Benign: Ovary

Question 1

Gonadoblastoma

Answer 1

Histology:

• Large cellular nests composed of germ cells and sex-cord cells, separated by fibrous stroma.
• Cells surround circular eosinophilic basement membrane material.
• Stroma may contain dsytrophic calcification and cells resembling Leydig cells

Seen with mixed gonadal dysgenesis, patient may have Y chromosome material

Considered benign, but malignant transformation can happen if not excised (dysgerminoma).

Question 2

Brenner tumor

Answer 2

Nests of urothelium within fibrous stroma

Can have glandular spaces and mucinous metaplasia

+ CK7, uroplakin III

TCC of the ovary are negative for markers of urothelial diff

Question 3

Sertoli cell tumor

Answer 3

Most manifest unilaterally

Variants: oxophylic (eosinophilic cytoplasm), lipid-rick (folliculoma lipidique)

Can present with signs of excess estrogen, excess androgen or rarely both

• Negative for EMA

many + AE1/AE3 & abundant lipid filled cytoplasm + by oil Red O

subset pf patients have Peutz-Jeghers syndrome

Question 4

What malignancy is most commonly associated with mature teratoma?

Answer 4

Squamous cell carcinoma

rarely reported: PTC, melanoma, rhabdomyosarcoma, osteosarcoma

Question 5

Ovarian TB

Answer 5

Difficult to differentiate TB from neoplasia pre-op due to similar presentations

CA-125 may be elevated

In adolescents, difficult to differentiate from germ cells tumors pre-op

Can lead to infertility