Ovarian tumor explained

Ovarian tumors, or ovarian neoplasms, are tumors in the ovary.^[1] Not all are ovarian cancer.^[1] They consist of mainly solid tissue, while ovarian cysts contain fluid.^[2]

In 2020, the World Health Organization (WHO) divided ovarian tumours as 90% epithelial, 3% germ cell, and 2% sex cord-stromal types.^[3]

Histopathologic classification

Tumor of the ovary vary remarkably as they may arise from any of the 3 cell types of the normal ovary.

Ovarian tumors are classified according to the histology of the tumor, obtained in a pathology report. Histology dictates many aspects of clinical treatment, management, and prognosis.

The most common forms are:

Type	Subtype	Relative incidence[4]	Percent malignant	Comments	Micrograph
	Mature cystic teratoma	46.0%	0.17% to 2%[5]	Cystic, with elements of all 3 germ layers (endoderm, mesoderm and ectoderm).[6]
		2.5%	100%	A teratoma that contains anaplastic immature elements, and is often synonymous with malignant teratoma.[7]
	Other germ cell tumors	3.0%		Others mainly include dysgerminoma, yolk sac tumor, struma ovarii and squamous cell carcinoma arising from a dermoid cyst, and malignant mixed germ cell tumor.
	Serous tumor	25%	18.5%	Benign serous tumors of the right ovarian cyst are thinwalled unilocular cysts that are lined by ciliated pseudostratified cuboidal or columnar epithelium.[8]
	Mucinous tumor	15%	8.8%	Benign mucinous tumors of the ovary consist of simple, nonstratified columnar epithelium with basally-located hyperchromatic nuclei and resemble gastric foveolar epithelium.
		1%	Almost 100%	Tubular glands, resembling endometrium.[9]
	Other surface-epithelial tumors	1.5%		Others include mainly malignant mixed Müllerian tumor, Brenner tumor and mixed epithelial tumor.
		1.5%	0%	Spindle-shaped fibroblastic cells and abundant collagen.[10]
		1%	Almost 100%	Small, bland, cuboidal to polygonal cells in various patterns.[11]
	Other sex cord-stromal tumors	1%		Others include mainly juvenile granulosa cell tumor, thecoma and sclerosing stromal tumor
Secondary/metastatic) tumor		2%	100%	Usually from breast cancer, colon cancer, endometrial cancer, stomach cancer or cervical cancer.[12]

Mixed tumors contain elements of more than one of the above classes of tumor histology.

History

An 1882 article appearing in Scientific American mentions the case of a patient at University of Pennsylvania Hospital when Dr. William Goodell removed a 112 lbs tumor from a 31 year old patient, who weighted 75 lbs after removal from the tumor.^[13]

See also

• International Ovarian Tumor Analysis trial

Notes and References

1. Book: Female genital tumours: WHO Classification of Tumours. 2020. WHO Classification of Tumours Editorial Board. International Agency for Research on Cancer. Lyon (France). 5th. 4. 978-92-832-4504-9. 1. Tumours of the ovary: introduction. 32–35.
2. Book: Euscher . Elizabeth D. . Hui . Jian-Jun . Wei . Jian-Jun . Hui . Pei . Practical Gynecologic Pathology: Frequently Asked Questions . 2021 . Springer . Switzerland . 978-3-030-68608-6 . 225–262 . https://books.google.com/books?id=DMcpEAAAQBAJ&pg=PA225 . en . 9. Ovarian epithelial neoplasia .
3. De Leo . A . Santini . D . Ceccarelli . C . Santandrea . G . Palicelli . A . Acquaviva . G . Chiarucci . F . Rosini . F . Ravegnini . G . Pession . A . Turchetti . D . Zamagni . C . Perrone . AM . De Iaco . P . Tallini . G . de Biase . D . What Is New on Ovarian Carcinoma: Integrated Morphologic and Molecular Analysis Following the New 2020 World Health Organization Classification of Female Genital Tumors. . Diagnostics (Basel, Switzerland) . 14 April 2021 . 11 . 4 . 697 . 10.3390/diagnostics11040697 . free . 33919741 . 8070731 .
4. Unless otherwise specified in boxes, reference is: Vaidya. SA. Kc. S. Sharma. P. Vaidya. S. Spectrum of ovarian tumors in a referral hospital in Nepal. Journal of Pathology of Nepal. 4. 7. 2014. 539–543. 2091-0908. 10.3126/jpn.v4i7.10295. free.
5. Mandal. Shramana. Badhe. Bhawana A.. Malignant Transformation in a Mature Teratoma with Metastatic Deposits in the Omentum: A Case Report. Case Reports in Pathology. 2012. 2012. 1–3. 2090-6781. 10.1155/2012/568062. 23082264. 3469088. free.
6. Web site: Skin nonmelanocytic tumor - Other tumors of skin - Benign (mature) cystic teratoma. Hillary Rose Elwood. pathology Outlines. Topic Completed: 1 November 2016. Revised: 4 April 2019
7. Sun. Hang. Ding. Hongxin. Wang. Jianjun. Zhang. Emma. Fang. Yihua. Li. Zhenhua. Yu. Xiao. Wang. Chongren. Zhao. Yifan. Chen. Kan. Wen. Siwan. Li. Liang. Shan. Shan. Hong. Liu. Chen. Face. Su. Pu. The differences between gonadal and extra-gonadal malignant teratomas in both genders and the effects of chemotherapy. BMC Cancer. 19. 1. 2019. 408. 1471-2407. 10.1186/s12885-019-5598-0. 31039746. 6492338. free.
8. Baradwan. Saeed. Alalyani. Haneen. Baradwan. Amira. Baradwan. Afnan. Al-Ghamdi. Maram. Alnemari. Jameel. Al-Jaroudi. Dania. Bilateral ovarian masses with different histopathology in each ovary. Clinical Case Reports. 6. 5. 2018. 784–787. 2050-0904. 10.1002/ccr3.1466. 29744056. 5930217. free.
9. Web site: Ovary tumor - Endometrioid tumors - General. Shahrzad Ehdaivand. Pathology Outlines. Topic Completed: 1 December 2012. Revised: 6 March 2020
10. Parwate. Nikhil Sadanand. Patel. Shilpa M.. Arora. Ruchi. Gupta. Monisha. Ovarian Fibroma: A Clinico-pathological Study of 23 Cases with Review of Literature. The Journal of Obstetrics and Gynecology of India. 66. 6. 2015. 460–465. 0971-9202. 10.1007/s13224-015-0717-6. 27821988. 5080219.
11. Web site: Ovary tumor - Sex cord stromal tumors - Granulosa cell tumor - adult. Shahrzad Ehdaivand. Pathology Outlines. Topic Completed: 1 December 2012. Revised: 9 March 2020
12. Web site: Ovarian tumours : an overview. Lisa Lee-Jones, University of Wales College of Medicine. 2003-12-01. Atlas of Genetics and Cytogenetics in Oncology and Haematology.
13. Book: Scientific American. 1882-02-25. Munn & Company. 114. en.