Ovarian mucinous tumor with mural nodules of anaplastic carcinoma: Three case reports

doi:10.12998/wjcc.v10.i21.7459

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Jul 26, 2022; 10(21): 7459-7466
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7459

Ovarian mucinous tumor with mural nodules of anaplastic carcinoma: Three case reports

Xiao-Juan Wang, Chun-Yan Wang, Yan-Feng Xi, Peng Bu, Pei Wang

Xiao-Juan Wang, Yan-Feng Xi, Peng Bu, Department of Pathology, Shanxi Cancer Hospital and Institute, Taiyuan 030013, Shanxi Province, China

Chun-Yan Wang, Department of Molecular Biology, Department of Blood Transfusion, Shanxi Cancer Hospital and Institute, Taiyuan 030013, Shanxi Province, China

Pei Wang, Department of Gynecology, Shanxi Cancer Hospital and Institute, Taiyuan 030013, Shanxi Province, China

Author contributions: Wang XJ and Bu P performed histological and immunohistochemical evaluation; Wang XJ and Xi YF were involved in the literature review and drafted the manuscript; Wang CY was involved in collecting clinical data; Wang P participated in the correspondence and reviewing and editing of the drafted manuscript as per journal policy and its submission; All authors read and approved the final manuscript.

Supported by the Medical Key Science Project of Shanxi Province, No. 2020XM52; and the Scientific and Technological Activities for Overseas Students in Shanxi Province, No. 20200042.

Informed consent statement: Written informed consent was obtained from the patient for publication of this report and all accompanying images.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Pei Wang, MD, Doctor, Department of Gynecology, Shanxi Cancer Hospital and Institute, No. 3 Zhigongxin Village, Xinghualing District, Taiyuan 030013, Shanxi Province, China. wangpei674325@sina.com

Received: November 3, 2021
Peer-review started: November 3, 2021
First decision: December 27, 2021
Revised: January 8, 2022
Accepted: June 4, 2022
Article in press: June 4, 2022
Published online: July 26, 2022
Processing time: 250 Days and 1.4 Hours

Abstract

BACKGROUND

Anaplastic carcinoma mural nodules in ovarian mucinous tumors are very rare. This study aimed to report the morphological characteristics, molecular detection results, clinical treatment and prognosis of three ovarian mucinous tumors with mural nodules of anaplastic carcinoma.

CASE SUMMARY

The pathomorphological features, molecular detection results, clinical treatment and prognosis of anaplastic carcinoma mural nodules were described in three cases. In case 1, sarcoma-like mural nodules (SLMNs) coexisted with anaplastic carcinoma mural nodules. No mutation was found in mucinous tumors. KRAS mutation was found in anaplastic carcinoma nodules and heterotypic cells were found in SLMNs. In case 2, KRAS mutation occurred in the mucinous epithelium and BRAF mutation occurred in mural nodules. In case 3, both mural nodules and mucinous tumors had the same KRAS mutation and a morphological transition between them was observed. All three patients died within 2 years, whether receiving chemotherapy or not.

CONCLUSION

Anaplastic carcinoma mural nodules may develop from dedifferentiation of mucinous tumors or are unrelated to mucinous tumors.

Keywords: Anaplastic carcinoma; BRAF; KRAS; Mucinous tumor; Mural nodules; Case report

Core Tip: Anaplastic carcinoma mural nodules in ovarian mucinous tumors are rare. The pathomorphological features, molecular detection results, clinical treatment and prognosis of anaplastic carcinoma mural nodules were described in three cases. After limited molecular detection, it is inferred that the mural nodules of anaplastic carcinoma may arise from (1) dedifferentiation of mucinous tumors or (2) a tumor unrelated to mucinous tumors and the KRAS signal pathway may be involved in the formation of this tumor and is unrelated to mucinous tumors. The KRAS signal pathway may be involved in the formation of mural nodules of anaplastic carcinoma. The mural nodules of anaplastic carcinoma may promote the progression of borderline mucinous ovarian tumors.