Ovary tumor
Serous tumors
Serous cystadenocarcinoma / carcinoma

Authors: Shahrzad Ehdaivand, M.D. (see Authors page)

Revised: 19 May 2016, last major update June 2012

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: serous carcinoma[title], serous cystadenocarcinoma[title]
Cite this page: Serous cystadenocarcinoma / carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorserouscarcinoma.html. Accessed November 15th, 2018.
Definition / general
  • High grade tumors often have extreme drug resistance
Gross description
  • Solid, hemorrhagic, necrotic
Gross images

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Bilateral tumor

Solid and cystic components

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Many papillations on inner surface

Mostly composed of solid tissue

Uterus and right adnexa

Partially cystic, partially solid tumor

Microscopic (histologic) description
  • Low grade:
    • Extensively papillary with many psammoma bodies
    • May have papillae, glands, cribriform glands, cysts, or irregular nests of cells with uniform round to oval nuclei with evenly distributed chromatin, variable nucleolus
    • Usually 10 mitoses/HPF
    • Variable amounts of fibrous stroma

  • High grade:
    • Branching papillary fronds, slit-like fenestrations, glandular complexity, moderate to marked nuclear atypia with marked pleomorphism, prominent nucleoli, stratification, frequent mitoses, stromal invasion (irregular or destructive infiltration by small glands or sheets of cells)
    • Variable psammoma bodies (calcium concretions with concentric laminations, may be intracellular due to autophagocytosis)
    • Stroma may be fibrous, edematous, myxoid, or desmoplastic
Microscopic (histologic) images

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Grade 1 adenocarcinoma

Grade 4: resembling choriocarcinoma

Low grade

Epithelial inclusion glands

High cellularity, extensive formation of cellular papillae and irregular slit-like spaces

Complex papillae form glomeruloid structures

Poorly differentiated

Thin tubular glands lying in dense stroma

Small nests of well differentiated epithelial cells

Slightly pleomorphic and focally hyperchromatic tumor cells

Adenoid cystic-like component

Mixed epithelial tumor

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Serous carcinoma

Nuclei: grades 1-3

Psammoma bodies

Various patterns

Positive stains
  • p53 (90%), WT1 (78%), CA125 (78%), mesothelin (also lung, pancreas, endometrial adenocarcinomas)
  • Also CK5/6 (55%) and D2-40 (23%) (Mod Pathol 2008;21:1147)
Molecular / cytogenetics description
  • Frequent loss of heterozygosity of p53 and BRCA1 loci in high grade tumors; disseminated tumors appear to be monoclonal (Mod Pathol 1996;9:166)

Histopathology Ovary - Serous cystadenocarcinoma
Differential diagnosis