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

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 - see mesothelial inclusion cyst.

Gross

Cystadenoma:

• Usually unilocular.

Cystadenofibroma and adenofibroma:

• Solid or solid and cystic.

Note:

• Cystic lesions must be >=1 cm in size, smaller lesions are surface epithelial inclusion cysts.

Image

• Serous cystadenoma (webpathology.com).

Microscopic

Features:

• 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.

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

• Serous cystadenofibroma - low mag. (webpathology.com).
• Serous cystadenofibroma - high mag. (webpathology.com).

IHC

Features:

• 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.

See also

• Ovarian tumours.
• Pancreatic serous cystadenoma.
• Adenofibroma.