Benign Ovarian Neoplasms

Question 0

How to think about ovarian tumors

Answer 0

Surface derived tumors- serous tumors, mucinous tumors, endometrioid, and brenner tumor.

Germ cell tumors - cystic teratoma, dysgerminoma, yolk sac tumor

Sex cord stromal tumor - thecoma-fibroma, granulosa-theca cell tumor, sertoli-leydig cell tumor, gonadoblastoma

Tumors mestatic to the ovary- metastasis from mullerian tumors or extra-mullerian tumors, krukenberg tumors.

Question 1

Serous cystadenoma

Answer 1

Most common ovarian neoplasm. Thin walled, uni- or multi-locular.

Lined with fallopian like epithelium. Often bilateral.

Question 2

Mucinous cystadenoma

Answer 2

Multiloculated (having many small cavities or cells), large. Lined by mucus secreting epithelium. May be associated with a Brenner tumor.

Question 3

Endometrioma

Answer 3

Mass arising from growth of ectopic endometrial tissue. Complex mass on ultrasound. Presents with pelvic pain, dysmenorrhea, dyspareunia.

Question 4

Mature cystic teratoma / dermoid cyst

Answer 4

Germ cell tumor with all 3 germ lays. Pain secondary to ovarian enlargement or torsion. Can also contain functional thyroid tissue and present as hyperthyroidism (struma ovarii).

Question 5

Brenner tumor

Answer 5

Looks like a bladder. Solid tumor that is pale yellow in color and appears encapsulated. Coffee bean nuclei on h and e.

Remember: max brenner –> coffee beans –> coffee –> makes you pee from your bladder –> pee is pale yellow.

Question 6

Fibromas

Answer 6

Bundle of spindle shaped fibroblasts.

Question 7

Meigs syndrome

Answer 7

Triad of ovarian fibroma, ascites, and hydrothorax.
Pulling sensation in the groin.

Fat, fibrous, and fighting for air.

Question 8

Thecoma

Answer 8

Like granulosa tumors, may produce estrogen. Usually present as abnormal uterine bleeding in a postmenopausal woman