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Age : 55-65 yo
Risk fx : obecity, DM, Hypertension,
infertility
Morphology :
◦ Type 1 : Low grade
◦ Type II : (serous) high grade
Type 1 endometrial ca
Tipe 2 endometrial ca
OVARIES
Non neoplastic and Functional cysts
1. Follicles and lutheal cyst
◦ Cystic follicles >>>, from unruptured graafian
follicles or in follicles that have ruptured and
immediately sealed
◦ Lutheal cyst are present in the normal ovaries in
reproductive age
2. Polycistic Ovaries and stromal Hyperthecosis
Ovarian tumors
WHO Classification of
Ovarian Neoplasms
Surface epithelial-stromal tumors
Serous tumors
Benign (cystadenoma, cystadenofibroma)
Borderline (serous borderline tumors)
Malignant (Low and high grade serous
adenocarcinoma)
…WHO Classification of
Ovarian Neoplasms
Mucinous tumors, endocervical like and
intestinal type
Benign (cystadenoma, cystadenofibroma)
Borderline (mucinous borderline tumors)
Malignant (mucinous adenocarcinoma)
Endometrioid tumors
Benign (cystadenoma, cystadenofibroma)
Borderline (endometrioid borderline
tumors)
Malignant (endometrioid adenocarcinoma)
…WHO Classification of Ovarian
Neoplasms
Clear cell tumors
◦ Benign
◦ Borderline
◦ Malignant (clear cell adenocarcinoma)
Transitional cell tumors
• Benign Brenner tumors
• Brenner tumor of borderline malignancy
• Malignant Brenner tumors
Epithelial stromal
Adenosarcoma
Malignant mixed mullerian tumor
…WHO Classification of Ovarian
Neoplasms
Sex cord- stromal tumor
Granulosa tumors
Fibroma
Fibrothecomas
Sertoli-leyding cell tumors
Steroid (lipid) cell tumor
Germ cell tumors
Teratoma
Dysgerminoma
Yolk sac tumor
Mixed germ cell tumors
Metastatic cancer from non ovarian
primary
Serous tumors
>>, 40% of all ca in ovary
70% are benign and borderline
Morphology :
◦ Multicystic lesion in which papillary epithelium is
cointain with a few fibrous walled cysts
(intracystic) or as a mass projecting from ovarian
surface
◦ Borderline cointain an increased number of
papillary projections
◦ Larger areas of solid or papillary tumor mass,
tumor irregularity and fixation or nodularity of
the capsule : malignancy
…Serous tumors
Micros :
cyst are lined by columnar epithelium,
which has abundant cilia in benign tumor,
papillae may be found
Borderline :
◦ increase complexity of the stromal papillae,
◦ stratification of epithelium
◦ mild nuclear atypia
◦ Invasi of the stroma (-)
…Serous tumors
Mikros :
Serous carcinoma
Low grade and high grade
Marked nuclear atypia, pleomorphism,
atypical mitotic figure, multinucleation
High grade are distiguised from low grade
by having more complex growth pattern
and in filtration of the underlying stroma
…Serous tumors
Mucinous tumors
20-25% all ovarian neoplasm
Occur in middle adult and rare before
puberty and after menopouse
Primary ovarian mucinous ca are are (3%)
of all ovarian neoplasma
Makros :
◦ tend to produce large masses—25kg,
multiloculated filled with sticky, gelatinous
fluid rich in glycoprotein
.. Mucinous tumors
Micros :
Benign :
lining of tall, columnar epithelial cells with
apical mucin that lack cilia
Type:
◦ gastric and intestional type >>
◦ Endocervical type <<
Borderline :
Epithelial stratification, tufting and or
papillary intraglandular growth
.. Mucinous cystadenoma
Clear cell tumors
Benign and borderline are rare
Clear cell carcinomaa are uncommon
Composed of large epithelial cells with
abundant clear cytoplasm
Solid or cystic
Mature(benign) teratomas
90% unilateral
Unilocular cyst cointaining hair and
sebaceous material
Micros :
◦ cyst wall lined by epidermis
◦ Cointain with : foci calcification, teeth, bone and
cartilage, thyroid, neural tissue
= dermoid cyst
1% undergo malignant transformation : SCC;
other cancer as well (thyroid ca, melanoma)
…Mature(benign) teratomas
DISEASE OF PREGNANCY
Ectopic pregnancy
Gestational trophoblastic disease :
◦ Hydatidiform mole : complete and partial
◦ Invasive mole
◦ Chorio carcinoma
Complete mole
choriocarcinoma
Macros : soft, fleshy, yellow-white tumor,
large pale areas of necrosis and
haemorhage
Micros :
◦ proliferating synctiotrophoblast and
cytotrtophoblast
◦ Mitosis abundant and abnormal
◦ Tumor invades underliying myometrium,
blood vessel, extend out the uterine serosa
and adjecent structur
choriocarcinoma