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- Title
'Clear cell morular elements' in carcinosarcoma of the female genital tract.
- Authors
Shirsat, H.; Offman, S. L.
- Abstract
Objective: Retrospectively review recent cases of carcinosarcoma (MMMT) of the female genital tract, and determine the frequency of a novel observation, coined 'clear cell morular elements (CCME)', in the high-grade carcinomatous components. Methods: Twenty-seven resection specimens of MMMT, diagnosed between 2011 and 2015 were retrieved using an LIS search. All histologic slides from each case were reviewed retrospectively for the presence of CCME and non-specific clear cell changes in the carcinomatous components. Data and Results: Site of primary involvement of MMMT included uterine (20), ovarian (4), tubal (1), tubo-ovarian (1), and omental (1). One ovarian example, and the tubal and omental cases, each represented sarcomatous 'dedifferentiation' within metastases of uterine or tuboovarian serous carcinoma. The age at diagnosis ranged from 48-79 years. Eight cases of MMMT included CCME (30%). These included both upper and lower mullerian tract sites, but preferentially included the examples of 'dedifferentiation' at metastatic sites (3/8). Microscopically, these included discrete nests of 'ambiguous' carcinomatous epithelium, with primitive high-grade cells located peripherally, and central 'morular' aggregates of clear cells with variable squamoid features. These areas did not resemble either typical endometrioid or clear cell carcinoma. Eighteen cases had clear cell change (not otherwise specified) in the high-grade carcinomatous component that lacked these specific features. Conclusion: Although present in only a minority of cases (30%), the presence of CCME in a high-grade carcinoma is a distinct pattern not previously described, and should raise suspicion for the presence of MMMT, and prompt one to carefully search for sarcomatous components. This may be particularly true of examples which represent 'dedifferentiation' of serous carcinoma.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p34
- ISSN
1918-915X
- Publication type
Article