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Low-grade Serous Neoplasms of the Ovary With Transformation to High-grade Carcinomas: A Report of 3 Cases

Garg, Karuna M.D.; Park, Kay J. M.D.; Soslow, Robert A. M.D

International Journal of Gynecological Pathology: September 2012 - Volume 31 - Issue 5 - p 423–428
doi: 10.1097/PGP.0b013e31824ae6f2
Pathology of the Upper Genital Tract: Original Articles

Ovarian borderline tumors usually occur in young patients and are associated with good clinical outcomes. A proportion of these tumors, particularly those with micropapillary features, may progress to low-grade serous carcinomas. Evolution of low-grade serous neoplasms to high-grade carcinomas is rare and infrequently reported. In this case report, we describe 3 cases of serous borderline tumor that progressed to high-grade carcinoma. Patient ages were 22, 35, and 47yr. Two patients were initially diagnosed with ovarian serous borderline tumor, and recurred in the pelvis 3 and 10 yr later with sarcomatoid carcinoma. The third patient presented with low-grade serous carcinoma arising in a micropapillary serous borderline tumor, and recurred with a carcinosarcoma 3 yr later. All 3 patients had an aggressive clinical course: 2 died of disease and 1 patient has disease progression on chemotherapy. Occasional low-grade serous tumors of the ovary may transform to high-grade carcinomas, which can occur many years after initial diagnosis. The presence of a high-grade component significantly worsens patient outcomes.

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY

The authors declare no conflict of interest.

Address correspondence and reprint requests to Karuna Garg, MD, Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. E-mail:

©2012International Society of Gynecological Pathologists