Noninvasive, microinvasive, and invasive mucinous carcinomas of the ovary - A clinicopathologic analysis of 40 cases

BACKGROUND. Whether ovarian mucinous tumors with epithelial stratification of more than three cell layers in the absence of stromal invasion (i.e., ca rcinomas diagnosed according to the Hart and Norris criteria) should be pla ced in the same category as mucinous tumors with stromal invasion (i.e., un questionable carcinomas) remains controversial. Because individual mucinous tumors frequently contain benign, borderline, and malignant components, th e adequacy of sampling has been emphasized. METHODS. Mie examined 21 mucinous carcinomas with no destructive stromal in vasion (MCNI), 4 mucinous carcinomas with microinvasion (MCMI) of < 2 mm, a nd 15 mucinous carcinomas with invasion (MCI) of greater than or equal to 2 mm. Tumors were diagnosed as MCNI according to Hart and Norris criteria (1 2 tumors) or when severe nuclear atypia was present (9 tumors). Cases of MC NI were selected for review if a section had been taken for each 2 cm or le ss of the tumor's greatest diameter. The International Federation of Gyneco logy and Obstetrics stage and follow-up data of each case were examined, an d differences among MCNI, MCMI, and MCI were analyzed. RESULTS. All 21 patients with MCNI and all 4 patients with MCMI had Stage I disease; there was no recurrence or death in these cases. In contrast, 7 o f 15 patients with MCI had Stage II or III disease, and 8 patients died. CONCLUSION. MCNI clearly should be distinguished from MCI and be classified as noninvasive carcinomas after the absence of destructive stromal invasio n has been confirmed by examining a sufficient number of sections. Cancer 2 000;89:1541-6. (C) 2000 American Cancer Society,.