{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:22:04Z","timestamp":1787840524347,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T00:00:00Z","timestamp":1749254400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Diffuse keratinization of peritoneum can be seen in various neoplastic and non-neoplastic diseases. This exuberant keratinization exhorts a granulomatous response with multinucleated giant cell reaction. In malignancy of ovary or endometrium they mimic tumor deposits, sometimes leading to erroneous upstaging. We report one such case of ovarian endometroid adenocarcinoma in 42-year multigravida with multiple nodules over peritoneum and pelvic tissue. The case was intraoperatively staged as FIGO stage III due to nodularity over momentum and pelvic areas. Hematoxylin and eosin-stained section from the ovary revealed endometroid adenocarcinoma (FIGO grade 1) with extensive squamous morales. Sections from the omentum showed diffuse keratinization with granulomatous response against keratin. There were no viable tumor cells in the multiple sections examined. The peritoneal fluid for cytology was negative for malignancy. Final stage was given as FIGO stage IB. This case highlights this rare presentation in Ovarian endometroid adenocarcinoma posing diagnostic dilemma to clinician and pathologist and emphasizes upon the importance of clinicopathological discussion, fluid cytology and extensive sampling for accurate staging.<\/jats:p>","DOI":"10.4103\/ijpm.ijpm_1005_23","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T05:00:14Z","timestamp":1749445214000},"page":"862-864","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Diffuse peritoneal keratinization in endometrioid adenocarcinoma of ovary masquerading as metastatic deposit"],"prefix":"10.4103","volume":"68","author":[{"given":"Pratibha","family":"Gautam","sequence":"first","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and GTB Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragya","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and GTB Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tripti","family":"Nakra","sequence":"additional","affiliation":[{"name":"Department of Pathology, University College of Medical Sciences and GTB Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bindiya","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University College of Medical Sciences and GTB Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,7]]},"reference":[{"key":"R1-20251208","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.gynor.2012.02.002","article-title":"Extensive peritoneal keratin granuloma in stage IV B endometrial carcinoma with an outstanding survival: A case report and review of the literature","volume":"2","author":"de Freitas Pina Ferreira","year":"2012","journal-title":"Gynecol Oncol Case Rep"},{"key":"R2-20251208","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1093\/ajcp\/103.6.673","article-title":"Reactive tumor-like lesions of the peritoneum","volume":"103","author":"Clement","year":"1995","journal-title":"Am J Clin Pathol"},{"key":"R4-20251208","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0002-9378(16)36104-X","article-title":"Cholesteatomatous endometriosis","volume":"82","author":"Montes","year":"1961","journal-title":"Am J Obstet Gynecol"},{"key":"R5-20251208","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1177\/10668969211016045","article-title":"Keratin granulomas in the peritoneum on frozen section: A case report with multiple suspects and the search for the culprit","volume":"30","author":"Katsakhyan","year":"2022","journal-title":"Int J Surg Pathol"},{"key":"R6-20251208","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1136\/ijgc-00009577-200601000-00069","article-title":"Ovarian endometrioid carcinoma with diffuse pigmented peritoneal keratin granulomas: A case report and review of the literature","volume":"16","author":"Wu","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"R7-20251208","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/1746-1596-6-104","article-title":"Peritoneal keratin granuloma associated with endometrioid adenocarcinoma of the uterine corpus","volume":"6","author":"Uehara","year":"2011","journal-title":"Diagn Pathol"},{"key":"R8-20251208","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1097\/00000478-199010000-00005","article-title":"Peritoneal keratin granulomas with carcinomas of endometrium and ovary and atypical polypoid adenomyoma of endometrium. A clinicopathological analysis of 22 cases","volume":"14","author":"Kim","year":"1990","journal-title":"Am J Surg Pathol"},{"key":"R9-20251208","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/j.1471-0528.1989.tb01669.x","article-title":"Peritoneal keratin granulomas from transtubal spread of endometrial carcinoma with squamous metaplasia (adenoacanthoma). Case report","volume":"96","author":"Wotherspoon","year":"1989","journal-title":"Br J Obstet Gynaecol"},{"key":"R10-20251208","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gynor.2013.01.006","article-title":"A very rare case of synchronous carcinomas of the endometrium and ovary with peritoneal keratin granulomatous involvement","volume":"5","author":"Cupp","year":"2013","journal-title":"Gynecol Oncol Case Rep"}],"container-title":["Indian Journal of Pathology and Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpm.ijpm_1005_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:24:27Z","timestamp":1787837067000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpm.ijpm_1005_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,7]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijpm.ijpm_1005_23","relation":{},"ISSN":["0377-4929","0974-5130"],"issn-type":[{"value":"0377-4929","type":"print"},{"value":"0974-5130","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,7]]},"assertion":[{"value":"2023-12-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}