This document provides guidance on examining and processing specimens from the ovary and fallopian tubes. It describes measuring and examining the organs, noting any abnormalities. It details cutting and fixing specimens of different sizes. It also describes examining cyst fluid and cyst walls. Key details to document include size, surface characteristics, solid or cystic areas, and contents. Sections are outlined for different specimen types. Various pathological conditions are defined by their presentations.

2.  Measure the dimensions of organ.
 Weigh it if it is obviously abnormal.
 During the reproductive period,
 Average size is 4 × 2 × 1 cm.
 Average weight is 5–8 g.
 After menopause, they shrink to one half or less of
this size.

3.  If the specimen received
is:
a Normal-sized or nearly
normal-sized organ: bivalve
the ovary with a cut
through its longest
dimension and fix for
several hours.
b Enlarged organ: make
several cuts at distance of 1
cm apart and fix for several
hours.

4.  External surface smooth or irregular?
 Capsule: thickened? adhesions?
haemorrhage? rupture?

5.  Cystectomies are usually performed for benign
lesions or in women with ovarian masses who
wish to preserve their fertility.
 If ovarian cystectomy specimen is received, after
weighing and measuring the specimen , examine
the external surface for evidence of rupture.
 In absence of rupture, place the cyst in a
container, and carefully make a small incision in
the wall to allow its contents to be drained.

6.  Note the colour and consistency of the cyst
fluid.
 Clear fluid – Serous tumour.
 Fluid to viscous material of mucoid nature –
Mucinous tumour.
 Thick sebaceous material along with hairs,
teeth etc - Dermoid cyst.
 Continue the incision with a pair of scissors to
expose the entire inner surface.

7.  In cystectomy specimen:-
 Examine the surfaces of the cysts for
evidence of granularity, nodules, or papillary
projections.
 The thickness of the cyst walls should also be
recorded.

8. Tumor :
 Size
 External surface
 Smooth or papillary?
 Solid or cystic?
Document area of each
separately, if both are
present in a specimen.
 Content of cystic mass
 Hemorrhage, necrosis, or
calcification?
Papillary projection
within the cyst
Solid area
Cystic area

9. 1 For incidental oophorectomies: one sagittal
section of each entire ovary, labeled as to side.
2 For cysts: up to three sections of cyst wall
(particularly from areas with papillary
appearance).
3 For tumors: three sections or one section for
each centimeter of tumor, whichever is greater;
also, one section of non-neoplastic ovary, if
identifiable

10.  If the ovary and fallopian tube were removed
as a prophylactic procedure in a woman with
a family history of ovarian or breast
carcinoma, the entire ovary and fallopian
tube should be submitted.

11. Follicular cysts
Cyst diameter exceeding 2.5 cm
Stein–Leventhal syndrome
Numerous follicular cysts

12. The luminal content is
typically hemorrhagic
corpus luteum cyst. Endometrosis

13. Uni-/ multiloculated cysts
filled with clear fluid
Serous
cystadenoma Increased papillary projections
within cyst
Borderline serous
cystadenoma
- irregular tumour mass
- ↑ solid/ papillary
- necrosis/ haemorrhage
Serous cystadenocarcinoma

14. Mucinous cystadenoma
Uni-/ multiloculated cysts (filled with
mucinous material)
Borderline mucinous cystadenoma
-multiloculated
cysts
-papillae
Mucinous cystadenocarcinoma
Necrosis/
Haemorrhage

15. - Solid /cystic / combination
-Cyst content- haemorrhagic usually
Endometrioid carcinoma Clear cell
adenocarcinoma
- Spongy, often cystic
-Unilocular cysts with solid nodules

16. - Mostly solid
- well circumscribed
- On cut- firm, white/yellowish white
Brenner tumour

17. On cut- predominantly solid with areas of
haemorrhage, necrosis (+) cartilage/bone
ImmatureTeratoma
Mature teratoma
cheesy sebaceous material
Hair
Teeth

18. Struma ovarii
-Thyroid tissue predominantly
- solid, gelatinous or cystic
- Locules
- brown/ greenish brown fluid
Carcinoid
tumour
Typically firm, tan to yellow, solid or cystic

19. Encapsulated,smooth, lobulated surface
On cut-
solid, fleshy with foci of
haemorrage & necrosis

20. -Smooth, glistening
external surface.
-On cut-variegated
Yolk sac tumour Embryonal carcinoma
External surface- smooth & glistening
Cut surface- solid, variegated with extensive
haemorrhage & necrosis

21. Adult Granulosa cell tumour
-encapsulated
-uniformly solid/cystic/ combination
- on cut:solid, yellow areas, haemorrhage
Juvenile Granulosa cell tumour
Solid,lobulated On cut:solid with cystic

22. Thecoma
-Encapsulated, Firm
- on cut: solid, yellow with white foci
Fibroma
Solid, lobulated
-On cut- firm, uniformly white
-cyst formation/ calcification/ haemorrhage/
necrosis

23. Krukenberg tumour Solid, multinodular
Metastasis of
large bowel
adenocarcinoma
solid, nodular

24. Presented by- Dr. Monika Nema