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ovarian tumors

Friday 25 July 2003

Classification (WHO)

I - ovarian epithelial tumors (Surface epithelial-stromal tumors )

ovarian serous tumors
- benign ovarian serous tumors
- proliferating ovarian serous tumors - borderline ovarian serous tumors
- ovarian serous borderline tumor with microinvasion
- ovarian serous carcinomas

ovarian mucinous tumors
- pseudomyxoma peritonei
- benign ovarian mucinous tumors
- proliferating ovarian mucinous tumors - borderline mucinous tumors
- mucinous ovarian adenocarcinoma

ovarian endometrioid tumors
- Benign (ovarian endometrioid cystadenoma )
- Borderline tumors (ovarian endometrioid borderline tumor )
- Malignant (ovarian endometrioid adenocarcinoma )

clear cell tumors
- Benign
- Borderline tumors
- Malignant (ovarian clear cell carcinoma )

ovarian transitional cell carcinoma

ovarian squamous cell tumors
- ovarian squamous cell carcinoma / ovarian SCC

epithelial-stromal tumors (mixed epithelial tumors )
- adenosarcoma
- carcinosarcoma (formerly "mixed Mullerian tumors ")

Undifferentiated / unclassified epithelial tumors
- adenocarcinoma (NOS)
- undifferentiated carcinoma

II - ovarian sex cord-stromal tumors

granulosa-stromal cell tumors
- thecoma - fibroma group
  - ovarian fibroma
  - thecoma
  - fibrothecoma

- granulosa cell tumors
  - Adult type
  - Juvenile type

Sertoli-stromal cell tumors
- Sertoli-Leydig cell tumor (Androblastoma )
- Sertoli cell tumor
- Stromal-Leydig cell tumor

Sex cord-stromal tumors of mixed or unclassified cell types
- Sex cord tumor with annular tubules
- Gynandroblastoma
- Sex cord-stromal tumor, unclassified, NOS

Steroid cell tumors
- Stromal luteoma
- Leydig cell tumor
  - Leydig cell tumor, Hilus cell tumor type
  - Leydig cell tumor, non-hilar type
  - Leydig cell tumor, NOS

- Steroid (lipid) cell tumors NOS
  - Well differentiated
  - Malignant

III - Ovarian germ cell tumors

Teratoma :
- Immature
- Mature
  - Solid
  - Cystic (dermoid cyst )
  - Monodermal (e.g., struma ovarii , carcinoid )

Dysgerminoma
Yolk sac tumor (endodermal sinus tumor )
Mixed germ cell tumors

IV. Miscellaneous tumors

Metastasis
- from colonic carcinomas , appendiceal carcinomas
- from gastric carcinomas (Krukenberg tumor )
- from mammary carcinomas

Macroscopical appearance

ovarian cystic tumors
ovarian surface epithelial tumors

Microscopical appearance

ovarian tumors with prominent spindle cells

Differential diagnosis

ovarian tumor-like lesions

follicle cyst
corpus luteum cyst
ovarian remnant syndrome
polycystic ovarian disease (PCOD)
stroma hyperthecosis
ovarian stromal hyperplasia
ovarian massive edema
ovarian fibromatosis
hilus Leydig cell hyperplasia
ovarian simple cyst
ovarian idiopathic calcification
uterus-like adnexal mass
splenic gonadal fusion
pregnancy luteoma
hyperreactio luteinalis
large solitary luteinized follicle cyst of pregnancy and puerperium
granulosa cell proliferations of pregnancy
hilus Leydig cell proliferation of pregancy
ectopic decidua
ovarian pregnancy
ovarian endometriosis (ovarian endometriotic cyst )
ovarian granulomas
- ovarian foreign body granulomas
- ovarian palisading granulomas
- ovarian granulomas secondary to systemic diseases

ovarian infections
- ovarian bacterial infections
  - ovarian actinomycosis
  - ovarian tuberculosis
  - ovarian malacoplakia

- ovarian fungal infections
- ovarian parasitic infections

mesothelial proliferations
surface epithelial-stromal proliferation
autoimmune oophoritis
ovarian torsion
ovarian infarction
ovarian changes secondary to metabolic diseases
mucicarminophilic histiocytosis

Diagnosis : diagnosis of ovarian tumors

References

Shih IeM, Kurman RJ. Ovarian tumorigenesis: a proposed model based on morphological and molecular genetic analysis. Am J Pathol. 2004 May;164(5):1511-8. PMID: 15111296