Difference between revisions of "Serous cystadenoma of the ovary"

Serous cystadenoma of the ovary
	Diagnosis in short
	; Ovarian serous cystadenoma. H&E stain.
LM	cyst lined by a single layer of cuboidal or columnar epithelium with bland nuclear features +/- cilia
Subtypes	cystadenofibroma, adenofibroma
Gross	cystadenoma: thin walled cyst, usu. unilocular; cystadenofibroma and adenofibroma: solid and cystic or solid
Site	ovary - see ovarian tumours
Clinical history	+/-abdominal distension, +/-abdominal pain
Symptoms	mass lesion
Prevalence	common
Prognosis	benign
Clin. DDx	other ovarian tumours
Treatment	cystectomy or oophorectomy

Latest revision as of 03:20, 7 June 2016

Serous cystadenoma of the ovary is a common benign finding in the ovary.

It is also known as ovarian serous cystadenoma. It is unrelated the pancreatic serous cystadenoma.

Serous cystadenofibroma and adenofibroma of the ovary can be considered variants, and are also dealt with in this article.

General

Benign.
Very common.
Not related to the serous cystadenoma of the pancreas.
Thought to arise from a cortical inclusion cyst that has undergone Muellerian metaplasia^[1]^[2] - see mesothelial inclusion cyst.

Gross

Cystadenoma:

Usually unilocular.

Cystadenofibroma and adenofibroma:^[3]

Solid or solid and cystic.

Note:

Cystic lesions must be >=1 cm in size, smaller lesions are surface epithelial inclusion cysts.^[4]

Image

Serous cystadenoma (webpathology.com).

Microscopic

Features:^[5]

Simple epithelium - key feature - usually with cilia.
- Cell morphology: columnar, cuboidal or flatted.
Absent or minimal nuclear atypia.
+/-Rare tufting.
+/-Non-branching papillae.
+/-Rare mitoses.

Note:

May have calcifications - uncommon.^[6]

DDx:

Cortical inclusion cyst - <1 cm in size, see mesothelial inclusion cyst.
Ovarian serous borderline tumour - branching papillae, tufting, mitoses, nuclear atypia.

Note - the following may be lumped with this entity:

Serous cystadenofibroma.
Adenofibroma.

Images

Serous cystadenoma

OSC - low mag.
OSC - intermed. mag.
OSC - high mag.
OSC - intermed. mag.
OSC - high mag.
OSC - very high mag.
OSC - extremely high mag.

Serous cystadenofibroma

SCAF - very low mag.
SCAF - low mag.
SCAF - intermed. mag.
SCAF - high mag.

www

IHC

Features:^[5]

CK7 +ve.
EMA +ve.
WT1 +ve.
CK20 -ve.

Sign out

OVARY, LEFT, CYSTECTOMY:
- BENIGN SEROUS CYSTADENOMA.

FALLOPIAN TUBE AND (PARTIAL) OVARY, LEFT, RESECTION:
- COMPATIBLE WITH SEROUS CYSTADENOMA.
- BENIGN OVARIAN PARENCHYMA WITH FOCAL EDEMA AND A BENIGN CALCIFICATION.
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

Cystadenofibroma

FALLOPIAN TUBE AND OVARY, LEFT, UNILATERAL SALPINGO-OOPHORECTOMY:
- OVARY WITH BENIGN SEROUS CYSTADENOFIBROMA.
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

FALLOPIAN TUBES AND OVARIES, BILATERAL SALPINGO-OOPHRECTOMY:
- BENIGN OVARIAN SEROUS CYSTADENOFIBROMA (BILATERAL).
- FALLOPIAN TUBES WITHIN NORMAL LIMITS.

Atypical

FALLOPIAN TUBE AND OVARY, RIGHT, SALPINGO-OOPHORECTOMY:
- BENIGN SEROUS CYSTADENOMA AND SEROUS CYSTADENOFIBROMA WITH FOCAL ATYPIA,
  SEE COMMENT.
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
A small focus of the sampled tissue has a complex architecture, compatible with a
borderline tumour; however, it represents less than 10% of the lesion. Thus, the 
lesion is best classified as benign with focal atypia.

Micro

The sections show fibrous tissue consistent with a cyst wall lined by a simple columnar to flat epithelium, focally with cilia.

Cautery is present imparting a pseudostratified appearance focally. No definite papillae or definite tufting is apparent. No significant nuclear atypia is seen. Mitotic activity is not apparent.

References

↑ Feeley, KM.; Wells, M. (Feb 2001). "Precursor lesions of ovarian epithelial malignancy.". Histopathology 38 (2): 87-95. PMID 11207821.
↑ Okamoto, S.; Okamoto, A.; Nikaido, T.; Saito, M.; Takao, M.; Yanaihara, N.; Takakura, S.; Ochiai, K. et al. (May 2009). "Mesenchymal to epithelial transition in the human ovarian surface epithelium focusing on inclusion cysts.". Oncol Rep 21 (5): 1209-14. PMID 19360296.
↑ Takeuchi, M.; Matsuzaki, K.; Harada, M. (Mar 2013). "Ovarian adenofibromas and cystadenofibromas: magnetic resonance imaging findings including diffusion-weighted imaging.". Acta Radiol 54 (2): 231-6. doi:10.1258/ar.2012.120516. PMID 23171527.
↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 384. ISBN 978-0443069208.
↑ ^5.0 ^5.1 Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 396. ISBN 978-0443069208.
↑ Okada, S.; Ohaki, Y.; Inoue, K.; Kawamura, T.; Hayashi, T.; Kato, T.; Kumazaki, T. (Feb 2005). "Calcifications in mucinous and serous cystic ovarian tumors.". J Nippon Med Sch 72 (1): 29-33. PMID 15834205.

[pmid11207821-1] Feeley, KM.; Wells, M. (Feb 2001). "Precursor lesions of ovarian epithelial malignancy.". Histopathology 38 (2): 87-95. PMID 11207821.

[pmid19360296-2] Okamoto, S.; Okamoto, A.; Nikaido, T.; Saito, M.; Takao, M.; Yanaihara, N.; Takakura, S.; Ochiai, K. et al. (May 2009). "Mesenchymal to epithelial transition in the human ovarian surface epithelium focusing on inclusion cysts.". Oncol Rep 21 (5): 1209-14. PMID 19360296.

[pmid23171527-3] Takeuchi, M.; Matsuzaki, K.; Harada, M. (Mar 2013). "Ovarian adenofibromas and cystadenofibromas: magnetic resonance imaging findings including diffusion-weighted imaging.". Acta Radiol 54 (2): 231-6. doi:10.1258/ar.2012.120516. PMID 23171527.

[Ref_GP384-4] Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 384. ISBN 978-0443069208.

[Ref_GP396-5] 5.0 ^5.1 Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 396. ISBN 978-0443069208.

[pmid15834205-6] Okada, S.; Ohaki, Y.; Inoue, K.; Kawamura, T.; Hayashi, T.; Kato, T.; Kumazaki, T. (Feb 2005). "Calcifications in mucinous and serous cystic ovarian tumors.". J Nippon Med Sch 72 (1): 29-33. PMID 15834205.

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 1: / Line 1: @@
-#redirect [[Ovarian_tumours#Serous_cystadenoma_of_the_ovary]]
+{{ Infobox diagnosis
+| Name       = {{PAGENAME}}
+| Image      = Ovarian serous cystadenoma -- very high mag.jpg
+| Width      =
+| Caption    = Ovarian serous cystadenoma. [[H&E stain]].
+| Synonyms   =
+| Micro      = cyst lined by a single layer of cuboidal or columnar epithelium with bland nuclear features +/- cilia
+| Subtypes   = cystadenofibroma, adenofibroma
+| LMDDx      =
+| Stains     =
+| IHC        =
+| EM         =
+| Molecular  =
+| IF         =
+| Gross      = cystadenoma: thin walled cyst, usu. unilocular; cystadenofibroma and adenofibroma: solid and cystic or solid
+| Grossing   =
+| Site       = [[ovary]] - see ''[[ovarian tumours]]''
+| Assdx      =
+| Syndromes  =
+| Clinicalhx = +/-abdominal distension, +/-abdominal pain
+| Signs      =
+| Symptoms   = mass lesion
+| Prevalence = common
+| Bloodwork  =
+| Rads       =
+| Endoscopy  =
+| Prognosis  = benign
+| Other      =
+| ClinDDx    = other [[ovarian tumours]]
+| Tx         = cystectomy or oophorectomy
+}}
+'''Serous cystadenoma of the ovary''' is a common benign finding in the [[ovary]].
+It is also known as ''ovarian [[serous cystadenoma]]''.  It is unrelated the [[pancreatic serous cystadenoma]].
+'''Serous cystadenofibroma''' and '''[[adenofibroma]] of the ovary''' can be considered variants, and are also dealt with in this article.
+==General==
+*Benign.
+*Very common.
+*'''Not''' related to the [[serous cystadenoma of the pancreas]].
+*Thought to arise from a ''cortical inclusion cyst'' that has undergone Muellerian metaplasia<ref name=pmid11207821>{{Cite journal  | last1 = Feeley | first1 = KM. | last2 = Wells | first2 = M. | title = Precursor lesions of ovarian epithelial malignancy. | journal = Histopathology | volume = 38 | issue = 2 | pages = 87-95 | month = Feb | year = 2001 | doi =  | PMID = 11207821 }}</ref><ref name=pmid19360296>{{Cite journal  | last1 = Okamoto | first1 = S. | last2 = Okamoto | first2 = A. | last3 = Nikaido | first3 = T. | last4 = Saito | first4 = M. | last5 = Takao | first5 = M. | last6 = Yanaihara | first6 = N. | last7 = Takakura | first7 = S. | last8 = Ochiai | first8 = K. | last9 = Tanaka | first9 = T. | title = Mesenchymal to epithelial transition in the human ovarian surface epithelium focusing on inclusion cysts. | journal = Oncol Rep | volume = 21 | issue = 5 | pages = 1209-14 | month = May | year = 2009 | doi =  | PMID = 19360296 }}</ref> - see [[mesothelial inclusion cyst]].
+==Gross==
+Cystadenoma:
+*Usually unilocular.
+Cystadenofibroma and adenofibroma:<ref name=pmid23171527>{{Cite journal  | last1 = Takeuchi | first1 = M. | last2 = Matsuzaki | first2 = K. | last3 = Harada | first3 = M. | title = Ovarian adenofibromas and cystadenofibromas: magnetic resonance imaging findings including diffusion-weighted imaging. | journal = Acta Radiol | volume = 54 | issue = 2 | pages = 231-6 | month = Mar | year = 2013 | doi = 10.1258/ar.2012.120516 | PMID = 23171527 }}</ref>
+*Solid or solid and cystic.
+Note:
+*Cystic lesions must be >=1 cm in size, smaller lesions are ''surface epithelial inclusion cysts''.<ref name=Ref_GP384>{{Ref GP|384}}</ref>
+===Image===
+*[http://www.webpathology.com/image.asp?n=3&Case=525 Serous cystadenoma (webpathology.com)].
+==Microscopic==
+Features:<ref name=Ref_GP396>{{Ref GP|396}}</ref>
+*Simple epithelium - '''key feature''' - usually with cilia.
+**Cell morphology: columnar, cuboidal or flatted.
+*Absent or minimal [[nuclear atypia]].
+*+/-Rare tufting.
+*+/-Non-branching papillae.
+*+/-Rare mitoses.
+Note:
+*May have calcifications - uncommon.<ref name=pmid15834205>{{Cite journal  | last1 = Okada | first1 = S. | last2 = Ohaki | first2 = Y. | last3 = Inoue | first3 = K. | last4 = Kawamura | first4 = T. | last5 = Hayashi | first5 = T. | last6 = Kato | first6 = T. | last7 = Kumazaki | first7 = T. | title = Calcifications in mucinous and serous cystic ovarian tumors. | journal = J Nippon Med Sch | volume = 72 | issue = 1 | pages = 29-33 | month = Feb | year = 2005 | doi =  | PMID = 15834205 | URL = https://www.jstage.jst.go.jp/article/jnms/72/1/72_1_29/_pdf }}</ref>
+DDx:
+*Cortical inclusion cyst - <1 cm in size, see ''[[mesothelial inclusion cyst]]''.
+*[[Ovarian serous borderline tumour]] - branching papillae, tufting, mitoses, nuclear atypia.
+Note - the following may be lumped with this entity:
+*Serous cystadenofibroma.
+*Adenofibroma.
+===Images===
+====Serous cystadenoma====
+<gallery>
+Image: Ovarian serous cystadenoma - alt -- low mag.jpg | OSC - low mag.
+Image: Ovarian serous cystadenoma - alt -- intermed mag.jpg | OSC - intermed. mag.
+Image: Ovarian serous cystadenoma - alt -- high mag.jpg | OSC - high mag.
+Image: Ovarian serous cystadenoma -- intermed mag.jpg | OSC - intermed. mag.
+Image: Ovarian serous cystadenoma -- high mag.jpg | OSC - high mag.
+Image: Ovarian serous cystadenoma -- very high mag.jpg | OSC - very high mag.
+Image: Ovarian serous cystadenoma -- extremely high mag.jpg | OSC - extremely high mag.
+</gallery>
+====Serous cystadenofibroma====
+<gallery>
+Image: Serous cystadenofibroma -- very low mag.jpg | SCAF - very low mag.
+Image: Serous cystadenofibroma -- low mag.jpg | SCAF - low mag.
+Image: Serous cystadenofibroma -- intermed mag.jpg | SCAF - intermed. mag.
+Image: Serous cystadenofibroma -- high mag.jpg | SCAF - high mag.
+</gallery>
+=====www=====
+*[http://www.webpathology.com/image.asp?case=525&n=4 Serous cystadenofibroma - low mag. (webpathology.com)].
+*[http://www.webpathology.com/image.asp?n=5&Case=525 Serous cystadenofibroma - high mag. (webpathology.com)].
+==IHC==
+Features:<ref name=Ref_GP396/>
+*CK7 +ve.
+*EMA +ve.
+*WT1 +ve.
+*CK20 -ve.
+==Sign out==
+<pre>
+OVARY, LEFT, CYSTECTOMY:
+- BENIGN SEROUS CYSTADENOMA.
+</pre>
+<pre>
+FALLOPIAN TUBE AND (PARTIAL) OVARY, LEFT, RESECTION:
+- COMPATIBLE WITH SEROUS CYSTADENOMA.
+- BENIGN OVARIAN PARENCHYMA WITH FOCAL EDEMA AND A BENIGN CALCIFICATION.
+- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
+- NEGATIVE FOR MALIGNANCY.
+</pre>
+===Cystadenofibroma===
+<pre>
+FALLOPIAN TUBE AND OVARY, LEFT, UNILATERAL SALPINGO-OOPHORECTOMY:
+- OVARY WITH BENIGN SEROUS CYSTADENOFIBROMA.
+- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
+- NEGATIVE FOR MALIGNANCY.
+</pre>
+<pre>
+FALLOPIAN TUBES AND OVARIES, BILATERAL SALPINGO-OOPHRECTOMY:
+- BENIGN OVARIAN SEROUS CYSTADENOFIBROMA (BILATERAL).
+- FALLOPIAN TUBES WITHIN NORMAL LIMITS.
+</pre>
+===Atypical===
+<pre>
+FALLOPIAN TUBE AND OVARY, RIGHT, SALPINGO-OOPHORECTOMY:
+- BENIGN SEROUS CYSTADENOMA AND SEROUS CYSTADENOFIBROMA WITH FOCAL ATYPIA,
+  SEE COMMENT.
+- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
+- NEGATIVE FOR MALIGNANCY.
+COMMENT:
+A small focus of the sampled tissue has a complex architecture, compatible with a
+borderline tumour; however, it represents less than 10% of the lesion. Thus, the
+lesion is best classified as benign with focal atypia.
+</pre>
+===Micro===
+The sections show fibrous tissue consistent with a cyst wall lined by a simple columnar to flat epithelium, focally with cilia.
+Cautery is present imparting a pseudostratified appearance focally.  No definite papillae or definite tufting is apparent. No significant nuclear atypia is seen. Mitotic activity is not apparent.
+==See also==
+*[[Ovarian tumours]].
+*[[Pancreatic serous cystadenoma]].
+*[[Adenofibroma]].
+==References==
+{{Reflist|2}}
+[[Category:Ovarian tumours]]
 [[Category:Diagnosis]]