Three cases of seromucinous carcinoma of the ovary arising in endometriotic cysts
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CASE REPORT
Three cases of seromucinous carcinoma of the ovary arising in endometriotic cysts Yukiko Taga1 · Yoshitsugu Chigusa1 · Sachiko Minamiguchi2 · Aki Kido3 · Naoki Horikawa1 · Akihito Horie1 · Junzo Hamanishi1 · Eiji Kondoh1 · Masaki Mandai1 · Ken Yamaguchi1 Received: 1 July 2020 / Accepted: 3 September 2020 © The Japan Society of Clinical Oncology 2020
Abstract Ovarian seromucinous carcinoma (SMC) is an uncommon neoplasia and is composed predominantly of serous and endocervical-type mucinous epithelium. Due to its low frequency and difficult diagnosis, the natural history, characteristic imaging findings, and pathological features of SMC have not been adequately described in the literature thus far. We herein report three cases of ovarian SMC along with magnetic resonance imaging (MRI) findings. The diagnosis of SMC was made after staging laparotomy in all cases, and systemic chemotherapy was performed in two cases. No recurrence was observed in any of the cases. The MRI findings in SMC were so varied that characteristic imaging features useful for diagnosis were not found. In two cases, MRI suggested endometriotic cysts, and endometriosis and seromucinous borderline tumors (SMBTs) were detected concurrently in all cases by histological examination. Thus, it was suggested that SMC develops in multiple stages via endometriosis and SMBT. The cooccurrence of endometriosis and SMBT could also make the diagnosis of SMC more convincing. Keywords Endometriosis · Endometrioid carcinoma · Seromucinous borderline tumor · Seromucinous carcinoma
Introduction Ovarian seromucinous tumors are characterized by various epithelial components mainly composed of uterine endocervical gland like mucinous epithelium, and pilus columnar epithelium resembling oviduct epithelium. These neoplasms were formally categorized in the revised 2014 World Health Organization (WHO) classification of tumors of female reproductive organs [1]. Similar to other epithelial ovarian tumors, this clinical entity includes benign adenomas, borderline tumors, and invasive carcinomas. However, most are borderline tumors (SMBTs), and seromucinous carcinomas * Yoshitsugu Chigusa [email protected]‑u.ac.jp 1
Department of Gynecology and Obstetrics, Kyoto University, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
2
Department of Diagnostic Pathology, Kyoto University, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
3
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
(SMCs) are very rare. Thus, little is known about SMC regarding natural history and magnetic resonance imaging (MRI) findings. In addition, there is much debate in terms of the pathological features of SMC. We herein report three cases of SMC of the ovary arising in endometriotic cysts. Furthermore, we discuss characteristic magnetic resonance imaging (MRI) findings for the diagnosis of SMC and the relationship between seromucinous tumors and endometriosis in the context of the
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