Types of Ovarian Tumors: Epithelial Tumors

00:01 We’ll begin our organization.

00:03 Most of your ovarian tumors will be of surface epithelial tumors.

00:09 Ladies and gentlemen, this is where your focus should be.

00:15 We will talk about specific surface epithelial tumors.

00:17 I have divided this into tables coming up next.

00:20 Let’s take a look.

00:24 Overall, the topic is surface epithelial cell tumors.

00:29 Overall, the frequency of all of your ovarian tumors, 65-70%.

00:34 This is where your focus should be.

00:37 The proportion of malignant ovarian tumors, 90% of your malignant ovarian tumors are surface epithelial.

00:47 Age group: Early.

00:49 It could be 20 plus.

00:51 Now, the types.

00:52 Serous, mucinous, endometrioid.

00:56 Let me stop there.

00:57 Why? Because endometrioid sounds an awful lot like endometriosis.

01:03 Sounds a lot like endometritis and it sounds a lot like your endometrioma.

01:08 This is your ovarian tumor.

01:12 It’s called endometrioid tumor.

01:15 Would you tell me what the suffix –oid means? Similar to.

01:19 Leukomoid reaction.

01:22 Endometrioid.

01:23 Epithelioid.

01:25 Right? So here, we have –oid.

01:27 It looks like endometrium, but it is an ovarian tumor.

01:30 Of what family? Surface-derived.

01:34 If you have a surface tumor, how does it like to spread? Surface, likes to seed.

01:42 What does seed mean? It is going to spread to adjacent structures.

01:47 Your focus, by the way, with surface-derived epithelial tumor will be on serous, serous, serous.

01:54 Let’s begin.

01:57 We have 75% of ovarian tumors are surface derived.

02:00 Usually women greater than 20.

02:02 Divided into – we’ll be doing serous, mucinous and endometrioid.

02:07 We’re not going to go through every single one.

02:09 We’ll go through the high yield types of our surface.

02:13 Overall, remember frequency, 65-70%.

02:17 So we will be going through this methodically.

02:20 And I want to make sure that I drill home to you those important salient features.

02:29 The etiology, continuing forward, cystic lesions lined by tall, columnar, cilated epithelial cells filled with serous fluid.

02:38 This is the one that you want to pay attention to and know the histology quite well.

02:43 It’s a cystic lesion, tall, columnar, cilated.

02:47 Usually papillary, so therefore the serous type of epithelial tumor will be papillary.

02:54 Take a look at the P in papillary.

02:57 Take a look at the P in psammoma.

03:00 Psammoma bodies, the description that they’ll give is calcium deposition.

03:06 Okay? You must know what a psammoma body is.

03:09 It’s calcium deposition.

03:11 Also, psammoma bodies is not only found in serous cystadenocarcinoma.

03:18 It can also be found with meningioma.

03:20 It could be found in a couple of places.

03:24 If epithelium is benign, then called papillary serous cystadenoma.

03:30 If it’s malignant, you call it serous cystadenocarcinoma.

03:35 What we’re looking at here is a papillary serous cystadenoma.

03:39 You’ll notice the following that on the image, you’ll find exactly that which is papillary-like with finger-like projections.

03:47 And histologically, you’ll find it to be well-encapsulated because this is a common – Actually, this is the most common, benign, ovarian tumor.

03:56 How do you know it’s benign? Look at the name.

03:58 Cystedenoma.

04:00 And upon histologic examination, it will be well-encapsulated, well-differentiated.

04:05 Serous epithelial tumor, etiology.

04:07 Epithelium is malignant, then we’d call it serous cystadenocarcinoma.

04:12 You must know that usually, it will be bilateral ovaries.

04:16 It is important that you know how many ovaries will be affected.

04:19 Unilateral or bilateral.

04:21 In this case, bilateral.

04:22 Just to make sure that you have the big picture, we’re doing surface-derived epithelial tumors, under that, we’re focusing upon the most common benign surface epithelial tumor, the serous cystadenoma.

04:36 And the next would be the most common malignant surface epithelial tumor, which is a serous cystadenocarcinoma.

04:45 A lot of names sound alike.

04:47 I want to make sure that we’re very clear and deliberate as to what we’re describing.

04:51 Here, you have a papillary serous cystadenocarcinoma, extremely chaotic within the ovary.

04:58 And number two, on histologic examination, you will find extremely poor differentiation.

05:05 Highly malignant.

05:07 Our second type of surface-derived epithelial tumor, let’s call it mucinous epithelial tumor.

05:15 The term mucinous means exactly that.

05:18 Mucin.

05:19 Here, you’d have cystic lesion, but this time instead of it being tall, columnar, ciliated, these will be mucin-producing cells filled with mucus.

05:30 There you have it.

05:31 Everything that you need to know about mucinous, mucus cells filled with mucus.

05:35 But you’re still going to form a cyst.

05:38 Rare before puberty and after menopause, so therefore would be taking place in a female in the reproductive age.

05:46 I’ve mentioned earlier that you want to pay attention to how many of the ovaries have been affected.

05:51 If it is serous, then it will be both, bilateral.

05:57 However, if it’s mucinous, most likely, not bilateral.

06:02 It can present with – now, here’s a term here called pseudomyxoma peritonei.

06:07 In ovarian tumor with mucinous ascites, sometimes referred to as being your malignant ascites.

06:14 The term here is pseudomyxoma peritonei, I would know this in greater detail since we have surface-derived epithelial tumor being high frequency of ovarian tumors.

06:25 In most cases, this is due to a GI primary with metastasis to the ovaries.

06:30 You can keep that in mind.

06:31 Mucinous.

06:32 A mucinous cystadenoma looks quite different from that of papillary.

06:37 The papillary serous cystadenoma and cystadenocarcinoma would have more of that papillary, well-defined type of structure.

06:45 A mucinous looks more sponge-like.

06:47 It looks like it has cavitations.

06:48 It looks like there’s a lot more cysts.

06:51 And you would find a lot more mucus and mucus cells that are then producing your mucus upon histology.

06:59 Our discussion, two different types of surface-derived epithelial tumors.

07:04 Serous and mucinous.