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Int J Clin Exp Pathol 2013;6(8):1688-1692

Case Report
Ovarian mucinous cystic tumor with sarcoma-like mural nodules and multifocal
anaplastic carcinoma: a case report

Jinfeng Zheng, Ming Geng, Peifeng Li, Yi Li, Yongcheng Cao

Department of Pathology, General Hospital of Jinan Military Command, Jinan, China; Department of oncology, Kunming General Hospital of
Chengdu Military Command, Kunming, China

Received June 7, 2013; Accepted June 29, 2013; Epub July 15, 2013; Published August 1, 2013

Abstract: A 48-year-old woman presented with left abdominal pain and fullness. Computed tomography scan revealed a multicystic mass with
multifocal mural nodules. Histologic examination showed a mucinous cystic tumor with cystadenoma, borderline malignant cystadenoma and
cystadenocarcinoma, which were associated with sarcoma-like mural nodules (SLMNs) and multifocal anaplastic carcinoma. Mural nodules
showed a positive reaction for CD56 and vimentin, but were negative for cytokeratin 7 and SMA. She underwent postoperative chemotherapy
and is currently under follow-up; no recurrence or metastases were found in the first year of follow-up. Ovarian mucinous cystic tumor with
SLMNs and foci of anaplastic carcinoma is extremely rare. To our knowledge, this case reports the most complex neoplastic and reactive
components. Our findings shed some light on the pathogenesis of this rather rare carcinoma. We think that the formation of SLMNs may be the
result of the reactive proliferation of undifferentiated mesenchymal cells, while the anaplastic carcinoma may be derived from mucinous
epithelium. Moreover, because of difficulties encountered in their differential diagnosis, we think that the existence of foci of anaplastic
carcinoma along with SLMNs necessitates careful histologic and immunohistochemical analysis of mural nodules for the determination of
treatment and prognosis. (IJCEP1306008).

Keywords: Mucinous cystic tumor, sarcoma-like mural nodule, anaplastic carcinoma, cystadenoma, cystadenocarcinoma

Address correspondence to: Dr. Ming Geng and Peifeng Li, Department of Pathology, General Hospital of Jinan Military Command, Jinan,
Shandong Province 250031, P.R. China. E-mail: gm2227@sina.com; lipeifeng00@hotmail.com