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Ovarian cancer is the 6th most common cancer in women. The main epithelial subtypes of ovarian cancer include high grade serous carcinoma, low grade serous carcinoma, endometrioid ovarian carcinoma, clear cell ovarian carcinoma and mucinous ovarian carcinoma. Our knowledge of the molecular basis of ovarian cancer has exponentially increased in the last few decades such that each subtype is now regarded as a distinct disease with specific morphological, immunohistochemical and molecular characteristics that allow for more personalized treatment. This article provides a comprehensive overview of the molecular pathology of the commonest types of epithelial ovarian carcinomas. This includes discussion of the scope of current molecular testing available in diagnostic practice and future avenues for testing as a result of translational studies. We also discuss the importance of pathologist involvement in molecular testing pathways, tumour board discussion and trial conduct with respect to ovarian cancer. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the safety of fertility-sparing surgery (FSS) in stage I endometrioid epithelial cancer (EEOC) and mucinous ovarian cancer (MOC). A retrospective case‒controlled study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database, focusing on stage I EEOC and MOC between 2000 and 2016. The effects of FSS on overall survival (OS) were compared using log-rank tests. Univariate and multivariate Cox analyses were performed to control for confounders. The study identified 970 patients with FIGO stage I EEOC and 810 with stage I MOC. Of these patients, 116 (12.0%) EEOC and 268 (33.1%) MOC patients underwent fertility-sparing surgery. The results showed that patients with G3 EEOC had a worse 5-year OS than patients with G1 EEOC (96.1% vs. 90.1%, p = 0.020). IC stage MOC patients had a worse prognosis than IA and IB stage patients (94.9% vs. 88.7%, p = 0.001). FSS did not significantly affect the 5-year OS of patients with EEOC (94.8% vs. 95.4%, p = 0.687) or MOC (95.9% vs. 92.3%, p = 0.071). Further subgroup analysis according to tumor stage and histological grade did not show a worse OS with FSS in stage I EEOC or MOC patients, even with high-risk types such as G3 histology and IC phase. In a multivariable analysis, the application of FSS was not associated with inferior OS in EEOC or MOC. FSS for patients with stage I EEOC or MOC does not lead to worse outcomes than radical surgery, making it a viable option for young patients with early-stage disease wishing to preserve fertility. [ABSTRACT FROM AUTHOR]

Objective: Overall, patients with mucinous ovarian carcinoma (MOC) are considered to have a better prognosis compared with the whole group of nonmucinous carcinomas. However, some studies indicate that patients with advanced-stage MOC might have a worse prognosis than those with advanced-stage serous ovarian carcinoma (SOC).We carried out a systematic review and meta-analysis of the current literature. Materials and Methods: A comprehensive literature search was carried out identifying 19 articles that compare survival of patients with MOC and patients with SOC. Meta-analyses were performed for risk ratio (RR) and hazard ratio (HR) for all International Federation of Gynecology and Obstetrics stages together, as well as for early- and advanced-stage diseases separately. Results: Overall, patients with MOC showed a lower risk of dying within 5 years (RR, 0.67; 95% confidence interval [CI], 0.64Y0.69; n = 45 333) and a longer survival (HR, 0.66; 95% CI, 0.58Y0.75; HR, 0.88; 95% CI, 0.78Y0.98, for univariate and multivariate analyses, respectively; n = 5540) compared with those with SOC. In contrast, in advanced-stage (International Federation of Gynecology and Obstetrics stages III and IV) disease, patients withMOChave a higher risk of dying within 5 years (RR, 1.15; 95%CI, 1.13Y1.17; n = 36 113) and a shorter survival (HR, 1.82; 95% CI, 1.71Y1.94; n = 19 907). Conclusions: Patients with advanced-stage MOC have a significantly worse prognosis compared with patients with SOC, whereas in early stage, the prognosis of patients with MOC is better. [ABSTRACT FROM AUTHOR]

Though ovarian malignancies are common, mucinous ovarian carcinomas of high grade are rare. They usually occur in a young female under 40 years of age. Here, we present a case of mucinous ovarian carcinoma (stage III), with omental involvement and incidental hydronephrosis in a 67-year-old female patient. A 67-year-old female patient presented to us with a history of lower abdominal pain for 2 months and per-vaginal discharge for the last 6 days. On deep palpation of the abdomen, a nodular mass occupying the suprapubic region was found. Bimanual palpation revealed a mass on the right and left adnexa. After visualization of septate cystic mass bilaterally on CECT, she was planned for staging laparotomy with bilateral salpingo-oophorectomy (BSO) with infra-colic omentectomy with peritoneal cytology. Incidentally, a horseshoe-shaped kidney with right mild hydronephrosis was found. After surgery and histopathologic examination, mucinous ovarian carcinoma (stage III), with omental involvement was confirmed. Mucinous ovarian carcinomas are rare malignancies, with different natural history, molecular profile, and prognosis as compared to other epithelial tumors of the ovary. These carcinomas can be either primary or secondary (those metastasized to the ovary from elsewhere), and this differentiation is essential. The therapeutic approach to the patients depends upon the stage at which these carcinomas are diagnosed. Mucinous ovarian carcinomas are rare and have unique features among the epithelial ovarian carcinomas. Appreciation of these features will surely make a positive impact in improving the management and thus the prognosis of these carcinomas. • Mucinous ovarian carcinomas are rare ovarian malignancies • They have distinct features when compared to other epithelial ovarian cancers • Appreciating the pathologic features will make diagnosis easier and hence a better prognosis [ABSTRACT FROM AUTHOR]