Invasive breast carcinoma - IARC

A
Fig. 2.119 Hepatoid carcinoma. A Note the trabecular pattern with thick cords of hepatoid cells. B Positive staining for alpha-fetoprotein is observed.
B
Immunoprofile
Immunohistochemical markers for neuro n
specific enolase are typically positive,
and a minority of cases were positive for
c h romogranin {761}.
Cytometric studies
The majority of neoplasms are aneuploid
by flow cytometry {761}.
Prognosis and predictive factors
The neoplasm is highly malignant, and
the behaviour has been aggre s s i v e
regardless of stage {761}.
Large cell neuroendocrine
carcinoma
Definition
A malignant tumour composed of large
cells that show neuroendocrine differentiation.
Synonym
Undifferentiated carcinoma of non-small
cell neuroendocrine type.
Clinical features
Two series of ovarian neuroendocrine
carcinomas of non-small cell type have
been reported {455,756}. The patients
were in the reproductive age group or
beyond (mean 56 years) and presented
with symptoms related to a pelvic mass
in the majority of cases {756}.
Histopathology
These tumours have in all the re p o rt e d
cases been associated with a tumour of
s u rface epithelial-stromal type, either
benign or malignant {455,542,756}. The
n e u roendocrine component consisted
of medium to large cells. Nuclei contained
prominent nucleoli, and mitoses
w e re frequent. The solid component
stained for chromogranin, and neuropeptides
were demonstrated in some
cases.
Prognosis and predictive factors
This type of tumour appears to be highly
a g g ressive; only the neuroendocrine carcinoma
component was present in the
metastatic sites {455}.
Hepatoid carcinoma
Definition
A primary ovarian neoplasm that histologically
resembles hepatocellular carc i n o-
ma and is positive for alpha-fetoprotein.
Epidemiology
Hepatoid carcinoma of the ovary is a
r a re tumour; only 12 cases have been
re p o rted {1798,2629,2951}. It mainly
occurs in postmenopausal women with
a mean age of 59.6 years (range, 35-78
years).
Clinical features
The symptoms are not specific and are
related to an ovarian mass {2629}.
Elevation of serum alpha-fetopro t e i n
(AFP) is characteristic, and CA125 is elevated
in most cases.
Macroscopy
Tumours vary from 4-20 cm in maximum
dimension with no distinctive macroscopic
features {1798,2629,2951}. In
some cases, formalin fixation re v e a l s
green-coloured areas suggestive of bile
production {2629}.
Histopathology
The tumour cells are arranged in sheets,
c o rds and trabeculae with moderate to
abundant amounts of eosinophilic cytoplasm
and distinctive cell borders re s e m-
bling hepatocellular carcinoma. Mitoses
a re generally conspicuous. PA S - p o s i t i v e ,
d i a s t a s e - resistant hyaline globules and
Hall stain-positive bile pigment can be
seen. The presence of immunore a c t i v e
AFP and protein induced by vitamin K
absence or antagonist II (PIVKA-II)
shows functional diff e rentiation toward
hepatocytes {1307,2629}. CA125 is positive
in one-half of the tumours {2629}.
Differential diagnosis
Metastatic hepatocellular carcinoma and
hepatoid yolk sac tumour must be ruled
out {3197}.
Histogenesis
Tumours admixed with serous carcinoma
and tumour cells positive for CA125 suggest
an ovarian surface epithelial origin
{1307,2610,2629}.
Prognosis and predictive factors
Clinical outcome is poor. Seven out of 12
patients died between 4 months and 5
years (mean, 19 months) after initial diagnosis,
and 2 patients had a tumour re c u r-
rence after 6-7 months {1798,2629,2 9 5 1 } .
Tumours resembling adenoid cystic
carcinoma and basal cell tumour
Definition
A group of primary ovarian tumours that
histologically resemble certain tumours
of the salivary glands or cutaneous basal
cell carcinoma.
184 Tumours of the ovary and peritoneum