We’ll begin our organization.
Most of your ovarian tumors will be of surface epithelial tumors.
Ladies and gentlemen, this is where your focus should be.
We will talk about specific surface epithelial tumors.
I have divided this into tables coming up next.
Let’s take a look.
Overall, the topic is surface epithelial cell tumors.
Overall, the frequency of all of your ovarian tumors, 65-70%.
This is where your focus should be.
The proportion of malignant ovarian tumors,
90% of your malignant ovarian tumors are surface epithelial.
It could be 20 plus.
Now, the types.
Let me stop there.
Because endometrioid sounds an awful lot like endometriosis.
Sounds a lot like endometritis
and it sounds a lot like your endometrioma.
This is your ovarian tumor.
It’s called endometrioid tumor.
Would you tell me what the suffix -oid means?
So here, we have -oid.
It looks like endometrium, but it is an ovarian tumor.
Of what family?
If you have a surface tumor,
how does it like to spread?
Surface, likes to seed.
What does seed mean?
It is going to spread to adjacent structures.
Your focus, by the way, with surface-derived
epithelial tumor will be on serous, serous, serous.
We have 75% of ovarian tumors are surface derived.
Usually women greater than 20.
Divided into -
we’ll be doing serous, mucinous and endometrioid.
We’re not going to go through every single one.
We’ll go through the high yield types of our surface.
Overall, remember frequency, 65-70%.
So we will be going through this methodically.
And I want to make sure that I drill home to you
those important salient features.
cystic lesions lined by tall, columnar, cilated
epithelial cells filled with serous fluid.
This is the one that you want to pay attention to
and know the histology quite well.
It’s a cystic lesion,
tall, columnar, cilated.
so therefore the serous type of epithelial tumor will be papillary.
Take a look at the P in papillary.
Take a look at the P in psammoma.
the description that they’ll give is calcium deposition.
You must know what a psammoma body is.
It’s calcium deposition.
Also, psammoma bodies is not only found in serous cystadenocarcinoma.
It can also be found with meningioma.
It could be found in a couple of places.
If epithelium is benign, then called papillary serous
If it’s malignant, you call it serous cystadenocarcinoma.
What we’re looking at here is a papillary serous cystadenoma.
You’ll notice the following that on the image,
you’ll find exactly that
which is papillary-like with finger-like projections.
And histologically, you’ll find it to be well-encapsulated
because this is a common -
Actually, this is the most common, benign, ovarian tumor.
How do you know it’s benign?
Look at the name.
And upon histologic examination,
it will be well-encapsulated, well-differentiated.
Serous epithelial tumor, etiology.
Epithelium is malignant, then we’d call it serous cystadenocarcinoma.
You must know that usually, it will be bilateral ovaries.
It is important that you know how many ovaries will be affected.
Unilateral or bilateral.
In this case, bilateral.
Just to make sure that you have the big picture,
we’re doing surface-derived
we’re focusing upon the most common benign
surface epithelial tumor,
the serous cystadenoma.
And the next would be the most common malignant surface
epithelial tumor, which is a serous cystadenocarcinoma.
A lot of names sound alike.
I want to make sure that we’re very clear and deliberate
as to what we’re describing.
Here, you have a papillary serous cystadenocarcinoma,
extremely chaotic within the ovary.
And number two,
on histologic examination,
you will find extremely poor differentiation.
The term serous cystadenocarcinoma has been updated to type 1, or low-grade serous carcinoma,
and type two, or high grade serous carcinoma.
Mucinous and endometrioid carcinomas, coming up next, are also described as type 1
which is low grade or type 2 which is high grade.
Our second type of surface-derived epithelial tumor,
let’s call it mucinous epithelial tumor.
The term mucinous means exactly that.
you’d have cystic lesion, but this time
instead of it being tall, columnar, ciliated,
these will be mucin-producing cells filled with mucus.
There you have it.
Everything that you need to know about mucinous,
mucus cells filled with mucus.
But you’re still going to form a cyst.
Rare before puberty and after menopause,
so therefore would be taking place in a female
in the reproductive age.
I’ve mentioned earlier
that you want to pay attention to how many
of the ovaries have been affected.
If it is serous, then it will be both, bilateral.
However, if it’s mucinous,
most likely, not bilateral.
It can present with -
now, here’s a term here called pseudomyxoma peritonei.
In ovarian tumor
with mucinous ascites,
sometimes referred to as being your malignant ascites.
The term here is pseudomyxoma peritonei,
All pseudomyxoma peritonei tumors arise from the appendix, or very rarely from neoplasms in the colon,
pancreas, or urachus. Although they can be found on the ovary,
they do not arise from the ovary. The term pseudomyxoma peritonei refers to a clinical syndrome
with diffuse mucinous peritoneal involvement from a ruptured appendiceal lesion.
It is not a histologically-based term, and is not used in the staging or histologic classification of appendiceal nor ovarian neoplasms.
A mucinous cystadenoma looks quite different from that of papillary
The papillary serous cystadenoma and cystadenocarcinoma
would have more of that papillary, well-defined type of structure.
A mucinous looks more sponge-like.
It looks like it has cavitations.
It looks like there’s a lot more cysts.
And you would find a lot more mucus and mucus cells
that are then producing your mucus upon histology.
Our discussion, two different types of surface-derived epithelial tumors.
Serous and mucinous.