Pathology of ovarian carcinoma
Section snippets
Serous carcinoma
Serous carcinoma is the most common type of ovarian cancer and accounts for more than 50% of malignant ovarian neoplasms. The peak age range is 45 to 65 years, with a mean of 57 years [1]. Two thirds of cases involve both ovaries. For stage I cases, about 40% are bilateral. Assessment of the character of the external surface is an important component of staging for tumors that are confined to the ovaries. This assessment is best done by the surgeon but also should be done by the pathologist.
Endometrioid carcinoma
Endometrioid carcinomas comprise 5.7% of ovarian surface epithelial neoplasms, 10% to 15% of ovarian carcinomas, and 93% of endometrioid ovarian neoplasms. These tumors are most common in women in their 40s and 50s, and the mean patient age is 56 years. Tumor size ranges from 12 to 20 cm with a mean of about 15 cm. The stage distribution differs significantly from serous carcinoma. A high proportion (43%) of endometrioid carcinomas are diagnosed in stage I. About 13% of early-stage (FIGO I to
Mucinous carcinoma
After exclusion of metastatic tumors to the ovaries, primary ovarian mucinous carcinomas are uncommon and are much less common than metastatic mucinous carcinomas [6]. Because of the limitations of the published data, clinical and pathologic features, including proportion of ovarian neoplasms, bilaterality rates, and stage distribution, are variable and may be unreliable. Mucinous carcinomas have been reported to comprise approximately 3.6% of ovarian epithelial neoplasms, 12% of ovarian
Clear cell carcinoma
Clear cell carcinomas comprise 2.4% of ovarian epithelial neoplasms and about 8% to 10% of ovarian carcinomas. The mean age of patients with clear cell carcinoma is 57 years. Clear cell carcinoma is the most common epithelial ovarian neoplasm to be associated with paraneoplastic hypercalcemia. Because the relationship with endometriosis is strongest for clear cell carcinoma among all types of ovarian carcinoma, endometriotic implants are commonly present in close proximity to the tumor or
Transitional cell carcinoma
There are two clinicopathologic types of malignant transitional cell tumor: malignant Brenner tumor, in which a benign or atypical proliferative Brenner component is identified, and transitional cell carcinoma (TCC), in which no benign or atypical proliferative Brenner component is identified [11]. At present, many experts believe that most tumors classified as ovarian TCC are serous carcinomas with a transitional-like pattern and that genuine TCC of the ovary is rare. Approximately 10% to 15%
Pathology of atypical proliferative (borderline) ovarian epithelial tumors and micropapillary (well-differentiated) serous carcinomas
The following discussion of serous neoplasms of the ovary designates the proliferative noninvasive epithelial ovarian neoplasms as atypical proliferative tumors rather than borderline or of low malignant potential. The borderline category of ovarian epithelial tumors was introduced officially in the early 1970s to describe a group of tumors that did not display overtly malignant features but that occasionally seemed to behave in a malignant fashion [13], [14]. Their behavior appeared to be
References (26)
- et al.
Ovarian serous borderline tumors: the citadel defended
Hum Pathol
(2000) - et al.
Ovarian serous borderline tumors: a critical review of the literature with emphasis on prognostic indicators
Hum Pathol
(2000) - et al.
Pseudomyxoma peritonei in women: a clinicopathologic analysis of 30 cases with emphasis on site of origin, prognosis, and relationship to ovarian mucinous tumors of low malignant potential
Hum Pathol
(1995) - et al.
Carcinoma of the ovary
J Epidemiol Biostat
(1998) - et al.
Surface epithelial tumors of the ovary
- et al.
Prognostic factors in patients with stage I epithelial ovarian cancer
Obstet Gynecol
(1990) - et al.
Early de novo ovarian carcinoma: a study of fourteen cases
Cancer
(1994) - et al.
A clinicopathologic analysis of atypical proliferative (borderline) tumors and well differentiated endometrioid adenocarcinomas of the ovary
Am J Surg Pathol
(2000) - et al.
Evaluation of diagnostic criteria and behavior of ovarian intestinal-type mucinous tumors: atypical proliferative (borderline) tumors, and intraepithelial, microinvasive, invasive, and metastatic carcinomas
Am J Surg Pathol
(1999) - et al.
Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up
Am J Surg Pathol
(1998)