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Table 2 Pathological features differentiating a secondary from primary ovarian tumor [2, 11, 14, 15]

From: Occult gallbladder carcinoma presenting as a primary ovarian tumor in two women: two case reports and a review of the literature

Pathological features

Secondary

Primary

Gross

  

Bilaterality

✓

 

Surface implants

✓

 

Multinodular growth

✓

 

Size > 10 cm

✓

✓

Smooth tumor surface

 

✓

Mural nodule

 

✓

Micro

  

Surface implants in the form of irregular/dilated/cystic/angulated/tubular glands/cell nests or single tumor cells within a desmoplastic/hyalinized stroma

✓

 

Infiltrative pattern (disorderly penetration of the stroma by small glands, tubules, or single cells, including signet-ring cells, usually within a desmoplastic stroma)

✓

 

Growth in the ovarian hilum

✓

 

Foci of uninvolved ovarian tissue

✓

 

Mucin without epithelial cells on the tumor surface or the residual ovarian surface

✓

 

A predominantly cystic gross appearance with only few solid necrotic or hemorrhagic areas

✓

✓

Grossly mucinous cyst contents

✓

✓

Areas of a cribriform, villous, or solid growth

✓

✓

Microscopic mucin extravasation into the stroma

✓

✓

Benign or borderline-appearing areas (either with atypia only or with intraepithelial carcinoma)

✓

✓

Focal endometrioid-like appearance

✓

✓

Microscopic cysts, generally > 2 mm

✓

✓

"Expansile" invasive pattern (sharply demarcated, multicystic or labyrinthine spaces lined by malignant-appearing epithelial cells, with minimal or no recognizable intervening stroma, in an area exceeding 10 mm and at least 3 mm in any single dimension)

 

✓

A complex papillary epithelial growth (branching papillae with epithelial stratification and little or no stromal support)

 

✓

Intraluminal necrotic material (tumor cell karyorrhectic nuclear fragments, neutrophils, and acellular debris) in gland-cyst lumens

 

✓

Immunohistochemistry

  

CK-7

✓

✓

CK-20

✓

✓

Dpc4

✓

✓