Case 204 - Discussion

Uploaded: 2008-04-05, Updated: 2008-04-05

  • IMMUNOHISTOCHEMISTRY STAININGS:

    • Keratin (CK 8/18): Negative

    • EMA: Negative

    • Vimentin: Positive

    • CD10: Negative

    • Inhibin: Positive

    • Calretinin: Positive

    • Chromogranin: Negative

    • CD56: Positive

    • Synaptophysin: Weakly positive

    • Melan A: Focally weakly positive

    • S100: Negative

    • CD45: Negative

     

  • FINAL DIAGNOSIS: 

    • Malignant sex cord-stromal tumor, unclassified.
      - The tumor measures 17 cm in diameter
      - Lymphovascular invasion identified
       

  • DISCUSSION:

    • The tumor consists of sheets, nests, tubules and ribbons of predominantly small to medium sized cells with scant cytoplasm separated by dense stroma. Mitoses are frequent and in places there is a significant cellular and nuclear pleomorphism, as well as extensive necrosis. Lymphovascular invasion is present. Immunohistochemically the neoplastic cells express inhibin, calretinin and CD56, while keratin, EMA, Melan-A are negative. Immunophenotypic results are characteristic for adult granulosa cell type of sex cord stromal tumor, but due to the aggressive and non-characteristic architectural presentation it is probably best to diagnose this tumor as an unclassified sex cord-stromal tumor.

Malignant sex cord-stromal tumor, unclassified

The Key Features

 

CLINICAL FEATURES

 

GROSS FINDINGS

 

MICROSCOPIC FINDINGS

 

SUBTYPES

 

DIFFERENTIAL DIAGNOSES

 

IMMUNOHISTOCHEMISTRY AND SPECIAL STAINS

 

ELECTRON MICROSCOPIC FINDINGS

 

CYTOGENETIC STUDIES

 

TREATMENT AND PROGNOSIS

 

REFERENCES