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J Clin Pathol doi:10.1136/jclinpath-2011-200320
  • Editorial

Mucinous tumours of the ovary

  1. Timothy J Perren1
  1. 1Department of Medical Oncology, St James's Institute of Oncology, Beckett Street, Leeds, UK
  2. 2Mid Yorks NHS Trust, Wakefield, UK
  1. Correspondence to Jay Naik, Department of Medical Oncology, St James's Institute of Oncology, Leeds LS9 7TF, UK; jay.naik{at}leedsth.nhs.uk
  1. Contributors TJP, JDN, JS: conception and design, analysis and interpretation of data; JDN, JS, TJP: drafting the article, revising it critically for important intellectual content, final approval of the version to be published.

  • Accepted 22 August 2011
  • Published Online First 19 October 2011

Introduction

Ovarian cancer represents the fifth most common cancer to affect women in the UK, with approximately 6700 cases diagnosed annually. The majority of ovarian cancers are serous epithelial ovarian cancers (sEOCs), with mucinous epithelial ovarian cancers (mEOCs) forming around 12% of diagnosed cases, and hence comparatively rare.1 Data from our own institute, St James's Institute of Oncology, shows that only 10 of the approximately 150 primary ovarian cancers seen annually are mucinous in origin.

Evolving evidence has demonstrated distinct histopathological and clinical contrasts between mEOC and sEOC, as discussed further in this issue, leaving oncologists questioning the current blanket approach to their treatment. Loco-regionally advanced sEOC and mEOC (the most prevalent presentation) is treated with a combination of chemotherapy and debulking surgery. However, there is evidence to suggest that mEOCs may be less sensitive to platinum based chemotherapy and the low prevalence of mEOC patients within randomised controlled trials (RCT) leaves the evidence base uncertain.2–4

Here, we outline clinicopathological evidence supporting the view of mEOCs as a separate clinical entity from sEOCs, how these considerations have led to the opening of a trial (the ‘mEOC’ trial) and finally how emerging technologies may impact upon diagnosis and treatment of mEOC.

Histopathological features of mEOCs

The histological diagnosis of mucinous ovarian tumours is often complex, requiring a multidisciplinary approach and correlation with the clinical picture. Undoubtedly, mEOCs share certain histopathological features with gastrointestinal (GI) tract cancers, and difficulties may present when differentiating occult GI tract tumour metastatic to the ovary from a mEOC (or sEOC) primary.

The clinical importance of a correct histopathological diagnosis of an ovarian tumour cannot be underestimated. …


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