Question: 20210005

Status


Final

Category


#1:   Reportability
#2:   Histology
#3:   Ovary


References


Source 1:   ICD-O-3
pgs:  
Notes:  
Source 2:   2021 ICD-O-3.2 UPDATE
pgs:  
Notes:   Table 1.


Question


Reportability/Histology--Ovary:  Is a 2020 ovary case reportable with the positive malignant findings in adnexal cystic fluid and peritoneal washing? See Discussion.



Discussion


11/24/20 Adnexal mass, cyst fluid: Positive for malignant cells. Clusters of inhibin-positive, CK7-negative cells, consistent with adult granulosa cell tumor cells. Groups of inhibin-negative, CK7-positive epithelial cells consistent with serous borderline tumor cells. Peritoneal washing: Positive for malignant cells. Small groups of inhibin-positive, CK7-negative cells, consistent with adult granulosa cell tumor cells.

A. Left ovarian mass: Adult granulosa cell tumor (AGCT) of ovary (see note). pTNM Stage: pT1c3 pNX - Serous borderline tumor (SBT) of ovary (see note). pTNM Stage: pT1a pNX.  Fallopian tube; unremarkable.

B. Right ovary: - Serous cystadenofibroma of ovary.  Fallopian tube; unremarkable.

C. Left pelvic wall nodule: Fibro-calcified nodule, consistent with necrotic appendix epiploica.

D. Uterus (hysterectomy):  Uterine leiomyomas. Endosalpingiosis of uterine serosa and paracervical tissue. Atrophic endometrium.

Note: The left ovarian mass is involved by a combined adult granulosa cell tumor and a serous borderline tumor. The AGCT mainly involves the thick-walled cystic area while the SBT the thin-walled cyst/s. The 2 neoplastic elements do, however, demonstrate areas of intimate and close intermingling. From the current literature, it appears that, based on FOXL2 mutation, the AGCT component of combined AGCT and ovarian epithelial tumors is either a true neoplastic processes or an AGCT- like proliferation morphologically indistinguishable from AGCT. To further evaluate the nature of the AGCT component, a FOXL2 analysis is in progress and an addendum will follow.



Answer


For cases diagnosed prior to 2021, report adult granulosa cell tumor of ovary only when stated to be malignant or when metastases are indicated, as by the positive peritoneal washings for this 2020 case.  Beginning in 2021, report all cases of adult granulosa cell tumor of ovary based on ICD-O-3.2.



History




Last Updated


01/14/2021

Date Finalized


04/02/2021