Papillary mesothelioma of ovary

Our plain-English summary of Papillary mesothelioma of ovary, by B.J. Addis, H. Fox (Histopathology, 1983).

The study

• Authors: B.J. Addis, H. Fox
• Journal: Histopathology
• Published: 1983;7(2):287-98
• Type of article: Case report
• Cited by: 18 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of primary papillary mesothelioma of the ovary is reported and its microscopic and ultrastructural features described. This tumour was an incidental surgical finding and was accompanied by multiple, partially cystic, peritoneal lesions with similar microscopic features. The histological pattern was predominantly papillary with well-differentiated mesothelial cells and a prominent stromal infiltrate that included large numbers of lymphocytes and lipid-filled macrophages. A comparison is made with adenomatoid tumours and with other tumours of ovarian epithelium and it is suggested that this tumour may represent the benign counterpart of one form of clear cell carcinoma of the ovary. The presence of multiple peritoneal lesions may indicate limited malignant potential comparable to some other papillary epithelial neoplasms of the ovary.

In plain English

This was a case report of one patient whose tumour the authors believed was a true papillary mesothelioma arising in the ovary. A 67-year-old Caucasian woman having planned gallbladder surgery was incidentally found to have a large left ovarian tumour and numerous small cystic lesions over the peritoneum and greater omentum. The ovary was removed and the peritoneal lesions were biopsied. The 183 g mass was mainly papillary. It was made of regular mesothelial cells, no mitoses were seen, and it contained lymphocytes and lipid-filled foamy macrophages. Electron microscopy showed mesothelial features. The omental lesions were mostly cystic, with similar papillary areas. Enquiries found no history of asbestos exposure, and no asbestos bodies were seen in the tissue. She recovered without further treatment and remained well; the article does not state for how long. The authors concluded this was a true ovarian neoplasm. They suggested its appearance indicated an indolent tumour whose spread would be limited to the peritoneal cavity, and proposed it might be the benign counterpart of one form of ovarian clear cell carcinoma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single patient), with light microscopy, special stains and electron microscopy of the tumour
• Who was studied: One 67-year-old Caucasian woman admitted for elective cholecystectomy, in whom an ovarian tumour was an incidental finding; place and date of treatment not stated beyond the authors' departments (Royal Naval Hospital, Haslar, and University of Manchester)
• Exposure: No asbestos exposure was found: enquiries revealed no history of exposure to asbestos, and tissue sections examined for asbestos bodies showed none
• Main results:
  • At surgery, a large tumour of the left ovary was found, adherent to the peritoneum over the bladder and sigmoid mesentery, with numerous small cystic lesions over the peritoneum and greater omentum
  • The ovarian mass weighed 183 g and measured 9 x 5.5 x 7 cm
  • No mitoses (dividing cells) were seen in any section of the tumour
  • The tumour's stroma contained an infiltrate of lymphocytes with lesser numbers of plasma cells, polymorphs and mast cells
  • Normal ovarian surface mesothelium was continuous with the tumour cells
  • No asbestos bodies were found in the stained or thick unstained sections
  • The omental (peritoneal) lesions were mainly cystic, lined by flattened mesothelium
  • The tumour's microscopic and electron-microscopic features matched those described as typical of papillary mesothelioma
  • The patient recovered without complications or further treatment and remained well; the length of follow-up is not given
• The authors' conclusion: The authors regarded the tumour as a true ovarian neoplasm, and as apparently the first fully documented example of ovarian mesothelioma. They considered it indolent, with a prognosis comparable to low grade mesotheliomas. They proposed that certain areas of clear cell carcinoma of the ovary might be a malignant counterpart of this tumour.
• Limitations the authors state:
  • The authors noted that judging whether mesothelial tumours are malignant from their microscopic appearance can be extremely difficult
  • The authors could not determine whether the peritoneal lesions came from spread of the ovarian tumour or arose separately in several places

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Well-Differentiated, Mesothelial Cells, Macrophage, Adenomatoid Tumor, Epithelium, Carcinoma, Neoplasm.

Related studies

• Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary; case report — M. Swerdlow (1959)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Talc and carcinoma of the ovary and cervix — W.J. Henderson, C.A. Joslin, et al. (1971)
• Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary — C.C. Wauters, F. Smedts, et al. (1995)
• Expression of calretinin in human ovary, testis, and ovarian sex cord-stromal tumors — Q.J. Cao, J.G. Jones, et al. (2001)
• An ultrastructural comparison of mesotheliomas and adenocarcinomas of the ovary and endometrium — M.J. Warhol, N.J. Hunter, et al. (1982)

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