Invasive breast carcinoma - IARC

whelmingly poor {1038,1547,2310}.
Histopathological criteria
Although the detection rate of
micrometastases in bone marrow and
body fluids has recently been shown to
be higher with reverse transcriptase
polymerase chain reaction of the EWS-
WT1 fusion transcript, the clinical significance
of molecularly-detectable micrometastases
of DSRCT remains unknown
{128}.
A
Primary epithelial tumours of
müllerian type
Definition
Primary epithelial tumours of the peritoneum
that resemble malignant ovarian
surface epithelial-stromal tumours.
Primary peritoneal carcinoma
Definition
A variety of extraovarian neoplasms that
histologically resemble surf a c e - e p i t h e-
lial-stromal tumours of ovarian origin.
B
Fig. 2.143 Desmoplastic small round cell tumour of the peritoneum. A Irregular islands of tumour cells are
separated by fibrous stroma. B The tumour cells are small and round with high nuclear to cytoplasmic
ratios.
Fig. 2.144 Primary peritoneal serous carcinoma. This serous tumour is composed of papillary fronds and
gland-like spaces.
Epidemiology
P r i m a ry peritoneal carcinoma (PPC)
occurs almost exclusively in women with
a median age of 62 years. The lifetime
risk is estimated to be 1 case per 500
women, since approximately 15% of "typical"
epithelial ovarian cancers are actually
PPCs {2575,2576}.
Histopathology
Histological and immunohistochemical
examination of PPC is virtually indistinguishable
from epithelial ovarian carcinoma.
The most common histological variant
is serous adenocarcinoma, but clear
cell, mucinous, transitional cell and
squamous cell carcinomas have all been
re p o rted to originate from the peritoneum.
Rare cases of primary psammocarcinoma
of the peritoneum have been
described {1001}. The following are
required to meet the criteria for PPC:
(1). Both ovaries must be normal in size or
enlarged by a benign pro c e s s .
(2). The involvement in the extraovarian
sites must be greater than the involvement
on the surface of either ovary
(3). The ovarian tumour involvement must
be either non-existent, confined to ovarian
s u rface epithelium without stromal invasion,
or involving the cortical stroma with
Peritoneal tumours 201