Malignancy: Ovary Flashcards
Struma Ovarii
Type of teratoma. Thyroid tissue. Unusual forms: cystic, malignant (PTC).
Heterologous Malignant Mixed Mullerian Tumor
Both malignant epithelial AND mesenchymal elements (e.g. cartilage; has to not be native to the uterine corpus; indicating heterologous differentiation)
Homologous Malignant Mixed Mullerian Tumor
Also both malignant & epithelial; mesenchymal elements (but that would normally arise in the uterus, such smooth muscle or endometrial stroma)
Granulosa cell tumor
Many patterns: diffuse, microfollicular, insular, trabecular
Microfollicular: Call-Exner bodies (contains eosinophilic debris lined by grooved nuclei)
Tumor secretes estrogen (which makes it look yellow on gross exam)
Strongly & diffusely positive for inhibin
Serous neoplasm of low malignant potential/borderline tumor VS. invasive serous carcinoma
Lack of stromal invasion in first
Micropapillary type of SBT may have poorer prognosis than the typical type
Metastasis TO the ovary
Signet ring: usually GI (colon or stomach); most common to mets to ovary (often bilateral; called Krukenberg tumors)
Lobular breast carcinoma can also resemble the above.
Ovarian neoplasms in adolescents
Most are of germ cell origin (62% of ovarian malignancies)
Epithelial tumors only 20%, more likely benign
<1-2% of all neoplasms in girls younger than 16 y.o.
60-70% of all GYN neoplasms in childhood and adolescence tho
Malignant in 29-55% of cases
Ovarian neoplasms in adults
Epithelial neoplasms are most common (90% of ovarian malignancies)
Sex cord-stromal tumors and germ cell tumors are 5%
Germ Cell tumors: general
most common malignancy in first 2 decades of life
Most common benign: mature teratoma
Most common malignant: dysgerminoma
Most common sex cord-stromal tumor in pediatrics
juvenile granulosa cell tumor
75% secrete estrogen > leading to sexual pseudoprecocity
5 year survival: 92%
Treatment: unilateral salpingo-oophorectomy
Immature teratoma
Graded based on amount of immature neuroepithelium (neural tubules & immature rossettes) -
Grade 1: < low-power field (4X) on worst slide
Grade 2: no more than 3 low power fields on worst slide
Grade 3: >3 low power fields on any slide
Often associated with yolk-sac tumor (diagnosis then changed to mixed germ cell tumor)
Tumors that produce estrogen
Granulosa cell tumor
Fibrothecoma
Steroid cell tumors
NOT: luteomas (see in pregnant women)
Endometrioid adenocarcinoma of the ovary
Similar histology to counterpart in uterus
Microglandular pattern may mimic an adult granulosa cell tumor
Dysgerminoma
+ PLAP (which is pos in all germ cells tumors)
Identical histology to testicular seminoma
Epithelioid granulomas common
Gonadoblastoma is a known precursor lesion (esp in intersex cases)
Show both isochromosome 12p and polysomy of chromosome 12p
Pulmonary-type small cell carcinoma
Primary to ovary
Extremely rare, approx 20 cases only in literature
Cells are small to medium sized, with finely stippled chromatin; molding; pyknosis and necrosis
Commonly associated with endometrial adenocarcinoma
Aggressive, poor prognosis
