Ovary

Mucinous tumors

Mucinous cystadenoma / adenofibroma


Editorial Board Member: C. Blake Gilks, M.D.
Deputy Editor-in-Chief: Jennifer A. Bennett, M.D.
Gulisa Turashvili, M.D., Ph.D.

Topic Completed: 28 September 2021

Minor changes: 28 September 2021

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PubMed Search: Mucinous cystadenoma[TI] OR mucinous adenofibroma[TI] ovary[TIAB] full text[SB]

Gulisa Turashvili, M.D., Ph.D.
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Cite this page: Turashvili G. Mucinous cystadenoma / adenofibroma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumormucinousbenign.html. Accessed October 15th, 2021.
Definition / general
  • Benign mucinous neoplasm composed of cysts and glands lined by gastrointestinal or Müllerian type mucinous epithelium lacking architectural complexity or cytologic atypia
Essential features
  • Includes cystadenoma and adenofibroma
  • Usually unilateral and composed of variable amounts of cysts and glands lined by bland gastrointestinal or Müllerian type mucinous epithelium and variably cellular stroma
  • May be associated with mature teratoma or Brenner tumor
  • Excellent prognosis, with rare recurrences associated with cystectomy or rupture
ICD coding
  • ICD-O:
    • 8470/0 - mucinous cystadenoma, NOS
    • 9015/0 - mucinous adenofibroma, NOS
  • ICD-11:
    • 2F32.Y & XH6H73 - other specified benign neoplasm of ovary and mucinous cystadenoma, NOS
    • 2F32.Y & XH59X8 - other specified benign neoplasm of ovary and mucinous adenofibroma, NOS
Epidemiology
Sites
Pathophysiology
Etiology
  • Unknown
Clinical features
  • Abdominal distention with or without palpable mass
  • Abdominal or pelvic pain
  • Other symptoms related to abdominal / pelvic mass
  • Rarely, estrogenic or androgenic manifestations secondary to stromal luteinization (Int J Gynecol Pathol 2005;24:4)
Diagnosis
  • Microscopic examination
Laboratory
Radiology description
  • Ultrasonography:
    • Usually large multilocular cystic adnexal mass with numerous thin septations
    • Various degrees of echogenicity in different locules
    • Low level internal echogenicity due to increased mucin content
  • Magnetic resonance imaging:
    • Usually large multilocular cyst containing fluid of various viscosity resulting in variable signal intensities on both T1 and T2 sequences (stained glass appearance)
  • Reference: Radiographics 2000;20:1445, Radiographics 2019;39:982
Radiology images

Images hosted on other servers:
Palpable lower abdominal mass

Palpable lower abdominal mass

Right pelvic pain and dysmenorrhea

Right pelvic pain

Prognostic factors
Case reports
Treatment
  • Oophorectomy or cystectomy
Gross description
  • Usually unilateral (95%)
  • Smooth or bosselated surface
  • Cystadenoma:
    • Uni or multilocular cyst with variably sized smooth walled locules
    • Filled with dense, viscous, sticky, gelatinous material
    • No solid areas or papillary excrescences
    • Mean size 10 cm, rarely > 30 cm
  • Adenofibroma:
Gross images

AFIP images

Mucinous cystadenoma

Associated with dermoid cyst

Frozen section description
  • Benign cystic neoplasm lined by a single layer of bland mucinous epithelium (cystadenoma) or solid and cystic neoplasm composed of small glands or cysts lined by a single layer of bland mucinous epithelium set in a fibromatous stroma (adenofibroma)
Frozen section images

Contributed by Gulisa Turashvili, M.D., Ph.D.
Unilocular cyst

Unilocular cyst

Bland mucinous epithelium Bland mucinous epithelium

Bland mucinous epithelium

Microscopic (histologic) description
Microscopic (histologic) images

Contributed by Gulisa Turashvili, M.D., Ph.D. and AFIP images
Unilocular cyst

Unilocular cyst

Bland mucinous epithelium Bland mucinous epithelium Bland mucinous epithelium

Bland mucinous epithelium

Mucinous adenofibroma Mucinous adenofibroma

Mucinous adenofibroma


Mucinous cystic tumor Mucinous cystic tumor

Mucinous cystic tumor

Virtual slides

Images hosted on other servers:
Mucinous cystic neoplasm

Mucinous cystic neoplasm

Mucinous cystadenoma associated with Brenner tumor

Mucinous cystadenoma associated with Brenner tumor

Mucinous cystadenoma with functioning stroma

Mucinous cystadenoma with functioning stroma

Mucinous cystadenoma, intestinal type

Mucinous cystadenoma, intestinal type


PAX8

PAX8

CK7

CK7

CK20

CK20

Cytology description
  • Usually negative cytology or reactive mesothelial cells
Positive stains
Molecular / cytogenetics description
Sample pathology report
  • Right fallopian tube and ovary, salpingo-oophorectomy:
    • Ovary: mucinous cystadenoma
    • Fallopian tube: benign
Differential diagnosis
Board review style question #1

Which immunohistochemical markers are useful for differentiating this primary ovarian tumor from a low grade appendiceal mucinous neoplasm involving the ovary?

  1. CK7, CK20, CDX2, SATB2 and PAX8
  2. CK7, CK20, CDX2, WT1 and SATB2
  3. CK7, CK20, PAX8, ER and SATB2
  4. CK7, CK20, SATB2, ER and PR
  5. CK7, CK20, SATB2, WT1 and PAX8
Board review style answer #1
A. CK7, CK20, CDX2, SATB2 and PAX8. Low grade appendiceal mucinous neoplasm is usually positive for CK20, CDX2 and SATB2 and negative for CK7 and PAX8.

Comment Here

Reference: Mucinous cystadenoma / adenofibroma
Board review style question #2
Which of the following is true for ovarian mucinous cystadenoma?

  1. Always positive for PAX8
  2. May be associated with mature teratoma or Brenner tumor
  3. Most common in postmenopausal women
  4. Usually bilateral ovarian involvement
  5. Usually positive for ER and PR
Board review style answer #2
B. May be associated with mature teratoma or Brenner tumor

Comment Here

Reference: Mucinous cystadenoma / adenofibroma
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