Ovary pathology DDx

Question 1

Case 2: Cystic lesion was seen in the ovary of a 20 year old female. It was not a neoplasm.

Answer 1

• follicular cyst
• corpus luteal cyst
• endometriosis cysts (chocolate cysts)

Question 2

Case 4: 45 year old female presented with abdominal distension and pelvic discomfort. A cystic mass was palpated in the right iliac fossa region. It was also felt on pelvic examination. Ultrasound- cystic mass in the right adnexa.

Answer 2

• tumours of the ovary
• Metastasis
• Epithelial, Stromal, Germ cell Cystic, Solid

Classification based on origin

• Surface epithelial: (65 - 70%) serous,mucinous, endometroid, Brenner, mixed, undifferentiated
• Germ cell: (15-20%) teratoma,dysgerminoma,
• Endodermal Sinus tumor, choriocarcinoma
• Sex cord stromal: (5-10%) fibroma,granulosa theca tumor, Sertoli Leydig tumor
• Metastasis: (5%)- variable

Question 3

Case 7: ovarian tumour w hirsuitism, masculine voice, hypertrophied clitoris

Answer 3

• Sertoli Leydig cell tumor (Androblastoma)
• Gonadoblastoma

Question 4

Case 6: lump in the breast which proved to be carcinoma. She was detected to have another primary tumor in the ovary.

Answer 4

• Sex cord stromal tumors
• Granulosa theca cell tumors
• Thecomas

Question 5

Case 5: 20 year female had presented with an ovarian tumor. It was solid( not cystic).

The physician sent blood samples for testing AFP,alpha-1-antitrypsin and HCG.

Answer 5

• Endodermal sinus tumor (Yolk sac tumor)
• Dysgerminoma
• Choriocarcinoma (nongestational)
• Embryonal carcinoma
• Polyembryoma
• Mixed germ cell tumor