Page 527 - Concise Pathology for Exam Preparation ( PDFDrive )

512 SECTION II Diseases of Organ Systems

Classification of Ovarian Tumours (WHO)

1. Surface epithelial-stromal ovarian tumours
(a) Occur primarily in adults (second decade onwards).
(b) Constitute 65–75% of all ovarian tumours.
(c) Thought to arise by transformation of coelomic epithelium, which may evolve into
serous (tubal), endometrioid (endometrial) and mucinous (cervical) epithelium
(coelomic epithelium gets incorporated into the ovaries by invagination of the
surface epithelium, which later gets detached).
Types:
• Serous tumours
• Benign (cystadenoma, cystadenofibroma)
• Borderline (serous borderline tumour)
• Malignant (low- and high-grade serous cystadenocarcinoma)
• Mucinous tumours
• Benign (cystadenoma, cystadenofibroma)
• Borderline (mucinous borderline tumour)
• Malignant (mucinous adenocarcinomas)
• Endometrioid tumours
• Benign (cystadenoma, cystadenofibroma)
• Borderline (borderline endometrioid tumour)
• Malignant (endometrioid adenocarcinoma)
• Epithelial–stromal tumours
• Adenosarcoma
• Mixed malignant mesodermal Müllerian tumours (MMMT)
• Clear cell tumours
• Benign
• Borderline
• Malignant
• Transitional tumours
• Brenner tumour
• Brenner tumour of borderline malignancy
• Malignant Brenner tumour
• Transitional cell carcinoma (non-Brenner type)
2. Germ cell ovarian tumours
(a) Derived from the egg-producing cells within the body of the ovary.
(b) Occur primarily in children and adolescents.
(c) Constitute 15–20% of all ovarian tumours and 3–5% of all ovarian cancers.
Types:
• Teratomas
• Dysgerminomas
• Endodermal sinus (Yolk sac) tumours
• Choriocarcinomas
• Mixed germ cell tumours
3. Sex cord–stromal ovarian tumours:
Rare, constitute 2–3% of all malignant ovarian tumours and produce steroid
hormones.
Types:
• Granulosa cell tumours
• Tumours of thecoma-fibroma type
• Sertoli–Leydig cell tumours
• Steroid lipid cell tumours
4. Cancers derived from other organs (colon, appendix, pancreas, biliary system, breast)
can also spread to the ovaries (metastatic cancers).

Aetiopathogenesis of Ovarian Cancer
• Two most important risk factors are nulliparity and positive family history.

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