Serous tumors
Serous cystadenoma / adenofibroma / surface papilloma

Topic Completed: 1 June 2012

Minor changes: 21 January 2021

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed search: Benign serous tumors

Page views in 2020: 42,803
Page views in 2021 to date: 16,386
Cite this page: Ehdaivand S. Serous cystadenoma / adenofibroma / surface papilloma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorserousbenign.html. Accessed April 15th, 2021.
Definition / general
  • Includes cystadenoma, cystadenofibroma, adenofibroma, papillary cystadenoma, papillary cystadenofibroma, papillary adenofibroma
  • The term used depends on the relative amount of fibrous stroma, but distinctions are often arbitrary
  • Benign; 10-20% bilateral; most are partially or completely cystic; > 1 cm in size (< 1 cm signifies a cortical inclusion cyst or endosalpingiosis)
Case reports
  • 11 year old girl with morbid obesity and giant serous cystadenoma arising from accessory ovary (J Med Case Rep 2008;2:7)
  • 48 year old woman with serous cystadenoma with mural nodules of genital rhabdomyoma (Hum Pathol 2005;36:433)
Gross description
  • Papillary tumors have papillary projections on outer surface or protruding into cystic cavity
  • Cystadenoma: Usually 3-10 cm, oval to round, smooth glistening surface; usually watery clear to pale yellow cyst fluid, but can be viscous and mucoid
  • Cystadenofibroma: varies from solid areas with knobby papillae to confluent firm areas
  • Adenofibroma: entirely solid appearing; if surface papillary projections are prominent, designate as surface papillary serous adenofibroma
Gross images

AFIP images

Lining of a thin walled cyst is smooth and glistening

Serous papillary cystadenoma

Images hosted on other servers:

Serous cystadenoma


Microscopic (histologic) description
  • Usually small, uni- to multi-locular cysts lined by a single layer of tall, columnar, ciliated cells resembling normal tubal epithelium or cuboidal non-ciliated epithelium resembling ovarian surface epithelium
  • Stroma contains spindly fibroblasts
  • If papillae are present, they are simple papillary processes
  • No atypia, no architectural complexity, no invasion
  • Adenofibromas and cystadenofibromas are composed predominantly of fibrous stroma, with glands and cysts forming a minor component
Microscopic (histologic) images

AFIP images

Cyst lined by
ciliated epithelium

Serous cystadenoma, low power


Images hosted on other servers:

Lining of simple cuboidal epithelium

Giant serous cystadenoma from accessory ovary


Cytology images

Images hosted on other servers:

Small epithelial cell cluster

Epithelium is CD68- but macrophages are CD68+


Histopathology Ovary - Serous cystadenoma
Differential diagnosis
  • Rete cystadenoma: located in ovarian hilus, undulating epithelium, smooth muscle wall
Back to top
Image 01 Image 02