Appendix 1: Ovarian Tumors With Mucinous Epithelium Primary Tumors ■ Surface epithelial tumors Mucinous cystic tumors of intestinal and endocervical-like type Surface epithelial tumors of mixed cell type with a mucinous component Mixed müllerian tumors (adenofibroma, adenosarcoma, MMMT a a Malignant müllerian mixed tumor. ) Brenner tumors ■ Germ cell tumors Teratomas (mature and immature) Mucinous and strumal carcinoid tumors ■ Other Sertoli–Leydig cell tumor with…

Tumor-Like Lesions Inflammatory and Reparative Lesions Granulomatous Peritonitis ( Figs. 20.1–20.2 ) ▪ Granulomatous peritonitis, which can be caused by a variety of infectious and noninfectious agents, can result in peritoneal nodules, potentially mimicking disseminated cancer. Most of the following show a histiocytic response that may be to varying degrees granulomatous. ▪ Peritoneal tuberculosis, which is not uncommon in developing countries, can mimic advanced ovarian cancer…

▪ Lesions considered here are characterized by müllerian differentiation on microscopic examination and reflect the metaplastic potential of the pelvic and lower abdominal mesothelium and the subjacent mesenchyme of females (‘secondary müllerian system’). ▪ The müllerian potential of these tissues is consistent with their close embryonic relation to the müllerian ducts that arise by invagination of the coelomic epithelium. Displacement of coelomic epithelium and subcoelomic mesenchyme…

General Features ( Figs. 18.1–18.8 ) ■ Tumors that spread to the ovary have been referred to as secondary (those spreading directly from adjacent sites) or metastatic (those spreading from distant sites), but all tumors that spread from outside the ovary are referred to here as metastatic. ■ Metastases to the ovary account for about 5% of ovarian cancers found at laparotomy. Patients with the most…

Small Cell Carcinoma of Hypercalcemic Type Clinical features ▪ This tumor (SCCH) is the most common undifferentiated ovarian carcinoma in women <40 years of age. The age range has been 7 months to 44 years, with a peak from 18–30 (mean, 24) years of age; only rare patients are in the first or fifth decades. ▪ Rare SCCHs are familial and possibly heritable; it has occurred…

Sex Cord–Stromal Tumors ▪ These tumors (SCSTs), which account for ~5% of all primary ovarian tumors, are classified primarily on the basis of the constituent recognizable cell types ( Table 16.1 ): granulosa and theca cells, Sertoli cells, Leydig cells, and fibroblasts. Table 16.1 Histologic classification of ovarian sex cord–stromal tumors Granulosa−stromal tumors Granulosa cell tumor Adult Juvenile Tumors in thecoma−fibroma group Fibroma Cellular fibroma Fibrosarcoma…

General features ▪ Germ cell tumors ( Table 15.1 ) account for 30% of primary ovarian tumors; 95% are dermoid cysts (mature cystic teratomas). Table 15.1 Classification of germ cell tumors of the ovary Primitive germ cell tumors (nonteratomatous) Dysgerminoma Yolk sac tumor Embryonal carcinoma Nongestational choriocarcinoma Mixed (specify types) Teratomas Mature Cystic (dermoid cyst) Solid Fetiform (homunculus) Immature a Polyembryoma a Monodermal Struma Carcinoid Insular…

Endometrioid Epithelial Tumors General features ■ Most endometrioid tumors are epithelial and account for about 3% of all ovarian tumors. Endometrioid carcinomas account for 10–15% of ovarian carcinomas and at least 50% of stage I carcinomas. Endometrioid stromal sarcomas, mesodermal adenosarcomas, and malignant mesodermal mixed tumors are considered under separate headings. ■ Benign endometrioid tumors are mostly adenofibromas or cystadenofibromas; cystadenomas are uncommon but probably underdiagnosed.…

General Features of Epithelial Ovarian Tumors Approach to Ovarian Tumor Diagnosis ( Tables 13.1 and 13.2 ) As this is the first chapter considering ovarian tumors, some remarks concerning their evaluation are appropriate. Most of these comments are basic and familiar to experienced pathologists but may be occasionally forgotten with potential failure to frame a correct differential diagnosis. Many, such as a thorough history, pertain to…

Follicular Lesions Follicle Cyst Clinical features ■ Solitary follicle cysts (FCs) are most common in nonpregnant women of reproductive age, particularly around the menarche and menopause and are likely due to abnormal pituitary gonadotropin secretion, such as an FSH-secreting pituitary adenoma (Kawaguchi et al.). Postmenopausal FCs are uncommon but rarely may cause postmenopausal bleeding. ■ FCs may present as a palpable mass or menstrual irregularities (due to…

Tumor-Like Lesions of the Fallopian Tube Inflammatory Lesions Usual Bacterial Salpingitis ( Figs. 11.1–11.6 ) ■ Bacterial salpingitis, an important cause of infertility, is usually a result of ascending sexually transmitted infections ( Neisseria gonorrhoeae , Chlamydia trachomatis , mycoplasma). Other organisms may enter the tubes via lymphatics or blood vessels, especially after an abortion or pregnancy, such as streptococci, staphylococci, coliform bacilli, and anaerobic bacteria.…

Trophoblastic Lesions ■ The WHO classification of gestational trophoblastic disease (GTD) and the TNM and FIGO classifications of gestational trophoblastic tumors are presented in Tables 10.1–10.4 . Table 10.1 Types of gestational trophoblastic disease With villi Hydatidiform mole Complete mole Partial mole Invasive mole Persistent mole Chorangiocarcinoma Without villi Placental site nodules and plaques Placental site trophoblastic tumor Epithelioid trophoblastic tumor Choriocarcinoma Table 10.2 World Health…