Serous cystadenoma of the ovary

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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

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

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:

Note - the following may be lumped with this entity:

  • Serous cystadenofibroma.
  • Adenofibroma.

Images

Serous cystadenoma

Serous cystadenofibroma

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.

See also

References

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