Page 759 - Textbook of Pathology, 6th Edition

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Figure 24.21 Papillary serous cystadenocarcinoma of the ovary. It
shows an enlarged ovary replaced with a large unilocular cyst with
intracystic papillae (arrow).

2. Borderline (atypical proliferating) serous tumour peritonei (page 579). As compared with serous tumours,
usually has stratification (2-3 layers) of benign serous type mucinous tumours are more commonly unilateral. Benign
of epithelium. There is detachment of cell clusters from mucinous tumours occur bilaterally in 5% of cases while
their site of origin and moderate features of malignancy borderline and malignant are bilateral in 20%. As per current
but there is absence of stromal invasion. concept, the diagnosis of primary ovarian mucinous
3. Serous cystadenocarcinoma has multilayered adenocarcinoma is made after excluding metastatic tumours
malignant cells which show loss of polarity, presence of to the ovary, while bilateral mucinous adenocarcinoma of
solid sheets of anaplastic epithelial cells and definite the ovary is invariably metastatic deposits to the ovary.
evidence of stromal invasion. Papillae formations are more Mucinous tumours occur principally between 2nd and 5th
frequent in malignant variety and may be associated with decades of life. Mucinous cystadenocarcinoma usually CHAPTER 24
psammoma bodies but mere presence of psammoma develops in women above the age of 40 years.
bodies is not indicative of malignancy (Fig. 24.22). Histogenesis of mucinous tumours, in line with that of
serous tumours, is by metaplasia from the coelomic
Mucinous Tumours epithelium that differentiates along endocervical type or
intestinal type of mucosa.
Mucinous tumours are somewhat less common than serous
tumours and constitute about 20% of all ovarian tumours
and 10% of all ovarian cancers. Over 80% are benign, 10- MORPHOLOGIC FEATURES. Grossly, mucinous
15% are borderline (atypical proliferating) and 5-10% are tumours are much larger than serous tumours. They are
malignant. These predominantly cystic tumours contain smooth-surfaced cysts with characteristic multiloculations
mucin which was previously described as pseudomucin. containing thick and viscid gelatinous fluid (Fig. 24.23). The Female Genital Tract
Well-differentiated borderline mucinous tumours are Benign tumours generally have thin wall and septa
associated with mucinous ascites termed pseudomyxoma dividing the loculi are also thin and often translucent, but

Figure 24.22 Papillary serous cystadenocarcinoma of the ovary. Microscopic features include stratification of low columnar epithelium lining
the inner surface of the cyst and a few psammoma bodies. The stroma shows invasion by clusters of anaplastic tumour cells.