Abstract：
Pilomatrix-like high-grade endometrioid carcinoma (PiMHEC) has recently been described as an aggressive variant of endometrial carcinoma. Herein, we described a case of ovarian PiMHEC, comparing it to endometrial PiMHEC and assessing previously published cases of putative ovarian PiMHEC. A 65-year-old woman underwent hysterectomy for an ovarian tumor characterized by solid nests of basaloid cells with prominent ghost cell keratinization. Immunohistochemistry showed nuclear β-catenin and CDX2 expression and loss of estrogen and progesterone receptors and PAX8. These features were consistently observed in all previously published cases and may represent diagnostic criteria of PiMHEC. Other frequent features were geographic necrosis and a low-grade endometrioid component. CK7, neuroendocrine, and basal/squamous markers were inconsistently expressed. All cases with available follow-up showed poor prognosis. PiMHEC should be distinguished from mimickers, such as high-grade endometrioid carcinoma with geographic necrosis, low-grade endometrioid carcinoma with ghost cell keratinization, and undifferentiated/dedifferentiated carcinoma. In conclusion, PiMHEC can also occur in the ovary and shows several consistent clinical, morphological, and immunophenotypical features. These features support that PiMHEC is a distinct entity requiring an aggressive management.
摘要：
Pilomatrix样高级别子宫内膜样癌（PiMHEC）最近被描述为子宫内膜癌的侵袭性变体。在这里，我们描述了一例卵巢PiMHEC,将其与子宫内膜PiMHEC进行比较，并评估先前发表的推定卵巢PiMHEC病例。一名65岁的妇女因卵巢肿瘤接受了子宫切除术，其特征是基底细胞的实巢，并伴有明显的鬼细胞角质化。免疫组织化学显示核β-catenin和CDX2表达以及雌激素和孕激素受体和PAX8的丢失。这些特征在所有先前发表的病例中均被一致观察到,并且可能代表PiMHEC的诊断标准。其他常见特征是地理坏死和低度子宫内膜样成分。CK7,神经内分泌,和基底/鳞状标记物表达不一致。所有有随访的病例预后较差。PiMHEC应该区别于模仿者，如高度子宫内膜样癌与地理坏死，低级别子宫内膜样癌伴鬼细胞角质化，和未分化/去分化癌。总之,PiMHEC也可以发生在卵巢中，并显示出几种一致的临床，形态学,和免疫表型特征。这些功能支持PiMHEC是一个需要积极管理的独特实体。
