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Mucinous Cystadenoma Coexisting With Adult Granulosa Cell Tumor in the Ovary: Is It a Composite Tumor or Heterologous Mucinous Elements in a Granulosa Cell Tumor?

Subrahmanya, Nagesh Babu M.D.; Kapadi, Surendra Nayak M.D.; Junaid, Thamradeen A. F.R.C.Path.

International Journal of Gynecological Pathology: July 2011 - Volume 30 - Issue 4 - p 386–390
doi: 10.1097/PGP.0b013e31820f31f6
Pathology of the Upper Genital Tract: Case Reports

We herein report a rare tumor combination of mucinous cystadenoma and an adult granulosa cell tumor in the same ovary of a 50-year-old woman. Ultrasound examination showed a multicystic mass in the left ovary. Histologically it showed 2 components that were intimately admixed. One was composed of cysts lined by mucinous epithelium of the intestinal type that was strongly positive for cytokeratin-20 and cytokeratin-7. The other was a granulosa cell tumor of the adult type in which the tumor cells showed microfollicular, sheets, and trabecular patterns. They were positive for calretinin, α-inhibin, and CD99. There are many theories for the histogenesis of such a combination. After discussing all the possibilities we conclude that the mucinous component is probably a heterologous mucinous differentiation within an adult granulosa cell tumor because of the intimate admixture of the 2 components and the mucinous epithelium being of the intestinal type.

Department of Histopathology (N.B.S., S.N.K.), Maternity Hospital

Department of Pathology (T.A.J.), Faculty of Medicine, Kuwait University, Kuwait

Address correspondence and reprint requests to Nagesh Babu Subrahmanya, MD, PO Box 2223, Al Ardiya-92400, Kuwait. e-mail: nageshbabu_s1@rediffmail.com

©2011International Society of Gynecological Pathologists