1. Metatatic Tumors to the ovary
1.1. Krukenberg tumors
1.1.1. Metastatic carcinoma
1.1.2. Signet ring cells
1.1.3. Sites of origin:
1.1.3.1. Stomach
1.1.3.2. Colon
1.1.3.3. appendix
2. Sex Cord Tumors
2.1. Rare tumor
2.2. Often produce steroids hormones
2.3. Types:
2.3.1. Granulosa cell tumor
2.3.1.1. Uni-lateral solid and cyst
2.3.1.2. Hormonally active tumor
2.3.1.3. MOST COMMON Estrogenic ovarian neoplasm.
2.3.1.4. can be associated with endometrial hyperplasia & carcinoma
2.3.1.4.1. why? bcoz it produce estrogen, and Enomertial hyperplasia & carcinoma are Estrogen responsive tumors !!
2.3.1.5. Forms:
2.3.1.5.1. Adult form
2.3.1.5.2. Juvenile form
2.3.1.6. Histologically:
2.3.1.6.1. Call-Exner bodies
2.3.2. Thecoma-Fibroma
2.3.2.1. Functional tumor = produce estrogen
2.3.2.2. in post-menopausal women
2.3.2.3. may develop endometrial hyperplasia and carcinoma.
2.3.2.4. Morphology
2.3.2.4.1. Gross
2.3.2.4.2. M/E
2.3.3. Sertoli-Leydig cell tumor
2.3.3.1. 1% of ovarian neoplasm
2.3.3.2. predominantly in young woemn
2.3.3.3. Androgenic
2.3.3.3.1. so it cause defminization of women
2.3.3.3.2. may cause virilization
2.3.3.4. morphology:
2.3.3.4.1. M/E:
3. Epithelial surface Tumors
3.1. MOST COMMON FORM
3.2. derived from the cells on the surface of the ovary.
3.3. Most common primary neoplasm in ovary
3.4. 90% of malignant tumors of ovary
3.5. occur in adult
3.6. Types:
3.6.1. Serous (Tubal)
3.6.1.1. Bilateral (30-66%)
3.6.1.2. 75% Bengin/borderline, 25% malignant
3.6.1.3. Tall columnar ciliated epithelium
3.6.1.3.1. same as what we see in uterine tube
3.6.1.4. Extension to peritonium = Bad prognosis
3.6.1.5. Malignant serous tumors
3.6.1.5.1. Commenst malignant ovarian tumor
3.6.1.5.2. Partly cystic partly solid with necrosis & hemorrhage
3.6.1.5.3. USUALLY present wth Ascites due to abdominal metastases !
3.6.1.5.4. also called: Serous cyst-adeno-carcinoma
3.6.1.5.5. Morphology:
3.6.2. Mucinous
3.6.2.1. Less common 25%, VERY LARGE
3.6.2.2. Rarly malignant
3.6.2.3. Rarly bilateral - 5-20%
3.6.2.4. Tall columnar, apical mucin
3.6.2.5. Pseudo-myxoma peritonei
3.6.2.5.1. production of abundant mucin which fills the abdominal cavity, if untreated mucin may compresses vital organs e.g colon, liver, kidneys etc..
3.6.2.6. Types:
3.6.2.6.1. Mucinous Cyst-adenoma-Borderline
3.6.2.6.2. Mucinous Cyst-adeno-Carcinoma
3.6.3. Endometrioid
3.6.3.1. Most are unilateral
3.6.3.2. Cells look like endonetrium even though they are coming from the ovary.
3.6.3.3. MOST OF THEM ARE malignant !!
3.6.3.3.1. many are associated with endometrial cancer (30%)
3.6.3.4. pt. may have concurrent endometriosis
3.6.3.5. Endometrioid adeno-carcinoma:
3.6.3.5.1. solid/cyst filled by hemorrhage & necrosis
3.6.3.5.2. Stromal invasion by irregular malignant endometrial glands.
3.6.4. Transitional cell (Brenners)
3.7. Morphology
3.7.1. Cystic
3.7.1.1. Cyst-adenomas
3.7.2. Solid/cystic
3.7.2.1. Cyst-adeno-fibromas
3.7.3. Solid
3.7.3.1. Adeno-fibroma
3.8. Behavior:
3.8.1. All types can be:
3.8.1.1. Benign:
3.8.1.1.1. Mostly cystic
3.8.1.2. Borderline:
3.8.1.2.1. Cystic/Solid foci
3.8.1.3. Malignant:
3.8.1.3.1. Mostly Solid
4. Germ cell tumors
4.1. occurs in children and teens
4.2. derived from the egg producing cells within the body of the ovary.
4.3. Rare tumor
4.4. Classification:
4.4.1. Germ cell
4.4.1.1. No differentiation:
4.4.1.1.1. Dysgerminoma
4.4.1.2. differentiation
4.4.1.2.1. Embryonal carcinoma
4.4.1.2.2. Extra-Embryonic tissue:
4.4.1.2.3. Embryonic tissue: