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Monoclonal origin of peritoneal implants and lymph node deposits in serous borderline ovarian tumors (s-BOT) with high intratumoral homogeneity.
- Source :
-
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists [Int J Gynecol Pathol] 2014 Nov; Vol. 33 (6), pp. 592-7. - Publication Year :
- 2014
-
Abstract
- Molecular studies have shown that the most prevalent mutations in serous ovarian borderline tumors (s-BOT) are BRAF and/or KRAS alterations. About one third of s-BOT represent peritoneal implants and/or lymph node involvement. These extraovarian deposits may be monoclonal or polyclonal in origin. To test both the hypotheses, mutational analyses using pyrosequencing for BRAF codon 600 and KRAS codon 12/13 and 61 of microdissected tissue was performed in 15 s-BOT and their invasive and noninvasive peritoneal implants. Two to 6 implants from different peritoneal sites were examined in 13 cases. Lymph node deposits were available for the analysis in 3 cases. Six s-BOT showed mutation in exon 2 codon 12 of the KRAS proto-oncogen. Five additional cases showed BRAF p.V600E mutation representing an overall mutation rate of 73.3%. Multiple (2-6) peritoneal implants were analyzed after microdissection in 13 of 15 cases. All showed identical mutational results when compared with the ovarian site of the disease. All lymph node deposits, including those with multiple deposits in different nodes, showed identical results, suggesting high intratumoral mutational homogeneity. The evidence presented in this study and the majority of data reported in the literature support the hypothesis that s-BOT with their peritoneal implants and lymph node deposits show identical mutational status of BRAF and KRAS suggesting a monoclonal rather than a polyclonal disease regarding these both tested genetic loci. In addition, a high intratumoral genetic homogeneity can be suggested. In conclusion, the results of the present study support the monoclonal origin of s-BOT and their peritoneal implants and lymph node deposits.
- Subjects :
- Adult
Aged
Cystadenofibroma pathology
DNA Mutational Analysis
Female
Humans
Lymphatic Metastasis pathology
Middle Aged
Ovarian Neoplasms pathology
Peritoneal Neoplasms secondary
Polymerase Chain Reaction
Proto-Oncogene Proteins genetics
Proto-Oncogene Proteins B-raf genetics
Proto-Oncogene Proteins p21(ras)
Young Adult
ras Proteins genetics
Cystadenofibroma genetics
Lymphatic Metastasis genetics
Ovarian Neoplasms genetics
Peritoneal Neoplasms genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1538-7151
- Volume :
- 33
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
- Publication Type :
- Academic Journal
- Accession number :
- 25272298
- Full Text :
- https://doi.org/10.1097/PGP.0000000000000103