Synchronous Versus Metastatic Gynecological Cancers: A Comparative Mutational Profiling Study.
Sihem Khelifa, Sydney D Finkelstein, Pei Hui. Yale University, New Haven, CT; RedPath Integrated Pathology, Pittsburgh, PA
Background: Separation of synchronous ovarian primary cancer from a metastatic uterine cancer to the ovary can be difficult and currently relies primarily on the conventional histological examinations, yet such a separation may have important clinical and therapeutic implications. Comparative mutational profiling (CMP) involves the analysis of loss of heterozygosity (LOH) among lesions to facilitate such differential diagnoses. We evaluated the efficacy of CMP in separating a synchronous ovarian primary vs. a metastatic endometrial carcinoma to the ovary
Design: Ten cases of endometrial adenocarcinoma with lesions simultaneously involving the ovary were retrospectively retrieved from our file. All cases were reviewed according to the conventional histological criteria in separation of a synchronous ovary primary with a metastatic endometrial carcinoma involving the ovary. Non-neoplastic tissue and multiple foci of both endometrial and ovarian tumors were microdissected and subject to comparative mutational profiling analysis involving 16 polymorphic loci. Allelic imbalance or LOH at each locus was documented and compared between the endometrial and the ovarian lesions.
Results: Among ten cases selected and histologically reviewed, 2 cases of synchronous endometrial and ovarian tumors, 7 cases of metastatic endometrial carcinomas, and 1 case of metastatic ovarian carcinoma were confirmed based on the conventional histological criteria (morphology, bilateral ovarian involvement, depth of myometrial invasion, lymphovascular involvement, and ovarian surface involvement). CMP analysis revealed an excellent correlation with the histological classification of the tumors in 9 out of 10 cases.
Conclusions: Comparative mutational profiling appears reliable in assessing the relatedness of gynecological cancerous lesions. Such an objective molecular approach has a diagnostic power at least similar to that of the histological evaluation. Additional studies are needed to further confirm the efficacy of CMP in the workup of gynecological tumors simultaneously involving multiple mullerian organs.
Category: Gynecologic & Obstetrics
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 164, Wednesday Afternoon