PATH - Ovarian Neoplasms

Question 1

Follicular cyst

Answer 1

Distention of unruptured *graafian follicle

May be associated with hyperestrogenism, endometrial hyperplasia

Most common ovarian mass in young women

Question 2

Theca-lutein cyst

Answer 2

Often bilateral/multiple

Due to gonadotropin stimulation

Associated with *choriocarcinoma and
*hydatidiform moles

Question 3

Serous cystadenoma

Answer 3

Benign ovarian neoplasms

Most common ovarian neoplasm

Lined with *fallopian tube–like epithelium

Often bilateral

Question 4

Mucinous cystadenoma

Answer 4

Benign ovarian neoplasms

Multiloculated, large

Lined by *mucus-secreting epithelium

Question 5

Endometrioma

Answer 5

Benign ovarian neoplasms

Endometriosis (ectopic endometrial tissue) within ovary with cyst formation

Presents with pelvic pain, dysmenorrhea, dyspareunia

symptoms may vary with menstrual cycle

*“Chocolate cyst”—
endometrioma filled with dark, reddish-brown blood.

Complex mass on ultrasound

Question 6

Mature cystic teratoma

dermoid cyst

Answer 6

Benign ovarian neoplasms

Germ cell tumor, most common ovarian tumor in females 10–30 years old

Cystic mass containing
elements from all 3 germ layers (teeth, hair, sebum)

Can present with pain 2° to ovarian enlargement or torsion

A monodermal form with thyroid tissue (*struma ovarii) uncommonly presents with hyperthyroidism

Question 7

Brenner tumor

Answer 7

Benign ovarian neoplasms

Looks like *bladder

Solid tumor that is pale yellow-tan and appears encapsulated

*“Coffee bean” nuclei on H&E stain

Question 8

Fibromas

Answer 8

Benign ovarian neoplasms

Bundles of spindle-shaped *fibroblasts.

*Meigs syndrome—triad of ovarian fibroma, ascites,
hydrothorax

*“Pulling” sensation in groin.

Question 9

Thecoma

Answer 9

Benign ovarian neoplasms

Like granulosa cell tumors, may produce estrogen.

Usually presents as *abnormal uterine bleeding in a postmenopausal woman.

Question 10

Granulosa cell tumor

Answer 10

Malignant ovarian neoplasms

Most common malignant stromal tumor

Predominantly women in their 50s

Often produces estrogen and/or progesterone and presents with postmenopausal bleeding, sexual precocity
(in pre-adolescents), breast tenderness

Histology shows *Call-Exner bodies (granulosa cells
arranged haphazardly around collections of eosinophilic fluid, resembling primordial follicles).

Question 11

Serous cystadenocarcinoma

Answer 11

Malignant ovarian neoplasms

Most common malignant ovarian neoplasm

frequently bilateral

*Psammoma bodies

Question 12

Mucinous

cystadenocarcinoma

Answer 12

Malignant ovarian neoplasms

*Pseudomyxoma peritonei–intraperitoneal accumulation of mucinous material from ovarian or
appendiceal tumor

Question 13

Immature teratoma

Answer 13

Malignant ovarian neoplasms

Aggressive, contains fetal tissue, neuroectoderm

Typically represented by immature/embryonic-like neural tissue.

Commonly diagnosed after menopause

Question 14

Dysgerminoma

Answer 14

Malignant ovarian neoplasms

Most common in adolescents

Sheets of uniform *“fried egg” cells

hCG, LDH = tumor markers

Equivalent to male *seminoma but rarer.

1% of all ovarian tumors;
30% of germ cell tumors.

Question 15

Yolk sac (endodermal sinus) tumor

Answer 15

Malignant ovarian neoplasms

Aggressive

in ovaries or testes (boys) and sacrococcygeal area in young children

Most common tumor in *male infants.

Yellow, friable (hemorrhagic), solid mass

50% have *Schiller-Duval bodies (resemble glomeruli)

AFP = tumor marker.

Question 16

Krukenberg tumor

Answer 16

*GI malignancy that metastasizes to ovaries–>mucin-secreting *signet cell adenocarcinoma.