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Case Report
An unusual case of ovarian high-grade carcinoma and neuroendocrine tumor: Dedifferentiated ovarian carcinoma or mixed adenocarcinoma and neuroendocrine carcinoma? Clinicopathologic features and literature review
1 Pathology Resident, Department of Pathology, Louisiana State University Health Sciences Center at New Orleans, New Orleans, LA 70112, USA
2 Assistant Professor, Department of Pathology, Louisiana State University Health Sciences Center at New Orleans, New Orleans, LA 70112, USA
Address correspondence to:
Ridin Balakrishnan
MD, Assistant Professor, Clinical Pathology, Department of Pathology, LSU Health Sciences Center, New Orleans, LA 70112,
USA
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Article ID: 100096Z11HW2025
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Wang H, Chen Y, Balakrishnan R. An unusual case of ovarian high-grade carcinoma and neuroendocrine tumor: Dedifferentiated ovarian carcinoma or mixed adenocarcinoma and neuroendocrine tumor? Clinicopathologic features and literature review. J Case Rep Images Pathol 2025;11(2):23–29.ABSTRACT
Introduction: Undifferentiated and dedifferentiated ovarian carcinomas are rare, aggressive neoplasms. While the dedifferentiated component may exhibit neuroendocrine differentiation, this is typically limited to less than 10% of the tumor.
Case Report: We report a unique case of a 73-year-old woman with a high-grade ovarian adenocarcinoma containing a morphologically distinct, diffusely neuroendocrine-rich component. Histologically, the tumor demonstrated two distinct patterns: a well-differentiated yet cytologically high-grade adenocarcinoma adjacent to sheets of monotonous, largely dyscohesive high-grade tumor cells with diffuse neuroendocrine marker expression. The dual morphology raised consideration of a mixed adenocarcinoma–neuroendocrine carcinoma as part of the diagnostic differential.
Conclusion: This case describes an uncommon ovarian carcinoma that shows more than 10% diffuse neuroendocrine differentiation which is not typically encountered in dedifferentiated ovarian carcinomas. The combination of high-grade adenocarcinoma with a neuroendocrine-rich component suggests a mixed adenocarcinoma–neuroendocrine carcinoma, a pattern that, to our knowledge, has not been previously documented in the ovary. These observations emphasize the importance of maintaining a broad differential diagnosis when evaluating ovarian carcinomas with prominent neuroendocrine features.
Keywords: CCNE1 gene, Dedifferentiated ovarian carcinoma, FBXW7 mutation, Mixed adenocarcinoma and endocrine carcinoma, SWI/SNF complex proteins
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Author ContributionsHaibo Wang - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Yaomin Chen - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ridin Balakrishnan - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Haibo Wang et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
