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Female

Genitalia IV

Ovary

Ovary
Inflammation
Non-neoplastic

cysts
Neoplasms

Ovary
Inflammation
Primary

inflammation is

rare
Usually secondary to
spread from fallopian
tube (tubo-ovarian
abscess)
Other causesappendicitis,

Ovary
Non-neoplastic cysts
Follicular

cysts - Polycystic
Ovarian Syndrome (SteinLeventhal)
Corpus luteum cysts - may
cause intraperitoneal
haemorrhage
Simple cysts
Endometriotic cysts haemorrhage within

Ovary
Neoplasms
Classification of Primary Neoplasms
Surface

(germinal) epithelium (approx.

65%)
Germ cells (approx. 20%)
Sex cord-stromal cells (approx. 10%)
Miscellaneous, i.e. tumours
not specific to the ovary
(approx. 5%)

Surface Epithelial
Neoplasms
Classification
Serous
Mucinous
Endometrioid
Brenner
Clear

cell
Undifferentiated

Surface Epithelial
Neoplasms
Cystadenomas/cystadenocarci
nomas
Serous - lining resemble
fallopian tube
Mucinous - resemble lining of
cervix
Endometrioid - resemble
endometrium

Serous Tumours
25%

of all ovarian tumours


30-50% bilateral
Benign ones, predominantly
cystic
Malignant ones, more solid
Papillary projections into cyst
cavities
Borderline (LMP) - features of
malignancy but no stromal

Mucinous & Endometrioid


Neoplasms
Mucinous

Less

common than serous,


10-20% bilateral
Benign, borderline,
malignant
Tend to grow to very large
size
Pseudomyxoma peritonei

Endometrioid
Resemble

endometrial

Sex Cord-Stromal
Tumours
Granulosa

cell

tumour
Thecoma/Fibroma
Sertoli-Leydig cell
tumour

Occur

Granulosa Cell
Tumours

at any age
Peak incidence, postmenopausal
25-75%

produce excessive
oestrogen
Children - precocious puberty
Reproductive age - menstrual
irregularities
Older age - p.m.b.

All

potentially malignant, but

Most behave benign

Thecoma/Fibromas
Originate

from theca cell

Thecoma

Solid, firm
May produce oestrogen; a
few produce androgens
Nearly always benign
Fibroma

Solid, invariable benign


Meigs syndrome

Sertoli-Leydig Cell
Tumours
Resemble

Sertoli & Leydig


cells of testis
Predominantly solid
Usually found in young
adults
About half accompanied by
excess androgen secretion
- virilization

Germ Cell Tumours


Dysgerminoma
Yolk

sac tumour (endodermal


sinus; embryonal ca)
Choriocarcinoma
Teratoma
Comprise about 20% of
ovarian tumours, but are
most COMMON ovarian
tumour in girls and young

Germ Cell Tumours


Dysgerminoma

All malignant
Very radiosensitive with
Up to 95% 5-yr survival
Yolk

sac tumour - highly


malignant; alpha-fetoprotein
Chorioca - Rare! Most are
metastases from corpus

Teratoma
Benign cystic teratoma (dermoid
cyst)
Most common GCT (up to 95% of
GCTs)
Are multilocular or unilocular
cysts
Containing cheesy or porridgelike sebaceous material with
matted hair
Sometimes cartilage, bone
and/or teeth grossly

Teratoma
Solid teratomas
Are invariably malignant
Are also known as "immature
teratomas"
Malignancy due to
immaturity of the tissues
usually immature
neuroepithelium

Secondary (Metastatic)
Tumours
Most

common - stomach,
colon, breast, corpus and
cervix uteri
Krukenberg tumour - bilateral,
solid, mucin-secreting signet
ring cells; usually from
stomach, colon, breast
Mets to ovary connote poor
prognosis

Ovarian Tumours
General Features
USA

- most fatal gynae.


malignancy; kill more than
ca.cx & corpus combined
Ranked 6th in women in Ja
Presentation - asymptomatic,
pain, mass, signs of
malignancy, hormonal changes
etc
Prognosis - tumour type; grade;