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Table of Contents
Definition / general | Epidemiology | Sites | Etiology | Clinical features | Laboratory | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Gupta N Mesothelioma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumormesothelioma.html. Accessed February 21st, 2019.
Definition / general
- Primary ovarian malignant mesotheliomas (POMM) are a rare, aggressive neoplasm of mesothelial cells, with poor prognosis
- Patients usually present with widespread peritoneal tumor, but occasionally involvement is limited to 1-2 ovaries
- Needs to be differentiated from secondary ovarian involvement by peritoneal malignant mesothelioma
- POMM: greater degree of ovarian enlargement, striking parenchymal replacement (Am J Surg Pathol 1996;20:1067)
Epidemiology
- Median age 52 years, range 16 to 63 years
Sites
- Peritoneum, pericardium, tunica vaginalis
Etiology
- Asbestos exposure, prior radiotherapy
Clinical features
- Abdominal or pelvic pain, abdominal swelling or adnexal mass (Am J Surg Pathol 1996;20:1067)
Laboratory
- CA-125, CA19-9, and AFP are usually normal (Acta Cytol 1995;39:164)
Case reports
- 50 year old woman with simultaneous occurrence of well differentiated papillary mesothelioma and endometrioid ovarian cancer (Gynecol Oncol Case Rep 2013;4:53)
Treatment
- Surgery with / without chemotherapy or radiotherapy
Gross description
- 3 to 15 cm, usually bilateral
- Solid with small cysts
Gross images
Solid mural nodule and tumor on cyst lining
Microscopic (histologic) description
- Epithelial or biphasic tumor with papillary, tubular-glandular or solid patterns with features of malignancy
- Tumor cells have moderate atypia and low mitotic rate
- Stroma is hyalinized, occasionally with striking hyalinized cores and psammoma bodies
Microscopic (histologic) images
Solid and tubulopapillary patterns
Surface of ovary
Images hosted on other servers:
Well differentiated papillary tumor
Biphasic tumor
Calretinin+
Positive stains
- Alcain blue+ intracytoplasmic material
- Calretinin, CD10, cytokeratin, WT1
Differential diagnosis
- Primary peritoneal malignant mesthelioma: main tumor bulk is outside ovary
- Reactive mesothelial hyperplasia: no atypia
- Serous papillary adenocarcinoma: multilayering, cell stratification, cytologic atypia, mitosis (Am J Surg Pathol 2010;34:627)
