D efinition — A malignant mucinous tumor arising in the ovarian cortex. Clinical Features Epidemiology The least common of the major malignant epithelial tumors, accounting for about 2.4% of all primary malignant epithelial tumors of the ovary. Average age in the sixth decade. Associated with borderline mucinous tumors. Associated with RAS mutations. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy…

D efinition — Low-grade serous tumor implants with high risk of a malignant or adverse outcome. Clinical Features Epidemiology Predominates in the fourth to sixth decades of life, but can be seen at virtually any age. Classically associated with borderline serous tumors, but also associated with frankly malignant low-grade serous carcinomas of the ovary. Comprises growth on mesothelial surfaces with high risk of adverse outcome. You’re…

D efinition — An invasive low-grade serous carcinoma. Clinical Features Epidemiology The less common serous carcinoma. Predominates in the fourth to sixth decades of life, but can be seen at virtually any age. Can arise in a serous borderline tumor (SBT) or SBT with complex architecture (intraepithelial carcinoma). Associated with mutations in regulators of the MAPK pathway (KRAS, BRAF, ERBB2) in about two thirds of tumors.…

D efinition — A serous borderline tumor (SBT) with evidence of early, noninfiltrative carcinoma. Clinical Features Epidemiology Associated with the most common epithelial tumor of the ovary. Predominates in the fourth to sixth decades of life, but can be seen at virtually any age. Viewed as early malignant change on the surface of the papillae. An intermediate biology between SBT and well-differentiated invasive serous carcinoma. You’re…

D efinition — A proliferative serous tumor of the ovary conferring a small (less than 5%) risk of adverse outcome. Clinical Features Epidemiology The most common epithelial tumor of the ovary. Predominates in the fourth to sixth decades of life, but can be seen at virtually any age. These tumors can be associated with endometriosis but more often are seen as part of a continuum merging…

D efinition — A malignant ovarian neoplasm composed of benign glandular and malignant stromal elements. Clinical Features Epidemiology Rare. Occurs over a wide age range with a mean of 54 years. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition — An ovarian malignancy with mixed epithelial and mesenchymal differentiation. Clinical Features Epidemiology Rare tumors, comprising less than 4% of epithelial ovarian carcinomas. Presumed to arise in most cases from a single neoplastic clone. Can be associated with endometriosis, but can coexist with any epithelial cell type. Present at an older age than most epithelial carcinomas, in the seventh and eighth decades. You’re Reading…

D efinition — A distinct variant of low-grade endometrioid carcinoma with a spindled or squamotransitional phenotype. Clinical Features Epidemiology Similar to other low-grade endometrioid adenocarcinomas. Associated with endometriosis of the ovary. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition — A granulomatous disease of uncertain etiology characterized by histiocytic infiltrates (von Hansemann cells) with calcified inclusions (Michaelis-Gutmann bodies). Clinical Features Epidemiology Most often associated with the urinary tract with a female preponderance (4 : 1). There is no relationship to gender in other sites. Wide age range, but the typical patient is older, with an overall mean age of 50 years. Invariably associated with some…

D efinition — The presence of epithelium resembling fallopian tube epithelium outside the fallopian tube. Clinical Features Epidemiology Endosalpingiosis has been noted in up to 7% of reproductive-age women. It can be found in association with other pelvic pathologic processes including endometriosis, infection (pelvic inflammatory disease), neoplasm, and tubal processes, such as hydrosalpinx. You’re Reading a Preview Become a Clinical Tree membership for Full access and…

D efinition — Ovarian cortical inclusion cysts (CICs) lined by either mesothelium (ovarian surface epithelium [OSE]) or müllerian epithelium. Clinical Features Epidemiology Very common. Found in the majority of ovaries in postmenopausal women. Associated with increasing age. Most plausible origin is entrapped tubal epithelium or shed cells from the fimbria. Another proposed mechanism is transdifferentiation of OSE. You’re Reading a Preview Become a Clinical Tree membership…

D efinition — A benign epithelial or epithelial stromal tumor with a serous (ciliated) epithelial component. Clinical Features Epidemiology Common; among the most frequently encountered of the benign epithelial tumors. Can be seen at any age, most commonly in postmenopausal women. Average age at presentation is in the mid-50s. May be associated with endometriosis. You’re Reading a Preview Become a Clinical Tree membership for Full access…

PITFALL D efinition — A variant of endometrioma that may be confused with malignancy on ultrasound. Clinical Features Epidemiology Relatively common. Seen during pregnancy. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition — Endometriotic epithelium with noncomplex architecture and nuclear atypia. Clinical Features Pathogenesis Occurs in endometriotic cysts. Possibly a very early neoplastic change akin to other lesions associated with endometriomas, such as müllerian mucinous cystadenomas, adenofibromas, and well-differentiated endometrioid adenocarcinomas. Can be associated with mutations in ARID1A. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership…

D efinition — Endometriotic epithelium with focal noncomplex mucinous differentiation. Clinical Features Pathogenesis Occurs in endometriotic cysts. Probably a very early neoplastic change akin to other lesions associated with endometriomas, such as müllerian mucinous cystadenomas, adenofibromas, and well-differentiated endometrioid adenocarcinomas. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition — An expansion of the ovarian cortex and medulla by a benign proliferation of ovarian cortical stromal cells and associated luteinized cells. Cortical stromal hyperplasia (CSH) is a mild form seen at menopause; stromal hyperthecosis is a more pronounced variant associated with symptoms comparable to polycystic ovarian syndrome. Clinical Features Epidemiology Seen in perimenopausal or postmenopausal women. May less commonly be seen as part…

D efinition — Benign incidental ovarian cyst most often noted in pregnant women. Clinical Features Epidemiology Uncommon to rare. Most often noted in pregnant or recently postpartum women. Can also be seen in nonpregnant, usually reproductive-age, women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here