Ovarian Tumors - Surface Epithelial Tumors PDF

## OVARIAN TUMORS ### I. BASIC PRINCIPLES - Ovary is composed of three cell types: surface epithelium, germ cells, and sex cord-stroma. - Tumor can arise from any of these cell types or from metastases. ### II. SURFACE EPITHELIAL TUMORS - Most common type of ovarian tumor (70% of cases) - Derive...

## OVARIAN TUMORS ### I. BASIC PRINCIPLES - Ovary is composed of three cell types: surface epithelium, germ cells, and sex cord-stroma. - Tumor can arise from any of these cell types or from metastases. ### II. SURFACE EPITHELIAL TUMORS - Most common type of ovarian tumor (70% of cases) - Derived from coelomic epithelium that lines the ovary; coelomic epithelium embryologically produces the epithelial lining of the fallopian tube (serous cells), endometrium, and endocervix (mucinous cells). - The two most common subtypes of surface epithelial tumors are serous and mucinous; both are usually cystic. - Serous tumors are full of watery fluid. - Mucinous tumors are full of mucus-like fluid. - Mucinous and serous tumors can be benign, borderline, or malignant. - Benign tumors (cystadenomas) are composed of a single cyst with a simple, flat lining; most commonly arise in premenopausal women (30-40 years old) - Malignant tumors (cystadenocarcinomas) are composed of complex cysts with a thick, shaggy lining; most commonly arise in postmenopausal women (60-70 years old) - Borderline tumors have features in between benign and malignant tumors. - Better prognosis than clearly malignant tumors, but still carry metastatic potential - BRCA1 mutation carriers have an increased risk for serous carcinoma of the ovary and fallopian tube. - BRCA1 carriers often elect to have a prophylactic salpingo-oophorectomy (along with prophylactic mastectomy due to the increased risk for breast cancer). - Less common subtypes of surface epithelial tumors include endometrioid and Brenner tumor. - Endometrioid tumors are composed of endometrial-like glands and are usually malignant. - May arise from endometriosis - 15% of endometrioid carcinomas of the ovary are associated with an independent endometrial carcinoma (endometrioid type). - Brenner tumors are composed of bladder-like epithelium and are usually benign. - Surface tumors clinically present late with vague abdominal symptoms (pain and fullness) or signs of compression (urinary frequency). ### III. PROGNOSIS - Prognosis is generally poor for surface epithelial carcinoma (worst prognosis of female genital tract cancers). - Epithelial carcinomas tend to spread locally, especially to the peritoneum. - CA-125 is a useful serum marker to monitor treatment response and screen for recurrence.