Retrospective Study of the Clinicopathological Characteristics of 31 Cases of Primary Mucinous Tumors of the Ovary at a
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ORIGINAL ARTICLE
Retrospective Study of the Clinicopathological Characteristics of 31 Cases of Primary Mucinous Tumors of the Ovary at a Tertiary Care Center Michelle Aline Antony1 Susan John5
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Ajith Toms2 • Latha Abraham3 • Sunitha Thomas3 • Sanju Cyriac4
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Received: 28 April 2020 / Revised: 15 May 2020 / Accepted: 18 May 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Aim This retrospective analysis aimed to evaluate the clinicopathological characteristics of primary mucinous tumors of the ovary (MOT) treated at a tertiary care center. Materials and Methods Demographic, clinicopathological, treatment and follow-up details of all patients with primary MOT treated from June 2015 till August 2019 were extracted from institutional cancer registry and Electronic Medical Records, after obtaining necessary clearance from institutional ethical committee, and institutional review board. The details obtained were tabulated and analyzed. Results Thirty-one patients were identified to have primary MOT: 20 cystadenomas, 10 carcinomas (mOC) and one borderline (mBOT). MOT was frequently noted between the fourth to sixth decades. Abdominal distension was the most common symptom at presentation. In total, 70% of cystadenomas were less than 15 cm, while 90% of mOC were 15 cm and above. In total, 95% cystadenomas were unilateral, while all cases of mBOT and mOC were unilateral. mOC showed elevated CA 125 in 42.86% cases, elevated CEA in 42.86% cases and elevated CA 19–9 in 75% cases. Imaging showed 30% of mOC as benign cysts and 42.1% of cystadenomas as complex cyst. Frozen section correctly diagnosed cystadenomas and mBOT, and two mOC were underdiagnosed as borderline. All had upfront surgery. Of cystadenomas, 11 underwent salpingoovariotomy, and nine had hysterectomy and salpingoovariotomy. All the mOC and mBOT underwent staging laparotomy. Three cases of mOC had a fertility preserving approach. No cases had positive lymph nodes, and appendix showed normal histology. In total, 40% were stage 1a, 30% 1C1 and 30% IC3. Two patients received postoperative chemotherapy. Conclusions Differentiation between benign MOT and mOC is crucial. A multidisciplinary approach, involving clinician, radiologist and pathologist, helps in clinching the diagnosis. mOC present at a younger age and fertility-sparing procedures are reasonable options in early-stage MOT. Keywords Epithelial ovarian carcinoma Mucinous tumor ovary Benign Malignant Borderline neoplasm Pseudomyxoma Gynecologic cancer Surgery Primary Oncology
& Michelle Aline Antony [email protected] 1
Department of Breast and GYN Oncology, Gimcare Hospital, Kannur, Kerala, India
2
Radiology Department, Rajagiri Hospital, Ernakulam, Kerala, India
3
Pathology Department, Rajagiri Hospital, Ernakulam, Kerala, India
4
Medical Oncology Department, Rajagiri Hospital, Ernakulam, Kerala, India
5
Clinical Epidemiologist, Rajagiri Hospital, Ernakulam, Kerala, India
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Introduction Epithelial mucinous tumors of the ovary
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