OVARIAN MUCINOUS CYSTADENOCARCINOMA WITH MALIGNANT MURAL NODULES

A case of ovarian mucinous cystadenocarcinoma with malignant mural nod ules is reported. The patient was a 28-year-old Japanese female (gravi da 0, para 0) with a 2 year history of increasing abdominal fullness a nd edema of the lower extremity. Physical examination showed a large m ass in the abdomen. An abdominal ultrasound and computed tomography de monstrated a multilocular cyst with a solid component. Lymph node and distant metastases were not found. These tests were followed by surger y. The resected right ovarian tumor measured 25 x 22 x 18cm. On cut se ctioning, it was multilocular with multiple mural nodules. Microscopic ally, the cyst wall was lined with papillary infoldings of atypical mu cinous epithelium (intestinal type). Nuclear stratification, cribrifor m and back-to-back glandular patterns and stromal invasion were observ ed. In addition, the solid area of the mural nodules showed spindle or polygonal cells with increased mitotic activity including atypical mi toses. Nuclear pleomorphism was marked. Necrosis and hemorrhage were a lso present. Reticulin stain showed these pleomorphic cell clusters ci rcumscribed by reticulin fibers and these cells were immunoreactive fo r vimentin and p53.