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Ovarian tumors

Ovarian tumors

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Ovarian tumors

  1. 1. OVARIAN TUMORS
  2. 2. Learning Objectives Classify tumors of the ovaries -Surface epithelial ovarian tumors - Germ cell tumors - Sex cord-stromal tumors Describe epidemiology and morphology of common epithelial ovarian tumors Enlist functional ovarian tumors and their consequences. 2
  3. 3. Ovarian Neoplasms Fifth leading cause of cancer mortality in women, originate from three cell types of the ovary: 1. Multipotent surface epithelium 2. Totipotent germ cells 3. Sex cord– stromal cells Surface epithelial 90% of ovarian cancers Germ cell and sex cord–stromal cell tumors constitute 20% to 30% of ovarian tumors
  4. 4. Frequency of Major Ovarian Tumors Tumor Type % of Malignancy % of Bilaterally Serous 40 •Benign (60%) 25 •Borderline (15%) 30 •Malignant (25%) 65 Mucinous 10 •Benign (80%) 5 •Borderline (10%) 10 •Malignant (10%) <5 Endometrioid carcinoma 20 40 Undifferentiated carcinoma 10 — Clear cell carcinoma 6 40 Granulosa cell tumor 5 5 Teratoma 15 •Benign (96%) •Malignant (4%) 1 Rare Metastatic 5 >50 (Krukernberg tumor, mets from breast and lung cancers) 4
  5. 5. Ovarian Surface Epithelial Tumors Risk Factors: • Null parity • Family history • Heritable mutations • Unmarried • Married with low parity • Gonadal dysgenesis • 5% to 10% of ovarian cancers familial, associated with mutations in BRCA1, BRCA2 and p53 tumor suppressor genes • Express HER2/neu 5
  6. 6. Serous Ovarian Neoplasms: Morphology Gross Most , large, rounded cystic mass up to 30 to 40 cm in diameter Benign tumors, serosal surface smooth and glistening as compare to nodular irregularities in the malignant On cut section, unilocular to multilocular cystic masses filled with a clear serous fluid Cystic cavities shows papillary projections, more prominent in malignant tumors
  7. 7. Serous Ovarian Neoplasms: Morphology Microscopy Benign; a single layer of tall columnar epithelial cells lines the cyst cavity Psammoma bodies in the tips of papillae Malignant; multilayered lining epihtelium,complex papillary pattern and nests or sheets of malignant cells invade axial fibrous tissue Borderline; exhibit less cytologic atypia and no stromal invasion Metastases; spread into peritoneal cavity and periaortic lymph nodes
  8. 8. Mucinous Neoplasms Gross Larger, multicystic masses, with mucinous cystic contents Capsular penetration and solid areas of growth; suggestive of malignancy Microscopy; Cysts lined by mucin-producing columnar epithelial cells Malignant tumors; characterized by the presence of architectural complexity, including solid areas of growth, cellular stratification, cytologic atypia and stromal invasion
  9. 9. Endometrioid Tumors Sometimes develop with endometriosis 15% to 30% of women have concomitant endometrial carcinoma Benign, borderline and malignant tumors Gross Solid or cystic masses Microscopy Tubular glands, similar to endometrium Endometrioid carcinomas of ovary have mutations in PTEN tumor suppressor gene similar to endometrioid carcinoma of uterus
  10. 10. Brenner Tumors May arise from the surface epithelium or from urogenital epithelium trapped within the germinal ridge Gross: Solid, encapsulated, gray-white ranging from a few cm to 20 cm in diameter Microscopy: Abundant stroma containing nests of transitional-type epithelium
  11. 11. Self Assessment Q. Name the hormone producing ovarian neoplasms and the type of hormone they produce.
  12. 12. References Basic Pathology, 10th Edition 2017; Kumar, Abbas, Aster www.webpathology.com

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