OVARIAN MUCINOUS CYSTADENOCARCINOMA WITH SARCOMA-LIKE MURAL NODULES

A rare case of ovarian mucinous cystadenocarcinoma with sarcoma-like m ural nodules is reported. Macroscopically, nodular or granular lesions were scattered over the inner surface of a huge, multilocular tumor i n the left ovary. The histopathological features were consistent with those of previously documented cases, except significant squamous meta plasia in the present case. The pleomorphic sarcoma-like cells showed a positive reaction for vimentin and alpha-antichymotrypsin but were n egative for carcinoembryonic antigen and common epithelial membrane an tigen by immunohistochemistry. Electron microscopically, the tumor cel ls had neither desmosomes nor secretory granules, but they possessed a bundant intermediate filaments. Both immunostaining and ultrastructure suggested that the sarcoma-like nodules were derived from reactive pr oliferation of fibrohistiocytic cells. The fibrohistiocytic reaction s eemed to occur in response to hemorrhage, because hemorrhage was repor ted to be associated with the mural nodules in most of the previous ca ses as well as ours. (C) 1995 Wiley-Liss, Inc.