Seromucinous ovarian tumors and endometriosis in reproductive-aged wo


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Abstract

Endometriosis affects up to 15% of reproductive-aged women. Consideration of this nosological entity in a new aspect is impelled by the evidence that 0.5-1% of cases develops endometriosis-associated ovarian neoplasms that are more represented by the endometrioid and clear-cell subtypes of tumors. This category also includes seromucinous ovarian tumors (SMOTs). Objective. To investigate the morphological and immunohistochemical (IHC) features of SMOTs in reproductive-aged women, including pregnant ones. Subjects and methods. Ovarian tumor samples from 15 patients who had been operated on in 2012-2016 were analyzed comprehensively at the National Medical Research Center of Obstetrics, Gynecology, and Perinatology: IHC examination was conducted using the biomarkers of estrogen and progesterone receptors and Ki-67. Results. Borderline SMOTs were characterized by papillary growths on the inner surface (in one case) and on the outer surface, with an adhesive process with the serous surface of the corpus uteri (FIGO Stage 1c), and mixed epithelial structures; leukocyte infiltration was observed in 4 cases. The epithelium of seromucinous carcinoma (n = 1) was similar to that of serous, endocervical, and endometrial types at the same time. All the samples exhibited a low Ki-67 expression and high positive receptor immunoreactivity. Endometriosis diagnosed in nine women was accompanied by benign seromucinous cystadenomas (n = 4), borderline tumors (n = 4), and carcinoma (n = 1). Conclusion. Most of the examined SMOTs showed the areas, covered with the endometrioid epithelium, with adjacent endometrial stroma, which indicated the development of carcinoma in the presence of endometrioid cyst. The revealed facts suggest that endometriosis plays an etiological role in developing SMOTs. When detected, most neoplasms are localized (limited to ovarian tissue, FIGO stage 1a) and characterized by a favorable prognosis as a whole.

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About the authors

Marina V. Shamarakova

Center for Family Planning and Reproduction

Email: mshamarakova@yandex.ru
MD, pathologist, Center of family planning and reproduction.

Leila V. Adamyan

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia

Email: a_asaturova@oparina4.ru
professor, academician of RAMS, head specialist in obstetrics and gynecology, deputy director

Alexandra V. Asaturova

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia

Email: a_asaturova@oparina4.ru
MD, pathologist, senior scientific assistant

Larisa S. Ezhova

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia

Email: l_ezhova@oparina4.ru
MD, pathologist, senior scientific assistant

Nikon V. Zaitsev

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia

Email: a_asaturova@oparina4.ru
MD, pathologist

Mariia V. Yurova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: yurova.m.vl@gmail.com
medical student of the International School «Medicine of Future»

Yana O. Martirosyan

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: marti-yana@yandex.ru
medical student

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