{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:16:39Z","timestamp":1786976199216,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["12978"],"award-info":[{"award-number":["12978"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009863","name":"Neuroendocrine Tumor Research Foundation","doi-asserted-by":"publisher","award":["654863"],"award-info":[{"award-number":["654863"]}],"id":[{"id":"10.13039\/100009863","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology CR"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Currently, the available literature provides insufficient support to differentiate between primary ovarian neuroendocrine tumors (PON) and neuroendocrine ovarian metastases (NOM) in patients. For this reason, patients with a well\u2010differentiated ovarian neuroendocrine tumor (NET) were identified through electronic patient records and a nationwide search between 1991 and 2023. Clinical characteristics were collected from electronic patient files. This resulted in the inclusion of 71 patients with NOM and 17 patients with PON. Histologic material was stained for Ki67, SSTR2a, CDX2, PAX8, TTF1, SATB2, ISLET1, OTP, PDX1, and ARX. DNA methylation analysis was performed on a subset of cases. All PON were unilateral and nine were found within a teratoma (PON\u2010T+). A total of 78% of NOM were bilateral, and none were associated with a teratoma. PON without teratomous components (PON\u2010T\u2212) displayed a similar insular growth pattern and immunohistochemistry as NOM (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u20090.05). When compared with PON\u2010T+, PON\u2010T\u2212 more frequently displayed ISLET1 positivity and were larger, and patients were older at diagnosis (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Unsupervised analysis of DNA methylation profiles from tumors of ovarian (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200916), pancreatic (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200922), ileal (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910), and rectal (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20097) origin revealed that four of five PON\u2010T\u2212 clustered together with NOM and ileal NET, whereas four of five PON\u2010T+ grouped with rectum NET. In conclusion, unilateral ovarian NET within a teratoma should be treated as a PON. Ovarian NET localizations without teratomous components have a molecular profile analogous to midgut NET metastases. For these patients, a thorough review of imaging should be performed to identify a possible undetected midgut NET and a corresponding follow\u2010up strategy may be recommended.\n                  <\/jats:p>","DOI":"10.1002\/2056-4538.70000","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T06:40:49Z","timestamp":1731048049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinicopathological and epigenetic differences between primary neuroendocrine tumors and neuroendocrine metastases in the ovary"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-5925","authenticated-orcid":false,"given":"Merijn CF","family":"Mulders","sequence":"first","affiliation":[{"name":"ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine Erasmus Medical Center Cancer Institute  Rotterdam The 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