Pathology of the ovary

WHO CLASSIFICATION OF TUMORS OF THE OVARY

(2003)

1. Surface epithelial-stromal tumors

• Serous tumors
- malignant: adenocarcinoma, surface papillary
adenocarcinoma, adenocarcinofibroma
- borderline: papillary cystic tumor, surface papillary
tumor, adenofibroma, cystadenofibroma
- benign: cystadenoma, adenofibroma,
cystadenofibroma, surface papilloma
 • Mucinous tumors
- malignant: adenocarcinoma,adenocarcinofibroma
- borderline: intestinal type, endocervical-like
- benign: cystadenoma, adenofibroma, mucinous cystic
tumor with pseudomyxoma peritonei
• Endometrioid tumors including variants with squamous
differentiation
- malignant: adenocarcinoma,adenocarcinofibroma,
malignant mullerian mixed tumor (carcinosarcoma)
- borderline: cystic tumor, adenofibroma
- benign: cystadenoma, adenofibroma
 • Clear cell tumors
- malignant: adenocarcinoma, adenocarcinofibroma
- borderline: cystic tumor, adenofibroma
- benign: cystadenoma, adenofibroma
• Transitional cell tumors
- malignant: transitional cell carcinoma (non-Brenner
type), malignant Brenner tumor
- borderline: Brenner tumor (proliferating type)
- benign: Brenner tumor
• Squamous cell tumors
malignant and benign
• Mixed epithelial tumors
malignant,borderline,benign
• Undifferentiated and unclasified tumors
 2. Sex cord-stromal tumors
• Granulosa-stromal cell tumors
- Granulosa cell tumor group:
adult, juvenile
- Thecoma-fibroma group:
thecoma, fibroma, fibrosarcoma
• Sertoli-stromal cell tumors
- Sertoli-Leydig stromal cell group
• Sex cord-stromal tumors
of mixed or unclassified cell types
sex cord tumor with annular tubules, gynandroblastoma
• Steroid cell tumor
 3. Germ cell tumors
• Primitive germ cell tumors
- Dysgerminoma
- yolk sac tumor
- embryonal carcinoma
-polyembryoma
- non-gestational choriocarcinoma
• Biphasic or triphasic teratoma
- immature teratoma
- mature teratoma
dermoid cyst
 • Monodermal teratoma
- thyroid tumor group
struma ovarii
- carcinoid group
- neuroectodermal tumor group
-carcinoma group
adenocarcinoma,squamous cell carcinoma
- melanocytic group
- sarcoma group
- etc....
 4. Germ cell sex cord-stromal tumors
5. Tumors of the rete ovarii
6. Miscellaneous tumors
7. Tumor-like conditions
- luteoma of pregnancy
- stromal hyperthecosis
- stromal hyperplasia
- fibromatosis
- massive ovarian edema
- others
8. Lymphoid and hematopoietic tumors
9. Secondary tumors
Surface epithelial-stromal tumors

etiology
risk factors
Benign serous tumors
 Benign serous tumors

gross and microscopic features

Borderline serous tumors
Serous adenocarcinoma
 Serous adenocarcinoma

gross and microscopic features

Benign mucinous tumors
 Benign mucinous tumors

gross and microscopic features

Borderline mucinous tumors
Mucinous adenocarcinoma
 Mucinous adenocarcinomas

gross and microscopic features

Pseudomyxoma peritonei
Endometrioid tumors
Endometrioid adenocarcinoma
Endometrioid adenocarcinoma

gross and microscopic features

Sex cord-stromal tumors

Granulosa cell tumor group

Granulosa cell tumor group

Adult granulosa cell tumor

Juvenile granulosa cell tumor
Thecoma-fibroma group
Thecoma
Thecoma
Fibroma
Germ cell tumors
 Malignant transformation of germ cell

• Mature • Embryonal
(multipotential)
• Undifferentiated
• Benign dysgerminoma
mature cystic teratoma • Primitive
struma ovarii embryonal carcinoma
• Somatic immature
• Malignant teratoma
squamous carcinoma • Trophoblast
carcinoid choriocarcinoma
thyroid carcinoma • Extraembryonic
yolk sac carcinoma
Mature teratoma
Mature teratoma
dermoid cyst
Monodermal teratomas
Immature (malignant) teratomas
Dysgerminoma