Herein, we report a clinicopathological and molecular analysis of a case of tubo-ovarian high-grade serous carcinoma (HGSC) with a sertoliform pattern. A 45-year-old woman underwent surgery due to an advanced bilateral adnexal carcinoma with peritoneal and appendiceal metastases. Histological examination revealed an HGSC exhibiting a distinct sertoliform component. Such component showed diffuse PAX8, p53 (mutation-type), and p16 (block-type) expression, increased vimentin and decreased WT1 expression compared to the conventional HGSC component, membrane β-catenin positivity, heterogeneous estrogen, and progesterone positivity, and retained PTEN and mismatch repair expression and negativity for GATA3, TTF1, inhibin, calretinin, CD10, CDX2, chromogranin, and synaptophysin. Molecular analysis showed a germline BRCA2 mutation; no mutations were detected in POLE, POLD1, MLH1, MSH2, MSH6, PMS2, APC, CTNNB1, MUTYH, and EPCAM. In conclusion, a sertoliform pattern can be part of the morphological spectrum of BRCA-related HGSC.
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Article Synopsis
- The 5th edition of WHO classification updates important information about tumors in the male genitourinary tract, specifically focusing on new entities like Signet-ring stromal tumors (SRST) and myoid gonadal stromal tumors (MGST).
- Both SRST and MGST have shown benign behavior post-surgery, with a recommendation for conservative surgical approaches, and there's a goal to form larger case studies to explore their characteristics further.
- The classification also adds the sertoliform cystadenoma to the Sertoli cell tumors, emphasizing the need for precise molecular and immunohistochemical analysis to understand these rare tumors better.
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