ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

High-grade versus low-grade serous carcinoma of the ovary – current differential diagnosis and perspectives



Introduction. Serous carcinoma is responsible for 47% of all ovarian cancers, and from these cases, only 5% are represented by low-grade serous carcinoma, the rest of them accounting for high-grade serous carcinoma.

Objective. The aim of this study is an observational approach of the differences and similarities of the two types of serous carcinoma of the ovary, that must be seen as different forms of cancer and rendered with care.

Methods. We performed a retrospective study using three cases of ovarian high-grade serous carcinoma and three cases of ovarian low-grade serous carcinoma, diagnosed at the University Emergency Hospital Bucharest. We analyzed patients’ age, clinical symptoms, macroscopic and microscopic features together with immunohistochemistry tests.

Results. Mean age for HG carcinoma was 71.3 years old and for LG carcinoma 47.6 years old. Average tumor diameter was with 5.67 cm higher for LG carcinoma. The most encountered stage for HG tumors was pT2a and for LG tumors was pT1a. Mean value for Ki67 was with 36.33% higher for HG carcinoma. AR expressed diffuse positivity in two cases of LG and only focal positivity in two cases of HG. CD44 expressed focal positivity in all cases of LG and had different patterns in HG.

Conclusions. We found considerable differences between patients’ mean age, macroscopic and microscopic features, together with immunohistochemistry expression for Ki67, AR, CD44.

Keywords: high-grade serous carcinoma, low-grade serous carcinoma, AR, CD44.


Abbreviation list

AR = androgen receptor

BRAF = human gene that encodes a protein called B-Raf

CD44 = cluster of differentiation 44

ER = estrogen receptor

HER2 = human epidermal growth factor receptor 2

HG = high-grade

Ki67 = Anti‑human Ki‑67 Antibody = proliferation index

KRAS = a gene that acts as an on/off switch in cell signaling, first identified as an oncogene in Kirsten RAt Sarcoma virus

LG = low-grade

MAPK= mitogen-activated protein kinase

p53 = tumor protein p53, encoded by tumor suppression gene TP53

Pi3K/mTOR = intracellular signaling pathway Phosphatidylinositol-4,5-bisphosphate 3-kinase/mammalian target of rapamycin

Rb1 = retinoblastoma protein

WHO = World Health Organization

WT1 = Wilms tumor protein, encoded by WT1 gene


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Address for correspondence:
Manuela POPA
Department of Pathology, „Carol Davila“ University of Medicine and Pharmacy, University Emergency Hospital, Bucharest, Romania
Address: Splaiul Independentei no 169, Bucharest, Romania, 050098


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Popa M, Birceanu Corobea A, Munteanu O, Cirstoiu MM, Sajin M. High-grade versus low-grade serous carcinoma of the ovary – current differential diagnosis and perspectives. Arch Balk Med Union 2018;53(4): 557-562. DOI 10.31688/ABMU.2018.53.4.11