From the photos of this local recurrence of malignancy, two possibilities enter into the list of differential diagnoses - (1) serous (cyst)adenocarcinoma and (2) malignant mesothelioma. The marked nuclear atypia is more consistent with the former than the latter. It would be useful to find out the pathologic diagnosis of the original tumor resected 1.5 years ago. It would be even better if original slides are available for review and comparison. Immunohistochemical stains for mesothelial markers (calretinin, HMW keratin 34betaE12, thrombomodulin, etc) would help rule out mesothelioma. It is important to examine the pelvic and abdominal organs by CT scans and MRI to see if there is any mass in the ovaries, uterine corpus, fallopian tubes, omentum and peritoneal surface.
(福星高照译)从这些恶性肿瘤局部复发的图片看，鉴别诊断包括有两种可能性：(1)浆液性(囊)腺癌和(2)恶性间皮瘤。 核异型性显著，前者比后者更符合。 找到一年半以前切除原发肿瘤的病理诊断是有用的。如果能提供原切片作复习和比较那就更好了。 免疫组织化学染色标记间皮 (calretinin, 高分子角蛋白34βE12、血栓调节素等),将有助于排除间皮瘤。CT和MRI检查盆/腹腔的器官很重要，看看卵巢、子宫体、输卵管、网膜、腹膜表面是否有肿块。

 同意马教授分析。

结合部位，脐尿管（urachal）来源或成肾性（nephrogenic）肿瘤也在鉴别之列。腺体之间好像有平滑肌！

 够高分化腺癌了。

 不知最后诊断是什么？

 

同意马教授分析。

 透明细胞癌

1，查有无剖宫产史；

2，前次病理结果，或增加取材，看有无子宫内膜异位症，一般都是来源于内膜异位症；

3，预后很差。

 期待最后结果

 还应与中肾腺癌相区别

 透明细胞癌或恶性间皮瘤。免疫组化结果？

 期待答案

 考虑透明细胞癌或中肾管腺癌.

 好病例，学习了