Ovary PathologyNon Neoplastic Lesions1.) Cystic Follicle - follicular cyst <2cm/<2.5cm

-thin walled with clear fluid contents

2.) Follicular Cyst - most common ovarian mass; non-neoplastic - accum of fluid in follicle; rupture= sterile peritoitis with p

ain - cystic follicle >2cm - lined by granulosa cells which are flattened out be

cause of fluid

3.) Corpus Luteum CYst - most common ovarian mass in pregnancy; corpus luteum that has become cystic; can develop even if not pregnant

- rupture may produce pain or even bleed (corpus lut cyst w/hemorrhage and rupture)

- bright yellow convloluted lining; hemorrhagic center

- lined by luteinized theca cells - >2.5cm

4.) Hyperreaction Luteinalis -

5.) PCOS - cyst with subserosal thickening

6.) Endometiotic Cyst -

Neoplastic TumorsA. Surface Epith - derived from coelomic epith; seed the ementum1.) Serous -

2.) Mucinous -

3.) Endometroid adenoCA -

4.) Clear Cell -

5.) Brenner -

B. Germ Cell Tumors1.) Teratomas - i. Immature - ii. Mature - iii. Monodermal -

2.) Dysgerminoma

3.) Embryonal CA -

4.) Yolk Sac Tumor

C. Sex Cord1.) Granulosa Cell Tumor -

2.) Thecoma - thecoma/fibroma grouphard to differntiate

3.) Fibroma -

4.) Sertoli-Leydig Cell -

Metastatic Tumors1.) Krukenberg Tumor - signet ring cells hematogenous spread usually of a gastric cancers

Clinical Findingssign of seeding from malignant surface - derived cancers; malignant ascites; induration of rectal pouch on digital exam; inc obstruction with colicky painpalpable ovarian mas in postmenopausal women - should not be aplpablemalignant pleural effusion - common site for cancer metscystic teratomas undergo torsion leading to infarct - calcifications from bone and teeth inside these cavitiessigns of hyperestrinism from estrogen secreting tumors - bleeding from endometrial hyper/CA; 100% superficial squamous cells in cervical pap smearhirsutism or virilization from androgen-secreting tumorstumor markers- CA125 and HE4 in surface derived malignant tumors

Clinical and moledcular featrues of 5 most common typesHGSCA, LGCA, MCA, ECA, CCCA = surface derived malignant ovarian tumors

risk factors for high gread serous = BRCA1/2endometrioid = HNPCC - those indiv with early dev't of endometrial and colonic CAsome artists would have developed both cancers=strong family historyprecursor lesions - tubal intraepithelial ca in hHGSCAserous BL tumor in LGSCAendometriosis has role in dev't of ECAcystadenoma? BL tumor? in MCAendometriosis also in CCCA

pattern of spread:hgsca - very early transceloemiclgsca - early transcoelemoic spreadMCA - confined to ovaryendometroid and clear cell - confined to pelvis

CHEMOSENSITIVITYHgsca - highly chemosensitive but poor prognosiscontrasted to favorable prognosis of mucinous and ECA Lgsca and CCCA - low response to chemo but intermediate prognosis