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Epithelial ovarian neoplasms constitute the majority of ovarian tumours and are the most common malignant ovarian neoplasm. They are the eighth leading cause of cancer deaths worldwide. This study evaluated the epidemiology and histological subtypes of epithelial ovarian neoplasms at a single institution. This retrospective, quantitative analysis evaluated 123 epithelial ovarian neoplasms between 2013 and 2017 and classified them according to age, biological behaviour and histological subtype. Of 123 cases, 64 (52.0%), tumours were benign, 30 (24.4%) were borderline and 29 (23.6%) tumours were malignant. Serous cystadenoma was the most common benign tumour (42.2%). Mucinous borderline tumours were the most common borderline neoplasm (50.0%). High-grade serous carcinoma was the most common carcinoma (58.6%). Patients presented at an older age with borderline tumours and malignant tumours, compared with patients with benign tumours. The current study demonstrated that serous tumours were the most common type of benign and malignant tumours whilst mucinous neoplasms were the commonest subtype of borderline tumours. These findings are congruent with multiple similar studies. A higher number of borderline tumours were seen in this cohort in comparison with previous studies. This suggests a need for additional sampling of borderline tumours, over and above the international standard, in our population, to definitively exclude invasive malignancy. This study also demonstrated the histological progression of benign serous and mucinous tumours to borderline tumours and low-grade serous carcinoma and mucinous carcinoma, respectively, which supports the stepwise tumour progression model of these tumours. [ABSTRACT FROM AUTHOR]

Endometrial carcinomas are common female genital tract malignancies. Western countries identified BRAF mutations in very few endometrial carcinomas, whilst an Eastern study documented mutations in one-fifth of endometrial carcinomas. We aimed to assess BRAF mutations in an ethnically mixed South African patient population using immunohistochemistry (IHC), polymerase chain reaction (PCR) and Sanger sequencing in relation to MLH1 methylation. A total of 145 endometrioid endometrial carcinoma cases were retrieved from departmental archives and underwent MLH1, MSH2, MSH6 and PMS2 IHC testing. The 37 cases that showed MLH1 loss underwent BRAF IHC, PCR and Sanger sequencing. Six out of 37 cases demonstrated BRAF mutations: 4 were identified by PCR, whilst IHC and Sanger sequencing identified one mutation each. Three PCR mutations were at the V600E codon, whilst 1 case had a V600D mutation. Agreement between IHC versus overall BRAF mutational status, and sequencing versus overall mutational status, was 86.49% (p-value < 0.005). There was agreement of 94.59% between PCR and overall mutational status with statistically significant, moderate non-random concordance (kappa = 0.77, p = 0.0001). BRAF mutations were identified in 16.21% of cases, which is higher than frequencies noted in Western studies, but less than in an Eastern study. There was no association between MLH1 methylation and BRAF status in endometrial carcinomas from our patient population (kappa = −0.0223, p = 0.6649). Our results in endometrial carcinomas, similar to findings from Western studies, indicate that BRAF mutations are not beneficial in distinguishing which patients have spontaneously occurring tumours from those who may harbour germline mutations and are suspected of having Lynch syndrome. [ABSTRACT FROM AUTHOR]

Primary ovarian neuroendocrine tumours are very uncommon tumours. Herein, we describe a case of 27-year-old female who presented with abdominal pain and an ovarian mass, for which she underwent a right salpingo-oophorectomy. Histopathological evaluation confirmed a right-sided primary ovarian neuroendocrine tumour occurring in a benign mature cystic teratoma. The patient has not undergone any additional therapy and is currently well. This case illustrates the need for thorough clinicopathological correlation together with adequate sampling to ensure accurate diagnosis and timeous management of the patient. [ABSTRACT FROM AUTHOR]

Neuroendocrine carcinomas (Merkel cell carcinomas) of the vulva are extremely rare tumours, with very few cases reported to date. Herein, a primary neuroendocrine carcinoma (Merkel cell carcinoma) of the vulva is reported. A 34-year-old HIV-positive female on antiretroviral therapy presented with a four-month history of a right-sided vulval mass. She underwent surgical excision of a histologically confirmed neuroendocrine carcinoma. Twenty-four weeks after surgery, she died. This case illustrates the importance of a broad differential diagnosis for neoplasms in the usual sites, and the aggressive nature of this tumour, which to date has had limited effective treatment options. [ABSTRACT FROM AUTHOR]

Diffuse large B-cell lymphomas are fairly common adult haematolymphoid malignancies. Approximately 40% of such tumours may present in an extranodal site. These lymphomas are, however, infrequently identified in the female genital tract and even more rarely, identified in the endometrium. The histopathological features and molecular findings of endometrial diffuse large B-cell lymphoma are discussed herein. A 36-year old female presented with per vaginal bleeding. She underwent an endometrial curettage, which demonstrated morphological and immunophenotypical features of a diffuse large B-cell lymphoma. Amplification of the immunoglobulin heavy chain (IgH) gene by polymerase chain reaction (PCR) confirmed B-cell clonality. Epstein–Barr encoding region (EBER) in-situ hybridisation was positive in tumour cells. Fluorescent in-situ hybridisation (FISH) for the detection of BCL6 and MYC gene rearrangement as well as for the detection of the t(14;18) (q32;q21) translocation was performed, all of which yielded negative results. Unfortunately, the patient was lost to follow-up. Whilst diffuse large B-cell lymphoma is not a commonly identified tumour within the uterine cavity, it should be included in the differential diagnosis of endometrial neoplastic infiltrates so as not to misdiagnose this tumour. This facilitates rapid commencement of further management for the patient. [ABSTRACT FROM AUTHOR]