Transitional Cell Carcinoma of the Ovary May Be Related to High-Grade Serous Carcinoma and Is Distinct from Malignant Brenner Tumor.
Rola H Ali, Jeffrey D Seidman, Steve Kalloger, Blake Gilks. Vancouver General Hospital, BC, Canada; Washington Hospital Center, Washington, DC
Background: According to the WHO, transitional cell tumors of the ovary include benign, borderline and malignant Brenner tumors (BT), as well as transitional cell carcinoma (TCC) in which a benign Brenner component is not seen. Some TCCs could conceivably be examples of malignant Brenner tumor with overgrowth of a benign Brenner component.
Design: Our objective was to compare the immunophenotype of BT to that of TCC and look for tumors with the immunophenotype of BT, but lacking a benign BT component, among a large cohort of ovarian carcinoma cases. Six BTs (3 benign, 2 borderline, 1 malignant) and 7 TCCs were stained for WT1, ER, p53, and p16. A database of 500 cases of ovarian carcinoma was searched for tumors with an immunoprofile similar to that of BT.
Results: BTs were negative for WT1, p53, ER (except for weak positivity in one case) and negative or weakly positive for p16. In contrast, the seven cases of TCC stained as follows: 4/6 +ve for WT1, 2/6 +ve for p53, 5/7 +ve for ER, 2/7 strongly +ve for p16. Of the 500 cases of ovarian carcinoma, 116 showed the following immunoprofile: WT1 –ve, ER –ve, p16 –ve or weak +ve, p53 –ve. Of these cases, (including 77 clear cell carcinoma, 14 endometrioid carcinoma, 12 mucinous carcinoma, 8 high grade serous carcinoma) none showed morphological features of TCC.
Conclusions: • Immunophenotypes of Brenner tumor and TCC are different, with the latter resembling that of high grade serous carcinoma.
• Tumors with the immunophenotype of Brenner tumor but lacking a benign Brenner component are uncommon and these tumors do not morphologically resemble transitional cell carcinoma.
• We found no evidence of carcinomas with morphological features of transitional cell carcinoma, but with the immunophenotype of BT (i.e. possible examples of malignant Brenner tumor where there has been overgrowth of benign BT components).
• These results suggest that BT and TCC are unrelated, and should not be combined for classification purposes.
Category: Gynecologic & Obstetrics
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 104, Tuesday Afternoon