肿瘤大约10cm，囊实性，散在菜花样乳头

浆液性乳头状腺癌

卵巢粘液性囊性乳头状癌（颈管型）

浆液性乳头状腺癌

混合性乳头状囊腺癌

卵巢浆液-黏液性乳头状囊腺癌？

怎么看都是粘液型，问题是交界还是癌？

粘液性乳头状囊腺癌

浆液性乳头状囊腺癌

Good point

粘液性乳头状囊腺癌，部分区域呈交界性。考虑患者16岁，如果肿瘤表面包膜完整光滑，无乳头，腹水细胞学未见肿瘤细胞，在临床处理上可以保守些。

1. Firstly, need to rule out metastatic ca. CK7/CK20/CDX2/PAX8 stains can be helpful. Of cause clinical correlation with imaging is needed.

2. If it is ovarian tumor, it is a mucinous tumor. Question is that it is a borderline tumor or carcinoma.

3. Check carefully to see if microinvasion is present.

4. It is not like stromal breakdown invasion. Need to see if it is enough to call expansile invasion.

5. Criteria of  expansile invasion: Some authors suggested the focus be at least 3 mm, or 5 mm or 10mm2; but some authors have no minimal size criteria.

浆乳癌

My feeling is that mucinous carcinoma with expansile invasion.

Of cause, need to review all slides for definite dx.

Generally speaking, staging is needed even though for ovarian borderline tumor

Should have many sections

究 结：borderline or carcinoma?

Anyway intraepithelial carcinoma is not present in this case

浆液性乳头状腺癌

谢谢赵老师，赵老师认为是膨胀性浸润，请问其与上皮内癌的区别如何把握？鉴于患者年轻诊断需要非常谨慎的，临床处理又有何不同？病例是会诊病例，原单位描述肿瘤直径达到16cm，关于该侧肿瘤的切片只有6张，目前所看见的代表性区域如图所示，主要是患者过于年轻，我目前的处理上好是建议原单位多取材或者拿标本来。如履薄冰啊