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Ovarian Basaloid Carcinoma with Shadow Cell Differentiation

DOI: 10.1155/2014/391947

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Abstract:

So-called shadow cell differentiation (SCD) is typical for pilomatrixoma and other skin lesions with follicular differentiation, but it was rarely described also in some visceral carcinomas. We report a case of ovarian basaloid carcinoma with SCD. The tumor presented as a 14?cm ovarian mass in a 45-year-old woman, and therefore the adnexectomy and hysterectomy were performed. The tumor was of high stage. Multiple metastases were found in the liver, retroperitoneal and mediastinal lymph nodes, and the lung. Histologically, the tumor showed a pattern of high-grade basaloid carcinoma with numerous shadow cells. Extensive histologic examination did not reveal any glandular or preexisting teratoma component. Immunohistochemically, the tumor expressed markers of squamous cell differentiation, such as p63, cytokeratin 5/6, and high-molecular-weight keratin. Cytokeratin 7 and CA125 were positive in scattered cells of the lesion. Estrogen and progesterone receptor, vimentin, and p53 were negative. Beta-catenin showed nuclear and cytoplasmic positivity, indicating possible tumor proliferation/differentiation via Wnt signaling pathway. To our knowledge, SCD in basaloid carcinoma of the ovary was not described before. In addition to the description of the case, we review the literature on SCD in visceral carcinomas. 1. Introduction So-called shadow cells (ghost cells) are specialized form of cornified cells in which, as a consequence of karyolysis, nuclei have faded, but empty spaces in the sites of the nuclei still can be recognized. The cytoplasm of the shadow cells is fine, filamentous or granular, eosinophilic, often with yellowish (amber- or honey-like) shade. They are typical for pilomatrixoma and other cutaneous tumors with follicular differentiation, and it was suggested that they represent faulty attempts at differentiation toward hair [1, 2]. Shadow cell differentiation (SCD) was, however, found also in noncutaneous lesions, such as craniopharyngioma [3], odontogenic cyst [3], gonadal teratomas [4–6], and in some visceral carcinomas, including uterine and ovarian endometrioid carcinomas [7–14]. To our knowledge, SCD was not reported in high-grade basaloid carcinoma of the ovary [15], before. We would like to demonstrate an example of such tumor here. 2. Case Report A 45-year-old para 2, gravida 3 patient, nonsmoker, was admitted for 3-week lasting pelvic pain. Her medical history included right adnexectomy for benign mucinous ovarian cystadenoma performed three years ago. Ultrasound scan found left-sided adnexal tumor measuring 13 × 9?cm, without apparent

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