Table 1: Tumor Immunohistochemistry. A uterine nodule biopsy was sent to pathology, which demonstrated a low-grade papillary neoplasm of unknown origin. Immunoprofiling of the uterine nodule biopsy showed that the cells were PAX8+, ER+, PR+, claudin 4+, Ber-EP4+, WT1-, D240-, calretinin focally+, and had WT p53 expression, which suggests serous differentiation. Positive tumor markers are displayed in bold.

Tumor Marker	Function & Clinical Context	Commonly Associated Gynecologic Cancers
PAX8	Migration & adhesion of epithelial cells [8] Development and differentiation of thyroid, kidney, brain, eyes, and Müllerian system epithelial cells [8,9] Regulates expression of the Wilms tumor suppressor gene (WT1) [9]	High grade serous ovarian carcinoma [10] Ovarian endometrioid adenocarcinoma [10] Mixed carcinoma of ovary [10] Endometrial adenocarcinoma [10]
ER	Maintain ovarian granulosa cell differentiation [11] Follicle and oocyte growth and development [11]	ER+ breast cancers Uterine cancers Ovarian cancers Granulosa cell tumors [12]
PR	Increases vascularization of endometrium [12] Inhibits lactation [12] Reduces uterine Contractility [12] Upregulates osteoblast activity [12]	PR+ breast cancers [13] Ovarian cancers [13] Granulosa cell tumors [12]
Claudin 4	Alteration of tight junction permeability in epithelial cells [14]	Epithelial ovarian cancers [15] Epithelial breast cancers [15]
Ber-EP4	Monoclonal antibody which detects epithelial-glycoprotein-adhesion-molecules (epCAM) proteins present on both normal and abnormal epithelia [16]	Serous ovarian carcinoma [16] Mucinous ovarian Carcinoma [16] Endometrioid ovarian carcinoma [16] Clear cell ovarian Carcinoma [16]
WT1	Encodes a zinc finger transcription factor that plays an important role in cell growth and differentiation in renal, mesothelial, gonadal, uterine, and progenitor tissues [17] mRNA metabolism [18]	High grade serous ovarian carcinoma [18] Gonadoblastoma [19]
D240	Monoclonal antibody marker for lymphatic endothelium which is used to indicate lymphatic invasion of a primary tumor [20]	n/a
Calretinin	Calcium binding protein which controls intracellular calcium signaling in some neurons, ovarian stroma, adipocytes, and mesothelial cells [21]	Sex cord stromal tumors [21] Serous ovarian carcinoma [21] Endometrioid ovarian carcinoma [21] Clear cell ovarian carcinoma [21]
Wild Type p53	Inhibits cell cycle at G₁/S and G₂/M checkpoints [22] Induces apoptosis [23]	n/a