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- 左卵巢囊肿，子宫内膜样癌？浆乳癌？（补传图片）
Chengquan, my friend, I am not totally convinced that this is an endometrioid adenocarcinoma. As matter of fact, it does not look like common ovarian primary carcinoma we usually seen. If I am forced to classify it according to 5 ovarian epithelial types, It looks more mucinous to me. If it is mucinous, then we have to expand our list of differential diagnoses. The most important issue is to make sure we exclude the metastasis from other sources for a mucinous adenocarcinoma in a ovary. Although it is unilateral, on left side and morphologically somewhat papillary , we cannot call this primary till we exclude metastasis. I totally agree with Dr. Zhao that you may want to do CK7, CK20, CDX2 to rule out GI origin first.
Also you want to examine to see if there is:
1) ovarian surface involvement, since most primary ovarian mucinous carcinoma are in low stage and do not involve ovarian surface. In contrast, most metastatic carcinoma will have surface involvement.
2) to see if any areas of benign mucinous cystadenoma or borderline mucinous tumor
3) to see if there is teratoma component, which can be good evidence for primary ovarian carcinoma.
4) to see if there is evidence of endometriosis
4) to get history to see if the patient has other known malignancy, such as stomach, cervix, breast, kidney or pancreas.
If all above are negative and immmunostain supports primary, then we can safely render it as a primary ovarian adenocarcinoma, favor mucinous type. In any sense, I feel this is not a straight forward case.
- 不坠青云之志，长怀赤子之心
| 以下是引用cqzhao在2009-9-8 12:34:00的发言：
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- If you have great talents, industry will improve them; if you have but moderate abilities, industry will supply their deficiency. 如果你很有天赋，勤勉会使其更加完美；如果你能力一般，勤勉会补足其缺陷。
| 以下是引用杨斌在2009-10-8 22:04:00的发言：
Chengquan, my friend, I am not totally convinced that this is an endometrioid adenocarcinoma. As matter of fact, it does not look like common ovarian primary carcinoma we usually seen. If I am forced to classify it according to 5 ovarian epithelial types, It looks more mucinous to me. If it is mucinous, then we have to expand our list of differential diagnoses. The most important issue is to make sure we exclude the metastasis from other sources for a mucinous adenocarcinoma in a ovary. Although it is unilateral, on left side and morphologically somewhat papillary , we cannot call this primary till we exclude metastasis. I totally agree with Dr. Zhao that you may want to do CK7, CK20, CDX2 to rule out GI origin first. Also you want to examine to see if there is: 1) ovarian surface involvement, since most primary ovarian mucinous carcinoma are in low stage and do not involve ovarian surface. In contrast, most metastatic carcinoma will have surface involvement. 2) to see if any areas of benign mucinous cystadenoma or borderline mucinous tumor 3) to see if there is teratoma component, which can be good evidence for primary ovarian carcinoma. 4) to see if there is evidence of endometriosis 4) to get history to see if the patient has other known malignancy, such as stomach, cervix, breast, kidney or pancreas. If all above are negative and immmunostain supports primary, then we can safely render it as a primary ovarian adenocarcinoma, favor mucinous type. In any sense, I feel this is not a straight forward case. |
- If you have great talents, industry will improve them; if you have but moderate abilities, industry will supply their deficiency. 如果你很有天赋，勤勉会使其更加完美；如果你能力一般，勤勉会补足其缺陷。
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