Ovary tumor
Surface epithelial tumors

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

Revised: 19 May 2016, last major update May 2012

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

PubMed Search: Ovarian surface epithelial tumors
Definition / General
  • Risk of malignancy rises with increase in grossly solid areas
  • Historically thought to be derived from surface epithelium (also called coelomic or germinal epithelium) that invaginates to form glands or cysts; this epithelium is continuous with mesothelium that lines peritoneal cavity
  • Ovarian epithelium may undergo metaplasia / neoplasia to resemble tubal, endometrial or endocervical mucosa (mullerian differentiation)
  • Recently, there has been an expanding literature focusing on an origin of high grade serous carcinomas from the distal fallopian tube (oviduct)
  • A proportion of early serous carcinomas (approximately 60%) involve the fallopian tube, either as an invasive or intraepithelial carcinoma (Am J Surg Pathol 2010;34:1407)
  • Additionally, high-grade mullerian pelvic carcinomas and tubal intra-epithelial carcinomas seem to share altered p53, PTEN and PAX2 expression (Mod Pathol 2010;23:1316)
  • These findings, in combination with the theory of drop metastases from small fallopian tube lesions onto the surface of the ovary, have suggested a fallopian tube origin of these tumors (Am J Surg Pathol 2010;34:433)
  • Classify based on cell type (serous, endometrioid, etc), pattern (cystic, solid, surface), amount of fibrous stroma (adenofibroma vs adenoma), invasiveness / atypia (adenoma vs adenocarcinoma)
  • For classification and staging, sample solid foci, base of papillary formations, areas adjacent to ovarian surface when grossing
Micro Images

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High-grade serous and endometrioid carcinomas

Paired H&E and PTEN stains

Absence of PAX2 and PTEN staining