肿瘤大约10cm，囊实性，散在菜花样乳头

本例无论年龄大小，从图片看足够癌了，是膨胀性浸润性生长。宫颈型黏液性乳头状囊腺癌。

Need 1 slide per cm for ovarian tumor.

treatment is the duty of gyncologists.  

膨胀性浸润 mean confulent growth in size 3 or 5 mm. It means invasive ca

上皮内癌 if foci of mucinous borderline tumor show high nuclear grade (grade 3), you can dx mucinous borderline tumor with focal intraepithelial ca. It is not invasion.

there is no the concept of 上皮内癌 in serus or endometrioid borderline tumor.

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

浆液性乳头状腺癌

究 结：borderline or carcinoma?

Anyway intraepithelial carcinoma is not present in this case

Should have many sections

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

My feeling is that mucinous carcinoma with expansile invasion.

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

浆乳癌

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.

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。

Good point

浆液性乳头状囊腺癌

粘液性乳头状囊腺癌

怎么看都是粘液型，问题是交界还是癌？

卵巢浆液-黏液性乳头状囊腺癌？

混合性乳头状囊腺癌

浆液性乳头状腺癌