Gross pathology of an ovarian carcinoma.
Benign, borderline, or malignant neoplasm involving the ovary
Ovarian tumors , or ovarian neoplasms, are tumors in the ovary .[ 1] Not all are ovarian cancer .[ 1] They consist of mainly solid tissue, while ovarian cysts contain fluid.[ 2]
In 2020, the World Health Organization (WHO) divided ovarian tumours as 90% epithelial, 3% germ cell, and 2% sex cord-stromal types.[ 3]
Histopathologic classification
Ovarian tumors by incidence and risk of ovarian cancer [ 4]
Tumor of the ovary vary remarkably as they may arise from any of the 3 cell types of the normal ovary.
Ovarian tumors are classified according to the histology of the tumor, obtained in a pathology report. Histology dictates many aspects of clinical treatment, management, and prognosis .
The most common forms are:
Type
Subtype
Relative incidence[ 5]
Percent malignant[ 5]
Comments
Micrograph
Germ cell tumor
Mature cystic teratoma
46.0%
0.17% to 2%[ 6]
Cystic, with elements of all 3 germ layers (endoderm , mesoderm and ectoderm ).[ 7]
Hair follicles.
Immature teratoma
2.5%
100%
A teratoma that contains anaplastic immature elements, and is often synonymous with malignant teratoma .[ 8]
Other germ cell tumors
3.0%
Others mainly include dysgerminoma , yolk sac tumor , struma ovarii and squamous cell carcinoma arising from a dermoid cyst, and malignant mixed germ cell tumor.[ 5]
Surface epithelial-stromal tumor
Serous tumor
25%
18.5%
Benign serous tumors of the right ovarian cyst are thinwalled unilocular cysts that are lined by ciliated pseudostratified cuboidal or columnar epithelium.[ 9]
Mucinous tumor
15%
8.8%
Benign mucinous tumors of the ovary consist of simple, nonstratified columnar epithelium with basally-located hyperchromatic nuclei and resemble gastric foveolar epithelium.[ 9]
Endometrioid tumor
1%
Almost 100%
Tubular glands, resembling endometrium.[ 10]
Other surface-epithelial tumors
1.5%
Others include mainly malignant mixed Müllerian tumor , Brenner tumor and mixed epithelial tumor.[ 5]
Brenner tumor .
Sex cord-stromal tumor
Ovarian fibroma
1.5%
0%
Spindle-shaped fibroblastic cells and abundant collagen.[ 11]
Adult granulosa cell tumor
1%
Almost 100%
Small, bland, cuboidal to polygonal cells in various patterns.[ 12]
Other sex cord-stromal tumors
1%
Others include mainly juvenile granulosa cell tumor , thecoma and sclerosing stromal tumor [ 5]
Secondary/metastatic) tumor
2%
100%
Usually from breast cancer , colon cancer , endometrial cancer , stomach cancer or cervical cancer .[ 13]
Mixed tumors contain elements of more than one of the above classes of tumor histology.
History
An 1882 article appearing in Scientific American mentions the case of a patient at University of Pennsylvania Hospital when Dr. William Goodell removed a 112 lbs tumor from a 31 year old patient, who weighted 75 lbs after removal from the tumor.[ 14]
See also
References
^ a b WHO Classification of Tumours Editorial Board, ed. (2020). "1. Tumours of the ovary: introduction". Female genital tumours: WHO Classification of Tumours . Vol. 4 (5th ed.). Lyon (France): International Agency for Research on Cancer. pp. 32– 35. ISBN 978-92-832-4504-9 .
^ Euscher, Elizabeth D.; Hui, Jian-Jun (2021). "9. Ovarian epithelial neoplasia" . In Wei, Jian-Jun; Hui, Pei (eds.). Practical Gynecologic Pathology: Frequently Asked Questions . Switzerland: Springer. pp. 225– 262. ISBN 978-3-030-68608-6 .
^ De Leo, A; Santini, D; Ceccarelli, C; Santandrea, G; Palicelli, A; Acquaviva, G; Chiarucci, F; Rosini, F; Ravegnini, G; Pession, A; Turchetti, D; Zamagni, C; Perrone, AM; De Iaco, P; Tallini, G; de Biase, D (14 April 2021). "What Is New on Ovarian Carcinoma: Integrated Morphologic and Molecular Analysis Following the New 2020 World Health Organization Classification of Female Genital Tumors" . Diagnostics (Basel, Switzerland) . 11 (4): 697. doi :10.3390/diagnostics11040697 . PMC 8070731 . PMID 33919741 .
^ - Vaidya, SA; Kc, S; Sharma, P; Vaidya, S (2014). "Spectrum of ovarian tumors in a referral hospital in Nepal" . Journal of Pathology of Nepal . 4 (7): 539– 543. doi :10.3126/jpn.v4i7.10295 . ISSN 2091-0908 . - Minor adjustment for mature cystic teratomas (0.17 to 2% risk of ovarian cancer): Mandal, Shramana; Badhe, Bhawana A. (2012). "Malignant Transformation in a Mature Teratoma with Metastatic Deposits in the Omentum: A Case Report" . Case Reports in Pathology . 2012 : 1– 3. doi :10.1155/2012/568062 . ISSN 2090-6781 . PMC 3469088 . PMID 23082264 .
^ a b c d e Unless otherwise specified in boxes, reference is: Vaidya, SA; Kc, S; Sharma, P; Vaidya, S (2014). "Spectrum of ovarian tumors in a referral hospital in Nepal" . Journal of Pathology of Nepal . 4 (7): 539– 543. doi :10.3126/jpn.v4i7.10295 . ISSN 2091-0908 .
^ Mandal, Shramana; Badhe, Bhawana A. (2012). "Malignant Transformation in a Mature Teratoma with Metastatic Deposits in the Omentum: A Case Report" . Case Reports in Pathology . 2012 : 1– 3. doi :10.1155/2012/568062 . ISSN 2090-6781 . PMC 3469088 . PMID 23082264 .
^ Hillary Rose Elwood. "Skin nonmelanocytic tumor - Other tumors of skin - Benign (mature) cystic teratoma" . pathology Outlines . Topic Completed: 1 November 2016. Revised: 4 April 2019
^ Sun, Hang; Ding, Hongxin; Wang, Jianjun; Zhang, Emma; Fang, Yihua; Li, Zhenhua; Yu, Xiao; Wang, Chongren; Zhao, Yifan; Chen, Kan; Wen, Siwan; Li, Liang; Shan, Shan; Hong, Liu; Chen, Face; Su, Pu (2019). "The differences between gonadal and extra-gonadal malignant teratomas in both genders and the effects of chemotherapy" . BMC Cancer . 19 (1): 408. doi :10.1186/s12885-019-5598-0 . ISSN 1471-2407 . PMC 6492338 . PMID 31039746 .
^ a b Baradwan, Saeed; Alalyani, Haneen; Baradwan, Amira; Baradwan, Afnan; Al-Ghamdi, Maram; Alnemari, Jameel; Al-Jaroudi, Dania (2018). "Bilateral ovarian masses with different histopathology in each ovary" . Clinical Case Reports . 6 (5): 784– 787. doi :10.1002/ccr3.1466 . ISSN 2050-0904 . PMC 5930217 . PMID 29744056 .
^ Shahrzad Ehdaivand. "Ovary tumor - Endometrioid tumors - General" . Pathology Outlines . Topic Completed: 1 December 2012. Revised: 6 March 2020
^ Parwate, Nikhil Sadanand; Patel, Shilpa M.; Arora, Ruchi; Gupta, Monisha (2015). "Ovarian Fibroma: A Clinico-pathological Study of 23 Cases with Review of Literature" . The Journal of Obstetrics and Gynecology of India . 66 (6): 460– 465. doi :10.1007/s13224-015-0717-6 . ISSN 0971-9202 . PMC 5080219 . PMID 27821988 .
^ Shahrzad Ehdaivand. "Ovary tumor - Sex cord stromal tumors - Granulosa cell tumor - adult" . Pathology Outlines . Topic Completed: 1 December 2012. Revised: 9 March 2020
^ Lisa Lee-Jones, University of Wales College of Medicine (2003-12-01). "Ovarian tumours : an overview" . Atlas of Genetics and Cytogenetics in Oncology and Haematology .
^ Scientific American . Munn & Company. 1882-02-25. p. 114.