Morphologic changes in ovarian carcinoma after neoadjuvant chemotherapy: Report of a case showing extensive clear cell changes mimicking clear cell carcinoma Journal Article


Authors: Chew, I.; Soslow, R. A.; Park, K. J.
Article Title: Morphologic changes in ovarian carcinoma after neoadjuvant chemotherapy: Report of a case showing extensive clear cell changes mimicking clear cell carcinoma
Abstract: Neoadjuvant chemotherapy followed by interval debulking has become an alternative treatment option for patients with advanced-stage ovarian cancer. The effects of chemotherapy on the histologic features of the tumor have not been well described for ovarian carcinoma, especially related to changes that significantly alter the appearance of the tumor. In this study, we describe a case of ovarian serous carcinoma status-post neoadjuvant chemotherapy that showed exuberant clear cell/foamy change. This unusual morphology raised the possibility of a mixed epithelial carcinoma or a secondary malignancy. Immunohistochemical stains were performed to help distinguish whether the tumor was a serous carcinoma with chemotherapy-induced clear cell change or a distinct clear cell carcinoma of ovarian or extraovarian origin. The clear cell and conventional serous components showed diffuse positivity for CK7, CA125, and ER; however, only the clear cell component was positive for hepatocyte nuclear factor-1β and only the conventional serous component was positive for WT1. Although there was a slight discrepancy in the staining patterns, given the lack of other typical histologic features of clear cell carcinoma, the unusual clear cell morphology was most likely the result of chemotherapy-induced changes. © 2009 International Society of Gynecological Pathologists.
Keywords: immunohistochemistry; human tissue; aged; aged, 80 and over; cancer surgery; histopathology; splenectomy; case report; advanced cancer; hypertension; multimodality cancer therapy; paclitaxel; cancer adjuvant therapy; neoadjuvant therapy; cancer staging; salpingooophorectomy; cytoreductive surgery; ovarian neoplasms; cell structure; carboplatin; computer assisted tomography; multiple cycle treatment; diagnosis, differential; antineoplastic combined chemotherapy protocols; tumor markers, biological; cell differentiation; drug effect; lung embolism; tissue section; cancer size; staining; ovary carcinoma; heparin; mixed tumor; therapy effect; thorax radiography; clear cell carcinoma; morphologic changes; neoadjuvant chemotherapy; ovarian carcinoma; ca 125 antigen; cytokeratin 7; hepatocyte nuclear factor 1beta; wt1 protein; appendectomy; general condition improvement; pleura fluid; proctocolectomy; second cancer; vaginal hysterectomy; adenocarcinoma, clear cell; cystadenocarcinoma, serous; hypercholesterolemia; pleural effusion, malignant
Journal Title: International Journal of Gynecological Pathology
Volume: 28
Issue: 5
ISSN: 0277-1691
Publisher: Lippincott Williams & Wilkins  
Date Published: 2009-09-01
Start Page: 442
End Page: 446
Language: English
DOI: 10.1097/PGP.0b013e3181a071b5
PUBMED: 19696613
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 30 November 2010" - "CODEN: IJGPD" - "Source: Scopus"
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  1. Kay Jung Park
    305 Park
  2. Robert Soslow
    793 Soslow