Ovarian mucinous tumors with sarcoma‐like mural nodules. A report of seven cases

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Abstract
Seven cases of mucinous ovarian tumors with sarcoma-like nodules in their walls are reported. The age of the patients ranged from 18-81 yr. Each had a large abdominal mass which proved on exploration to be a stage Ia cystic ovarian tumor. All the specimens contained 1 or more discrete nodules in their walls, most of which were soft, dark brown and hemorrhagic. On microscopical examination the epithelial component of 4 of the tumors was of borderline malignancy and of 3 was well-differentiated carcinoma. Three patterns were encountered in the nodules: pleomorphic and epulis-like in 4 cases, pleomorphic and spindle-celled in 1 case and giant cell-histiocytic in 2 cases. These patterns simulated those of malignant giant cell tumor of soft parts, spindle cell sarcoma and well-differentiated rhabdomyosarcoma, respectively. Postoperative follow-up ranging from 1-11 1/2 yr (average, 7 1/2 yr) revealed no evidence of recurrence. Reports of 7 similar tumors were found in the literature. Although follow-up has been less complete in these cases, none of the tumors has spread beyond the ovary. Mural nodules of the types described possibly are not sarcomatous, but could represent a reactive process that has no effect on the prognosis of the patient.