2018, Number 04
Ginecol Obstet Mex 2018; 86 (04)
López-Carpintero N, Salazar-Arquero FJ, Ibáñez-Santamaría A, de la Fuente-Valero J, Aramendi-Sánchez T, Hernández-Aguado JJ
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ABSTRACTBackground: Microglandular hyperplasia is most commonly located in the endocervix, but may appear in any location with mucinous glandular epithelium. Ovarian presentation is exceptional. It has been described in women after exposure to progesterone as contraceptive, without history of hormonal exposure and in postmenopausal. In 2014, WHO classified mucinous ovarian tumors as borderline mucinous, borderline seromucinous (mucinous tumors of the endocervical/müllerian type) and mucinous carcinoma.
Objective: To describe the diagnosis of an uncommon benign ovarian tumor in a patient who underwent hormonal stimulation for reproductive purposes.
Clinical case: 38-year-old patient with an ultrasound finding of a 25 x 33mm cystic formation with a thick and irregular wall, a 6mm vascularized papilla and a heterogeneous cystic content. The patient had undergone controlled ovarian hyperstimulation on four occasions, the last one 6 months prior to the finding, when she was on combined contraception prior to a new cycle. Right adnexectomy and peritoneal lavage were performed. The anatomopathological diagnosis was an endocervical mucinous proliferative tumor with microglandular hyperplasia and inflammatory cytology of the aspirated fluid. The immunohistochemical profile was: cytokeratin 7 positive and cytokeratin 20, CDX2 (homeobox protein) and CEA (carcinoembryonic antigen) negative. The monoclonal antibody Ki-67 was ‹ 10%. Estrogen receptors were focally positive and progesterone receptors positive in a diffuse and intense form. After treatment, the patient had a favorable evolution.
Conclusions: Microglandular hyperplasia may be present in ovarian mucinous benign tumors. A hormonal involvement should be considered.