Invasive breast carcinoma - IARC

Clinical features
Adenoid cystic-like carcinoma presents
typically as a pelvic mass or abdominal
distension in postmenopausal women
{758}. On the other hand, the two cases
of adenoid cystic carcinoma occurred in
the reproductive age group {837,3248}.
Cases of basal cell carcinoma of the
ovary also typically present as a pelvic
mass but occur over a wide age range
{758}.
Histopathology
These neoplasms histologically re s e m b l e
adenoid cystic carcinoma, basal cell
tumours of salivary gland or cutaneous
basal cell carcinoma and occur in several
f o rms. The adenoid cystic-like carc i n o-
mas resemble adenoid cystic carc i n o m a
of salivary gland but lack a myoepithelial
component {758}. On the other hand a
myoepithelial component has been
demonstrated in the cases of adenoid
cystic carcinoma {837,3248}. Cribriform
p a t t e rns composed of uniform small cells
s u r rounding round lumens and cysts were
typical, and luminal mucin and hyaline
cylinders were common to both forms. A
s u rface epithelial-stromal component was
p resent in the great majority of cases of
adenoid cystic-like carcinoma {758} but
was absent in the cases of adenoid cystic
c a rcinoma {837,3248}. The cases of basal
cell tumour consisted of aggregates of
basaloid cells with peripheral palisading
{758}. Several tumours of this type had
foci of squamous diff e rentiation or gland
f o rmation, and some showed an
ameloblastoma-like pattern. A case of a
monomorphic adenoma of salivary gland
type described as a cribriform variant of
basal cell adenoma has been re p o rt e d
{2492}. In none of the re p o rted cases in
this group was there evidence of a teratoma
or other germ cell tumour.
Immunoprofile
Actin and S-100 protein stains were both
positive in the two cases of adenoid cystic
carcinoma {837,3248}; however, these
stains were negative in the cases of adenoid
cystic-like carcinoma {758}.
Fig. 2.120 Ovarian papillary mesothelioma. Note
the papillary tumour growth on the surface and a
haemorrhagic corpus luteum within the ovary.
cystic carcinoma have an excellent prognosis
with relatively limited follow up.
Ovarian malignant mesothelioma
Definition
Ovarian malignant mesotheliomas
(OMMs) are mesothelial tumours confined
mostly or entirely to the ovarian surface
and/or the ovarian hilus.
Aetiology
In the largest series there was no history
of asbestos exposure {526}.
Clinical features
The clinical presentation was usually
abdominal or pelvic pain or abdominal
swelling and an adnexal mass on pelvic
examination {526}.
Macroscopy
The tumours were typically solid and varied
from 3-15 cm in maximum dimension.
Most were bilateral.
Histopathology
The tumours usually involved both the
serosa and the parenchyma of the ovary.
The histological and immunohistochemical
characteristics of the OMM are analogous
to those observed in peritoneal
mesotheliomas. The pro l i f e r a t i n g
mesothelial tumour cells may invade and
partly replace ovarian tissue and/or the
hilar soft tissue.
Differential diagnosis
Just like diffuse peritoneal malignant
mesotheliomas, OMMs can extensively
involve one or both ovaries in a macroscopically
and histologically carcinomatous
growth pattern and may thus be
confused with ovarian epithelial neoplasms.
In this context immunohistochemical
detection of thrombomodulin,
calretinin, Ber-EP4 and cytokeratin 5/6
provide the most useful markers {2113}.
Prognosis and predictive factors
In the absence of sufficient follow-up
data for this rare neoplasm, OMM can be
assumed to have a prognosis similar to
its disseminated peritoneal analogue.
Prognosis and predictive factors
The prognosis of adenoid cystic-like carcinoma
is generally unfavourable and
appears to depend on the degree of
malignancy of the surface epithelial-stromal
component. On the other hand,
cases of basal cell tumour and adenoid
Fig. 2.121 Papillary mesothelioma of the ovary. Well differentiated papillary fronds of tumour grow from the
surface of the ovary.
Miscellaneous tumours and tumour-like conditions of the ovary 185