ENDOMETRIOID CARCINOMA OF THE OVARY WITH A PROMINENT SPINDLE-CELL COMPONENT, A SOURCE OF DIAGNOSTIC CONFUSION - A REPORT OF 14 CASES

Fourteen endometrioid carcinomas of the ovary with a prominent compone nt of spindle-shaped epithelial cells are reported. Eleven were initia lly misdiagnosed as sex-cord stromal tumors, malignant mesodermal mixe d tumors, tumors of probable wolffian origin, or metastatic carcinomas . All of the tumors, however, had one or more features establishing th em as endometrioid carcinomas, including (a) glands typical of endomet rioid adenocarcinoma, (b) foci of squamous differentiation, and (c) an adenofibromatous component. Six cases were examined immunohistochemic ally, and the epithelial nature of the spindle cells was supported by immunostaining for keratin and epithelial membrane antigen. The patien ts ranged in age from 42 to 89 years (mean, 61). Four cases were stage I, five stage II, and three stage III. Follow-up information was avai lable in seven cases. Five patients were free of disease at 8, 11, 32, 56, and 103 months, and two patients were alive with disease at 10 an d 20 months. The age of the patients, clinical presentation, tumor sta ge, and gross appearance were similar to those of typical endometrioid carcinomas. It is important that this tumor be distinguished from oth er ovarian neoplasms with a spindle-cell component because of differen ces in treatment and prognosis.