Have a significant solid component and may mimic malignant neoplasms on imaging.
 

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Metastatic carcinoma

  • Commonly bilateral with variable size (average size = 6 cm; but may extend up to 18 cm)
  • Generally show a multinodular cut surface.
  • Typically solid and cystic secondary to necrosis.
  • May present as a unilateral, cystic mass, simulating a primary ovarian neoplasm.
 
Dr. Ester Oliva

Dr. Melanie Kwan

Dr. Smiljana Spasic
Nucci, Marisa R, & Oliva, Esther. (2009). Gynecologic Pathology. Edinburgh: Elsevier.

This week's Gross Pathology Roundup was presented by Liana Bonanno, MD, PhD on Mon, Apr 26, 2021.