japan-korea-taiwan gyn conferece mini lecture
TRANSCRIPT
Yoshiki Mikami, M.D., Ph.D.
Department of Diagnostic PathologyKumamoto University Hospital
Seromucinous Tumor
Japan-Korea-Taiwan GYN ConfereceMini Lecture
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Mucinous tumorsIntestinal Benign
Borderline
Malignant
Endocervical-like Borderline
WHO2003
Mucinous tumorsBenign
Borderline
Malignant
Seromucinoustumors
Benign
Borderline
Malignant
WHO2014
Overview
•General understanding
•Controversies
–Discussion
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Seromucinous borderline tumor
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• Unilocular oroligolocular
• Granular or papillaryexcrescences
• Viscid and/orpurulent material
• Frequently bilateral(40%) and a/wendometriosis (50%)
Seromucinous borderline tumor
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• Microscopicfeatures
Architecturallyresembling SBT
Wide papillaeshowing hierarchicalbranching
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Seromucinous borderline tumor
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• Microscopicfeatures
Cytology• Mucinous cells• Ciliated cells
Seromucinous borderline tumor
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• Microscopicfeatures
Cytology• Mucinous cells• Ciliated cells
Seromucinous borderline tumor
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• Microscopicfeatures
Cytology• Mucinous cells• Ciliated cells• Indifferent cells
Implants11
Implants12
Implants13
14Implants（desmoplastic）
15Implants（desmoplastic）
Seromucinouscystadenoma / adenofibroma
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Seromucinous borderline tumorwith intraepithelial carcinoma
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Seromucinous carcinoma
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Overview
•General understanding
•Controversies
–Discussion
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30Normal endocervical glands
31Normal endocervical glands
32SeromucinousNormal
Endocervical gland
• Ovarian tumors of low malignantpotential exhibiting an epithelialproliferation of mucinous type cellsgreater than seen in their benigncounterparts but without destructivestromal invasion
• The mucinous epithelial cells resembleendocervical epithelium
Endocervical-like mucinousborderline tumor
WHO2003
• Non-invasive proliferative tumorcomposed of more than one typesof epithelial cells
• Predominantly serous andendocervical types
• Occasionally admixed withendometrioid, clear cell, andsquamous epithelium
Seromucinous borderline tumor
WHO2014
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Seromucinous borderline tumor
WHO2014
Synonyms
• Endocervical-like MBT• Müllerian MBT• Borderline müllerian tumor
Seromucinous borderline tumor
WHO2014
Name Morphology Definition
“Seromucinous” Endocervical Mixed müllerian
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Seromucinous borderline tumor
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Seromucinous borderline tumor
Endocervical type
Serous typeEndometrioid typeClear cell typeSquamous type(Transitional type)
! No strict quantitative criteria
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Seromucinous borderline tumor
! No strict quantitative criteria
Seromucinous ????
Serous typeEndometrioid typeClear cell typeSquamous type(Transitional type)
Endocervical type
Seromucinous borderline tumor
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KRAS mutation(Kim KR et al,2010)
Similar toendometrioidtumors
Seromucinous borderline tumor
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ER/PR＋WT1－CK20－、CDX2－ARID1A mutation(Kurman et al. 2016)
Similar toendometrioid orclear cell tumors
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Seromucinous Tumors of the OvaryWhat’s in a Name ?
Kurman RJ and Shih I-M. Int J Gynecol Pathol 2016; 35: 78-81
… Based on their clinicopathologic,immunohistochemical and molecular geneticfeatures we believe a more appropriatedesignation for this group of tumors is "mixedmüllerian tumors" which can be subcategorized as"mixed müllerian cystadenomas", "mixed müllerianatypical proliferative (borderline) tumors" and"mixed müllerian carcinomas".
Seromucinous carcinoma
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Vs Endometrioid carcinoma withmucinous differentiation
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Seromucinous carcinoma Endometrioid carcinomawith mucinousdifferentiation
Background Seromucinous borderline tumor Prototypical endometrioidcarcinoma
53Rambau PF, et al. Am J Surg Pathol. 2017;41: 685-695.
• Seromucinous carcinomamay be reclassified toendometrioid, low-gradeserous, and mucinouscarcinomas by integratingmorphology,immunophenotype, andgenotype.
• the category ofseromucinous carcinomabe discontinued asancillary molecular testscan assign cases to oneof the major histotypes
54Rambau PF, et al. Am J Surg Pathol. 2017;41: 685-695.
• Seromucinous carcinomamay be reclassified toendometrioid, low-gradeserous, and mucinouscarcinomas by integratingmorphology,immunophenotype, andgenotype.
• the category ofseromucinous carcinomabe discontinued asancillary molecular testscan assign cases to oneof the major histotypes
55Rambau PF, et al. Am J Surg Pathol. 2017;41: 685-695.
• Seromucinous carcinomamay be reclassified toendometrioid, low-gradeserous, and mucinouscarcinomas by integratingmorphology,immunophenotype, andgenotype.
• the category ofseromucinous carcinomabe discontinued asancillary molecular testscan assign cases to oneof the major histotypes
LG-ndometrioid
LG Serous
Mucinous
"SEROMUCINOUSCARCINOMA"
8/32 (25%)
23/32 (72%)
1/32 (3%)
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