Ovary tumor
Serous tumors
Serous carcinoma

Topic Completed: 1 June 2012

Minor changes: 5 June 2020

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PubMed Search: serous carcinoma[title], serous cystadenocarcinoma[title]

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Cite this page: Ehdaivand S. Serous carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorserouscarcinoma.html. Accessed July 2nd, 2020.
Definition / general
  • High grade tumors often have extreme drug resistance
Gross description
  • Solid, hemorrhagic, necrotic
Gross images

AFIP images

Bilateral tumor

Solid and cystic components

Images hosted on other servers:

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

AFIP images

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

Images hosted on other servers:

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
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