Ovarian Neoplasms
Objectives of this lecture1.To learn the different type of ov. Tumor . 2. to differentiate between benign& malignant ov.tumor . 3.to know the clinical presentation ,staging &diagnosis of ov. Tumor. 4. to learn the managment of ov. Tumor .
1.Tumors of Surface Epithelium form 90% of ovarian tumors 2. Germ Cell Tumors 3. Sex cord-stromal tumour 4.Metastatic Tumors of Ovary.
Surface Epithelium
1.Mucinous Tumors Incidence – 30% of ovarian neoplasmsMucinous cyst adenomaCommonest tumorAge group: 30-50 yrs Bilateral in 10%Mucinous cystadenocarcinomaAge group: 40-60 yrs Bilateral in 10 %Features Large multilocular pedunculated cyst Rare complication may occur with involvement of the peritoneum Psedomyxoma peritonei (jelly belly) May produce coarse calcifications in primary or metastases
Surface Epithelium
2.Serous Tumors Incidence – 50% of ovarian neoplasmsSerous cystadenoma: Age group: 20 – 30 yrsBilateral in 15%Malignant transformation in 20 – 30 %Serous cystadenocarcinoma:Age group: 40 – 60 yrs Bilateral in 30%5 year survival rate: 30 – 50 %Features: Contain fibrous walled cysts with papillary excrescences Locules contain straw-colored fluid Psammoma bodies=concentric calcification in papillary process Usually fine sand-like calcification frequently difficult to see on plain radiographs
Surface Epithelium
3.Endometrial tumors Incidence – 20% of ovarian tumorsMorphology: Tumors containing solid and cystic areasFilled with hemorrhagic fluidLined by glandular epitheliumSurface Epithelium
4.Clear Cell (mesonephroid tumor) Incidence: uncommonAge group: 50 – 60 yrs Morphology: Unilocular cysts with small cystic spaces5.Brenner tumor: Incidence: 1- 2% Occur commonly in perimenopausal women
Germ Cell TumorsOrigin : cells derived form oocytes Incidence: 15- 20% of all ovarian tumors, 5% malignant Age: young age
1.Dysgerminoma Incidence : very commonAge : 20 – 20 yrs Bilateral : 10 – 15 %Macroscopic features :Solid tumors, elastic rubbery consistency having smooth, firm capsule
2.Teratoma Derived from cells of all three germ layers Types: Mature or benign type (e.g. Dermoid cysts) Immature or malignant type (e.g. Solid Teratoma) Monodermal or highly specialized (e.g. Struma ovarii)
3.Choriocarcinoma and Embryonal Cell Carcinoma Choriocarcinoma mostly of placental origin occurs in prepubertal girls. Highly malignant Contains syncytiotrophoblasts and cytotrophoblasts Secretes large quantities of the tumor marker - HCG Embryonal cell carcinoma Incidence : rare Highly malignant