RESUMEN
The recent 2014 World Health Organization (WHO) Classification of Tumours of the Female Reproductive Organs introduced a new category of ovarian neoplasm designated "seromucinous tumours". The recognition of this distinctive group of tumors is an important addition to the classification but the term "seromucinous" has serious flaws that obscures the nature of these neoplasms. Morphologically, seromucinous tumors in addition to serous and endocervical-type mucinous epithelium, contain endometrioid, indifferent and squamous type epithelium. Their immunoprofile is characterized by frequent expression of ER, PR, infrequent expression of WT1 and lack of expression of CK20 and CDX2, an immunostaining pattern consistent with a "müllerian" immunophenotype. Unlike serous and intestinal type mucinous tumors, seromucinous tumors are frequently associated with endometriosis making them more analogous to endometrioid and clear cell neoplasms. Indeed, recent studies have shown that a high proportion of seromucinous tumors lost expression of ARID1A, a tumor suppressor gene, that is mutated in approximately 50% of endometrioid and clear cell tumors, in sharp contrast to serous and intestinal-type mucinous tumors which do not contain ARID1A mutations or lose its expression. Therefore, based on their clinicopathologic, immunohistochemical and molecular genetic features we believe a more appropriate designation for this group of tumors is "mixed müllerian tumors" which can be subcategorized as "mixed müllerian cystadenomas", "mixed müllerian atypical proliferative (borderline) tumors" and "mixed müllerian carcinomas".
Asunto(s)
Biomarcadores de Tumor/metabolismo , Endometriosis/clasificación , Tumor Mulleriano Mixto/clasificación , Neoplasias Ováricas/clasificación , Biomarcadores de Tumor/genética , Proteínas de Unión al ADN , Endometriosis/genética , Endometriosis/patología , Femenino , Humanos , Tumor Mulleriano Mixto/genética , Tumor Mulleriano Mixto/patología , Mutación , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo , Neoplasias Ováricas/genética , Neoplasias Ováricas/patología , Factores de Transcripción/genética , Factores de Transcripción/metabolismoRESUMEN
A review of the literature is presented which deals with modern aspects of Muller mixed tumors (MMT) classification and problems of their histo- and morphogenesis, immunohistochemical, ultrastructural and molecular-genetic peculiarities. Prognostic factors and survival rates are considered. Further study of MMT is necessary for verification of their histo- and morphogenesis and for development of their classification.
Asunto(s)
Tumor Mulleriano Mixto/clasificación , Tumor Mulleriano Mixto/patología , Neoplasias Uterinas/clasificación , Neoplasias Uterinas/patología , Femenino , Humanos , Persona de Mediana Edad , Tumor Mulleriano Mixto/mortalidad , Pronóstico , Tasa de Supervivencia , Neoplasias Uterinas/mortalidadRESUMEN
Muller mixed uterine tumors (MMUT): nomenclature and classification of these tumors are very complicated. Benign variants of these tumors are not considered at all in modem WHO classification although they are described in the literature and occur in practice. Histogenesis and morphogenesis are still not clear. The authors consider MMUT as a group which includes tumors with different biological activity and various histo- and morphogenesis as well as prognosis.
Asunto(s)
Tumor Mulleriano Mixto/clasificación , Tumor Mulleriano Mixto/patología , Neoplasias Uterinas/clasificación , Neoplasias Uterinas/patología , Femenino , HumanosAsunto(s)
Neoplasias Endometriales/patología , Leiomioma/patología , Tumor Mulleriano Mixto/patología , Sarcoma Estromático Endometrial/patología , Adenocarcinoma/diagnóstico , Carcinosarcoma/diagnóstico , Diagnóstico Diferencial , Neoplasias Endometriales/clasificación , Femenino , Humanos , Leiomioma/clasificación , Tumor Mulleriano Mixto/clasificación , Sarcoma Estromático Endometrial/clasificaciónRESUMEN
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