BENIGN OVARIAN

TUMORS
DR. NATASHA GUPTA
ASSISTANT PROFESSOR
AIIMS JAMMU
OVARIAN ENLARGEMENT

1. Non – neoplastic

2. Neoplastic
 FUNCTIONAL CYST
• Temporary hormonal disorder
• Less than 7cm
• Unilocular
• Asymptomatic
• Spontaneous regression
• Clear fluid
• Rarely complicated
FOLLICULAR CYST
• MC functional cyst
• Hyperestrinism – is the cause
• Unruptured graffian follicle
• Lining – granulosa cells
• Incidental finding
• Asymptomatic/vague pain
• Resolves in 4-8 weeks of expectant management
• Less/equal to 3 cm – no treatment
• Large cyst - follow up
• If grows- Cystectomy(laparoscopically/laparotomy)
CORPUS LUTEAL CYST
• Overactivity of corpus luteum
• Excessive bleeding inside CL
• Progesterone and estrogen secretion continues
• Menstrual cycle delayed/normal
• Often associated with pregnancy
• Spontaneously resolve or if Intraperitoneal hemorrhage –
laparotomy/laparoscopy – enucleation of the cyst(along
with initial resuscitation)
• Cut section - yellowish
TREATMENT OF H.mole/CC/ DRUG TO BE STOPPED
Lead to Infertility/ CPP
INTRODUCTION
Ovarian tissues are constantly
Principal ovarian tissue components
1. Epithelial cells – coelomic epithelium
2. Oocyte – primitive germ cells
3. Mesenchymal elements – gonadal stroma
CLASSIFICATION - WHO
• EPITHELIAL - SEROUS/MUCINOUS/BRENNER
• SEX CORD STROMAL – THECOMA/FIBROMA
• LIPID CELL
• GERM CELL – MATURE TERATOMA
(DERMOID)/STRUMA OVARII
• GONADOBLASTOMA
• UNCLASSIFIED
• METASTATIC
• GTD
The cell types of ovarian epithelial tumors recapitulate
the Mullerian duct epithelium –
1. Serous from endosalphinx
2. Mucinous from endocervix
3. Endometriod from endometrium
SEROUS CYST ADENOMA
• Origin – Totipotent surface of ovarian epithelium
• Most common
• RULE OF 40 – 40% OF OVARIAN tumors,
• Bilateral – 40 %
• Malignant – 40 %
• Naked eye- Big, smooth shiny grey white,
multilobulated, papillary projections, intracystic
hemorrhage, fluid- clear
Microscopic – Single layer of cubical epithelium
SEROUS CYST ADENOMA

• Histopathology - Psammoma Bodies -

• Tiny spherical laminated calcified
structure, found in areas of cellular
degeneration
 MUCINOUS CYST ADENOMA

• Origin – Totipotent surface of ovarian epithelium

• 20-25 % Of all the ovarian tumors
• Bilateral – 10 %
• Malignant – 5-10 %
• Naked eye- largest benign ovarian tumor, Smooth
multilobulated, whitish/bluish hue/ thin to be
translucent
• Cut section- thick mucin-glucoprotein
• Microscopic – Single layer of tall columnar epithelium
with basal nuclei
• Pseudomyxoma peritonei (PMP)
DERMOID CYST

• Origin – Germ cells, contains components of all 3 germ layers

• MC benign tumor in young women
• 20-40 % of all the ovarian tumors
• Bilateral – 15-25 %
• Malignant – 1-2 % (low)
• Naked eye-

Moderate size, Smooth & Tense capsule, Sebaceous material with

Hair, teeth, bone
Rokistansky’s protuberance- solid projection,covered with sebaceous
glands
Thyroid tissue – struma ovarii
DERMOID CYST

• Microscopic- stratified squamous

epithelium, ectodermal components
are MC
• Torsion – 15%
Solid, less than 2 cm in diameter, Usually arises from
squamous metaplasia

Estrogen is secreted, AUB, Unilateral

Oophorectomy in young woman, TH-BSO (if
aged)
HMB/PMB/Precocious Puberty – Granulosa cell tumor
Amenorrhea – Sertoli-Leydig cell tumor
Pain- torsion, rupture, hemorrhage, infection, endometrioma
Pressure symptoms- Early satiety,SOB,Urinary
frequency,Constipation,Edema