pathology of the ovary. who classification of tumors of the ovary (2003) 1. surface...

Pathology of the ovary

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Pathology of the ovary

WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003)

1. Surface epithelial-stromal tumors• Serous tumors

- malignant: adenocarcinoma, surface papillary adenocarcinoma, adenocarcinofibroma

- borderline: papillary cystic tumor, surface papillary tumor, adenofibroma, cystadenofibroma- benign: cystadenoma, adenofibroma, cystadenofibroma, surface papilloma

Page 3: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

• Mucinous tumorsmalignant: adenocarcinoma,adenocarcinofibroma

- borderline: intestinal type, endocervical-like- benign: cystadenoma, adenofibroma, mucinous cystic

tumor with pseudomyxoma peritonei• Endometrioid tumors including variants with squamous

differentiation- malignant: adenocarcinoma,adenocarcinofibroma, malignant mullerian mixed tumor (carcinosarcoma)

- borderline: cystic tumor, adenofibroma- benign: cystadenoma, adenofibroma

Page 4: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

• Clear cell tumorsmalignant: adenocarcinoma, adenocarcinofibroma

- borderline: cystic tumor, adenofibroma- benign: cystadenoma, adenofibroma

• Transitional cell tumorsmalignant: transitional cell carcinoma (non-Brenner

type), malignant Brenner tumor- borderline: Brenner tumor (proliferating type)

- benign: Brenner tumor• Squamous cell tumorsmalignant and benign

• Mixed epithelial tumorsmalignant,borderline,benign

• Undifferentiated and unclasified tumors

Page 5: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

2. Sex cord-stromal tumors• Granulosa-stromal cell tumors- Granulosa cell tumor group:

adult, juvenile- Thecoma-fibroma group:

thecoma, fibroma, fibrosarcoma• Sertoli-stromal cell tumors

- Sertoli-Leydig stromal cell group• Sex cord-stromal tumors

of mixed or unclassified cell types sex cord tumor with annular tubules, gynandroblastoma

• Steroid cell tumor

Page 6: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

3. Germ cell tumors• Primitive germ cell tumors

- Dysgerminoma- yolk sac tumor

- embryonal carcinoma-polyembryoma

- non-gestational choriocarcinoma• Biphasic or triphasic teratoma

- immature teratoma- mature teratoma

dermoid cyst

Page 7: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

• Monodermal teratoma- thyroid tumor group

struma ovarii- carcinoid group

- neuroectodermal tumor group-carcinoma group

adenocarcinoma,squamous cell carcinoma- melanocytic group

- sarcoma group- etc....

Page 8: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

4. Germ cell sex cord-stromal tumors5. Tumors of the rete ovarii

6. Miscellaneous tumors7. Tumor-like conditions

- luteoma of pregnancy- stromal hyperthecosis- stromal hyperplasia

- fibromatosis- massive ovarian edema

- others8. Lymphoid and hematopoietic tumors

9. Secondary tumors

Surface epithelial-stromal tumors

etiologyrisk factors

Benign serous tumors

Page 11: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Benign serous tumors

gross and microscopic features

Page 12: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Borderline serous tumors

Page 13: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Serous adenocarcinoma

Page 14: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Serous adenocarcinoma

gross and microscopic features

Page 15: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Benign mucinous tumors

Page 16: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Benign mucinous tumors

gross and microscopic features

Page 17: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Borderline mucinous tumors

Page 18: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Mucinous adenocarcinoma

Page 19: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Mucinous adenocarcinomas

gross and microscopic features

Page 20: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Pseudomyxoma peritonei

Page 21: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Endometrioid tumors

Page 22: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Endometrioid adenocarcinoma

Page 23: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Endometrioid adenocarcinoma

gross and microscopic features

Page 24: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Sex cord-stromal tumors

Granulosa cell tumor group

Page 25: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Granulosa cell tumor group

Adult granulosa cell tumor

Page 26: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Juvenile granulosa cell tumor

Page 27: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Thecoma-fibroma groupThecoma

Page 28: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Thecoma

Page 29: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Fibroma

Page 30: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Germ cell tumors

Page 31: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Malignant transformation of germ cell

• Mature

• Benign mature cystic teratoma

struma ovarii• Malignant

squamous carcinoma

carcinoid

thyroid carcinoma

• Embryonal (multipotential)

• Undifferentiated dysgerminoma

• Primitive embryonal carcinoma

• Somatic immature teratoma

• Trophoblast choriocarcinoma

• Extraembryonic yolk sac carcinoma

Page 32: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Mature teratoma

Page 33: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Mature teratomadermoid cyst

Page 34: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Monodermal teratomas

Page 35: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Immature (malignant) teratomas

Page 36: Pathology of the ovary. WHO CLASSIFICATION OF TUMORS OF THE OVARY (2003) 1. Surface epithelial-stromal tumors Serous tumors - malignant: adenocarcinoma,

Dysgerminoma

Precancer, benign and malignant tumors of the uterus and ovary Eduard Kučera

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