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REGUB: Pathology of the Fallopian Tubes and Ovaries (iii) Ovarian…
REGUB: Pathology of the Fallopian Tubes and Ovaries (iii) Ovarian Neoplasms cntd
Germ cell tumours
20%
derived from germ cells
most common = benign cystic teratoma
malignant forms exist
v similar to testicular tumours
teratoma
mature
slow
benign
adult tissue
may contain elements from the 3 embryonic germ layers
bilat in 10%
cystic: teeth, hair, brain, skin, tissue resembling mature adult
1% undergo malignant transformation
immature
fast - rapid prolif
malignant
resembles foetal tissue (the greater the amount of immature tissue the greater the risk of spread)
all 3 germ layers
in younger patients
can be monodermal (specialised tissue)
ovarian carcinoid
struma ovarii - thyroid tissue
dysgerminoma
uncommon
equivalent to seminoma in males
clear cells
fibrous tissue
lymphocytes
childhood + young adults
ALL MALIGNANT
no endocrine function
Yolk sac tumour
aka endodermal sinus tumour
schiller duval body
hyaline droplets
rapid growth + aggressive
mixed germ cell tumours
embryonal/polyembryoma
choriocarc
same tumour can occur from placenta (ectopic pregnancy)
can only be ovarian primary if prepuberty
identical to placental lesions
aggressive
mets via blood all over body
Sex cord / Stromal
ovarian mesenchyme
same mesenchyme may give rise to male + female structures
male - sertoli (androgens) + Leydig
female
granulosa + theca
most are composed entirely of granulosa cells or mixed
5%
2/3 post-menopausal
unusually unilateral, any size
yellow if produce hormones (yellow tissue is either hormone-producing, necrosis, or fat)
insular, trabecular, central nucelar grooves, coffee-bean shaped nuclei
granulosa subtypes
adult + juvenile
tumours of the theca-fibroma group
4%
usually unilateral
fibroblasts + theca cells
a/w ascites, hydrothorax (Meig's syndrome - unilateral pleural effusion a/w ovarian fibroma)
sclerosing
stromal with minor sex cord elements
sertoli (androblastomas)
sex cord with annular tubules
gynandroblastoma
steroid (lipid) cell tumours
granulosa can be small, cuboidal cells, cords, sheets or strands, call-Exner bodies
theca: clusters or sheets of cuboidal to polygonal cells
produce oestrogen
endometrial hyperplasia
breast disease
malignant potential - 10% develop endometrial carc