Difference between revisions of "Serous cystadenoma of the ovary"

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Serous cystadenoma of the ovary (view source)

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{{ 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]].
'''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 the [[pancreatic serous cystadenoma]].   
It is also known as ''ovarian [[serous cystadenoma]]''.  It is unrelated the [[pancreatic serous cystadenoma]].   


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


==General==
==General==
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==Gross==
==Gross==
Cystadenoma:
*Usually unilocular.
*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===
===Image===
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==Microscopic==
==Microscopic==
Features:
Features:<ref name=Ref_GP396>{{Ref GP|396}}</ref>
*Simple epithelium with cilia - '''key feature'''.
*Simple epithelium - '''key feature''' - usually with cilia.
**Cell morphology: columnar, cuboidal or flatted.
**Cell morphology: columnar, cuboidal or flatted.
*Absent or minimal [[nuclear atypia]].
*+/-Rare tufting.
*+/-Non-branching papillae.
*+/-Rare mitoses.


Note:
Note:
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DDx:
DDx:
*Cortical inclusion cyst - see ''[[mesothelial inclusion cyst]]''.
*Cortical inclusion cyst - <1 cm in size, see ''[[mesothelial inclusion cyst]]''.
*[[Ovarian serous borderline tumour]].
*[[Ovarian serous borderline tumour]] - branching papillae, tufting, mitoses, nuclear atypia.


Note - the following may be lumped with this entity:
Note - the following may be lumped with this entity:
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===Images===
===Images===
*[http://www.webpathology.com/image.asp?case=525&n=4 Serous cystadenofibroma (webpathology.com)].
====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==
==Sign out==
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<pre>
<pre>
FALLOPIAN TUBE AND OVARY, LEFT, UNILATERAL SALPINGO-OOPHERECTOMY:
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.
- OVARY WITH BENIGN SEROUS CYSTADENOFIBROMA.
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
- NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR MALIGNANCY.
</pre>
</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==
==See also==
*[[Ovarian tumours]].
*[[Ovarian tumours]].
*[[Pancreatic serous cystadenoma]].
*[[Pancreatic serous cystadenoma]].
*[[Adenofibroma]].


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Ovarian tumours]]
[[Category:Ovarian tumours]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]
Michael
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