CASE 04/04/2016 CUT THRU EVERY LOCULE AND SAMPLE ANYTHING THAT LOOKS DIFFERENT GROSS EXAM: SAMPLE, SAMPLE, SAMPLE
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1 CASE 22 YOF G2P1 SVD US: LARGE COMPLEX OVARIAN MASS WITH NODULAR COMPONENT LFU; ADMITTED TO ER WITH SEVERE ABDOMINOPELVIC PAIN EXPLOR LAP LARGE CYST FILLED ABDOM/PELVIS RUPTURED AT REMOVAL & SPILLED 7500 cc INTO PELVIC CAVITY GROSS EXAM: SAMPLE, SAMPLE, SAMPLE RUPTURED TUMOR MEASURED 17.0 x 16.3 x 4 cm PAUCILOCULAR TUMOR (white arrows & ellipse) SPONGY MURAL NODULE 4.0 x 2.5 x 1.5 cm (black arrows) CUT THRU EVERY LOCULE AND SAMPLE ANYTHING THAT LOOKS DIFFERENT 1
2 MUCINOUS BORDERLINE TUMOR WITH FOCAL BORDERLINE MICROINVASION IN A 22 YO POSTPARTUM PATIENT MUCINOUS BORDERLINE TUMOR IN A 22 YO POSTPARTUM PATIENT 22 YOF WITH MBOT AND MIV MBOT MUCINOUS BORDERLINE TUMOR WITH MICROINVASION (BLMIV) 2
3 MBOT WITH MIV MBOT WITH MICROINVASION VS MICROINVASIVE CARCINOMA FAQ: WHAT ARE THE TYPES OF MICROINVASION IN MBOTs? 3
4 CONFLUENT (EXPANSILE) MICROINVASIVE MUCINOUS CARCINOMA OVARIAN TUMOR WITH MICROINVASIVE MUCINOUS ADENOCARCINOMA PRIMARY OVARIAN MUCINOUS CYSTADENOMA 4
5 OVARIAN MUCINOUS CYSTADENOMA, GI TYPE MUCINOUS BORDERLINE OVARIAN TUMOR LOADING DOCK SCALE 102 LBS 30 YOF MUCINOUS BORDERLINE OVARIAN TUMOR 30 YOF 5
6 MUCINOUS BORDERLINE OVARIAN TUMOR 30 YOF MUCINOUS BORDERLINE OVARIAN TUMOR WITH FOCAL INTRAEPITHELIAL CARCINOMA 30 YOF MUCINOUS BORDERLINE TUMOR (UPPER VILLUS) AND INTRAEPITHELIAL CARCINOMA (LOWER VILLUS) 6
7 MUCINOUS BORDERLINE TUMOR W/ INTRAEPITHELIAL CARCINOMA 16 YOF BORDERLINE OVARIAN TUMORS, GI (L) AND SEROMUCINOUS TYPES SEROMUCINOUS OVARIAN BORDERLINE TUMOR (MULLERIAN ENDOCERVICAL TYPE) 7
8 SEROMUCINOUS BORDERLINE OVARIAN TUMOR Immunohistochemical Findings of a Panel of IHC Markers in OMNs and Metastatic Colorectal Adenocarcinomas in the Ovary. Lin X et al. (Appl Immunohistochem Mol Morphol 2008;16: ) Neoplasm CDX-2 (%) CA-125 (%) CK7 (%) CK20 (%) No. Intestinal type OMN Endocervical-like OMN Colorectal adenoca WELL DIFFERENTIATED OVARIAN MUCINOUS ADENOCARCINOMA 8
9 UNICYSTIC MUCINOUS ADENOCARCINOMA OF THE OVARY MET COLON CA TO OV HOW OFTEN ARE PRIMARY OVARIAN MUCINOUS TUMORS BILATERAL? RARELY! CLX CASE: 54 YOF BILATERAL OVARIAN TUMORS EACH ~1.2 KG CONSULT:? MBOTs PRIOR PANCREATIC RESECTION FOR 8 CM CYSTIC INTRADUCTAL PAPILLARY NEOPLASM AND 2 MM OF CYST WALL INVASION 9
10 UNILATERAL OVARIAN MUCINOUS TUMOR IN A 68 YOF METASTATIC COLON CA TO OVARY SIMULATING PRIMARY MUCINOUS TUMOR ENDOMETRIOID CARCINOMA OF THE COLON ENDOMETRIOID COLON CARCINOMA 10
11 COLON ADENOCARCINOMA WITH CLEAR CELL CHANGE CK 7- Metastatic intestinal carcinomas simulating primary ovarian clear cell carcinoma and secretory endometrioid carcinoma: a clinicopathologic and immunohistochemical study of five cases. Am J Surg Pathol CK 20+ CDX2+ PSEUDOMYXOMA PERITONEI PRIMARY APPENDICEAL MUCINOUS TUMOR WITH OVARIAN AND OMENTAL METASTASES APPENDICEAL MUCOCELE (arch.) CONTAINING GLAIRY MUCUS 11
12 PRIMARY APPENDICEAL MUCINOUS TUMOR WITH METASTASES TO RIGHT OVARY PRIMARY APPENDICEAL MUCINOUS TUMOR WITH METASTASES TO RIGHT OVARY OVARIAN METASTASIS FROM APPENDICEAL PRIMARY LAMN 12
13 TOO TALL ET AL. LAMN & PMP APPX LAMN WITH PUSHING INVASION AND RUPTURE 13
14 PMP DERIVED FROM LAMN Am J Surg Pathol 2016;40:14 26 HOW TO PSIGN OUT PSEUDOMYXOMA PERITONEI MUCINOUS ASCITES ORGANIZING MUCINOUS ASCITES DISSECTING MUCIN WITH FIBROSIS CLASSIFICATION OF PMP MUCIN WITHOUT EPITHELIAL CELLS: ACELLULAR MUCIN 14
15 MUCINOUS ASCITES, PERITONEUM ACELLULAR MUCIN ORGANIZING MUCIN, PERITONEUM CLASSIFICATION OF PMP PMP WITH LOW GRADE HISTOLOGIC FEATURES: LOW GRADE MUC CA PERITONEI OR DISSEMINATED PERITONEAL ADENOMUCINOSIS 15
16 LOW GRADE PERITONEAL MUCINOUS NEOPLASIA HOW PSCELLULAR IS THE PSEUDOMYXOMA? WHO DISSECTING MUCIN WITH FIBROSIS, PERITONEUM 16
17 CLASSIFICATION OF PMP PMP WITH HIGH GRADE HISTOLOGIC FEATURES: HIGH GRADE MUCINOUS CARCINOMA PERITONEI OR PERITONEAL MUCINOUS CARCINOMATOSIS INVASIVE ADENOCARCINOMA APPX AND PERITONEUM PERITONEUM APPX MUCINOUS ADENOCA PERITONEI, HI GRADE CLASSIFICATION OF PMP PMP WITH SIGNET RING CELLS: HIGH GRADE MUC CA PERITONEI WITH SIG RING CELLS OR PERITONEAL MUCINOUS CARCINOMATOSIS WITH SIG RING CELLS 17
18 PERITONEAL COLLOID CARCINOMA: NOT PSEUDOMYXOMA PERITONEI! FINIS 18
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