Immunohistochemistry for estrogen and progesterone receptors in the distinction of primary and metastatic mucinous tumors in the ovary: an analysis of 124 cases

Estrogen (ER) and progesterone receptor (PR) expression in primary ovarian mucinous tumors and the utility of these markers for distinguishing metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors have not been extensively investigated. Immunohistochemical studies were performed on 124 mucinous tumors, including 52 primary ovarian tumors ( 30 atypical proliferative ( borderline) mucinous tumors of gastrointestinal type, 11 atypical proliferative ( borderline) mucinous tumors of seromucinous ( endocervical-like) type, and 11 invasive mucinous carcinomas of usual ( gastrointestinal) type) and 72 metastatic mucinous carcinomas in the ovary ( primary sites: colorectum ( 24), pancreas ( 13), endocervix ( eight), stomach ( four), gallbladder/ bile duct ( four), appendix ( four), and unknown ( 15)). All atypical proliferative mucinous tumors of gastrointestinal type, primary ovarian mucinous carcinomas, and metastatic mucinous carcinomas were negative for ER and PR with the exception of three metastatic endocervical adenocarcinomas which exhibited only weak expression of ER without PR. All atypical proliferative mucinous tumors of seromucinous type expressed ER to some degree and seven had some expression of PR. Immunohistochemical assessment of hormone receptor expression is of no value in distinguishing the common types of primary ovarian mucinous tumors ( atypical proliferative mucinous tumors of gastrointestinal type and mucinous carcinomas of usual type) from the vast majority of mucinous carcinomas metastatic to the ovary. The above observations on hormone receptor expression in primary ovarian mucinous tumors support the concept that atypical proliferative ( borderline) mucinous tumors of gastrointestinal and seromucinous (endocervical-like) types are distinctive tumors.