Clear cell carcinoma of the ovary: a clinicopathologic analysis of 34 cases

The clinical and pathologic aspects of 34 cases of pure clear cell carcinoma of the ovary are discussed. These tumors represented 12.1% (34/280) of all ovarian cancers. The ages of the patients ranged from 34 to 78 years (mean 51.6 years) and 59% were postmenopausal. The clinical stages (FIGO) of these patients were as follows; I 22, II 5, III 6, and IV 1. Thirty-nine percent of the patients were nulligravidas. The diameters of the tumor varied from 6 to 31 cm (mean 16 cm), and 47% of the patients had endometriosis. Thirteen tumors were directly connected with endometriosis and this suggests that some ovarian clear cell carcinoma arose from the epithelium of an endometriotic cyst. Three architectural patterns (solid, papillary, and tubulocystic) were recognized. Forty-seven percent of the tumors were predominantly papillary and 24% contained mixtures of these three patterns. Four cell types such as clear, hobnail, eosinophilic, and flattened were also seen. Thirty-eight percent of the tumors had psammoma bodies. Histological patterns and cell types were not prognostic factors, and the stage at presentation was the most important prognostic factor. The 5-year survival rate was 54% (7/13) which was better than that in patients with serous adenocarcinoma of the ovary. The estimated survivals in patients with clear cell carcinoma however, were worse than those in patients with serous adenocarcinoma when compared stage for stage.