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8/31/2011
1
Diseases of ovary
Cystic follicles • Distention of atretic follicles > 2.5 cm = Follicular cysts • infancy - menopause • children - precocious puberty • adults - endometrial hyperplasia
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Corpus luteum cyst • luteinizing cell linings • bloody contents • rupture : pain, hemoperitoneum
Ovary
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Polycystic ovary • multiple cystic follicles • understood pathogenesis Stein-Leventhal syndrome : amenorrhea : infertility : endometrial hyperplasia
Polycystic ovary
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Ovarian neoplasms • palpable mass • pain • pressure symptoms : GI, urinary • abnormal uterine bleeding • incidental findings
Ovarian neoplasms • Surface epithelium 70% • Germ cells 20% • Sex cord and stromal cells 10%
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Ovarian neoplasms
Epithelial neoplasms embryonic coelomic epithelium • Mucinous tumors : endocervix • Serous tumors : tubal epithelium • Endometrioid / Clear cell carcinoma : endometrium • Brenner tumor : urothelium
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Serous / Mucinous tumors • Cystadenoma • Borderline malignancy • Cystadenocarcinoma
Cystadenomas
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Cystadenocarcinomas
Epithelial cell linings
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Carcinomas
Mucinous cystadenocarcinoma Endometrioid carcinoma
Germ cell tumors • 95% mature cystic teratomas • 8% mixed germ cell tumors The younger the patient, the more
germ cell tumor be malignant
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Germ cell tumors • Dysgerminoma (Seminoma) • Embryonal carcinoma • Yolk sac tumor (Endodermal sinus tumor) • Choriocarcinoma
Histogenesis
Dysgerminoma(Seminoma)
Extraembryonic tissueYolk sac tumor
Choriocarcinoma
Embryonic tissueMature teratoma
Immature teratoma
Totipotential cellsEmbryonal carcinoma
Primitive germ cells
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Teratomas Mature cystic teratoma (Dermoid cyst) • malignant change : SCC, adenocarcinoma,
carcinoid tumor Mature solid teratoma (grade 0 immature
teratoma) Monodermal teratoma Immature teratoma
Mature cystic teratoma
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Mature cystic teratoma
Struma ovarii
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Fetiform teratoma
Homunculus
Immature teratoma
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Malignant germ cell tumor
Stromal sex-cord tumors • Fibroma • Thecoma • Granulosa cell tumor
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Fibroma • solid tumor • fibroblastic proliferation • Meigs’ syndrome + ascites + right-sided pleural effusion
Fibroma
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Granulosa cell tumor • 2/3 menopause • estrogen production : precocious puberty : endometrial hyperplasia
Granulosa cell tumor
Call-Exner body
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Metastatic tumor • adenocarcinoma • stomach, colon, appendix, breast,
uterus, lung • Krukenberg’s tumor : bilateral : signet ring cells
Krukenberg’s tumor
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Men are born to succeed, not to fail.
Henry David Thoreau, 1817-1862, poet and philosopher, American
Thank you