Student name :- Saeed Ayed saed -432800220 Abdulrahman Awagi Alnami -432800221 Muhannad Ali Asiri -432800225 Faris Ali Nasser- 432800229 Ovarian Tumor
Introduction Common neoplasms. Ovarian cancer is second common malignancy of the female genital tract (after endometrial cancer). 80% are benign – young (20-45) 20% are Malignant - older (>40) o 50% deaths due to late detection o Majority of ovarian tumors are benign
1-Serous Tumors: Frequently bilateral (30-66%). 75% benign and Borderline / 25% malignant. *Cysts are lined by tall columnar, ciliated epithelial cells (fallopian tube type) & filled with serous fluid. *Types: 1-Benign Serous Tumors (Cystadenomas): ( 60%) smooth lining & no solid areas 2- Borderline Serous Tumors : (15%) epithelial atypia, but no stromal invasion. 30% are bilateral. 3-Malignant Serous Tumors (Cystadenocarcinomas): (25%) multilayered epithelium with atypia&invading the stroma.
Serous Cystadenoma: single layer of columnar ciliated Fine papillae
2-Mucinous Tumors : Less common 25%, very large. Rare malignant - 15%. Multi loculated, many small cysts. Rarely bilateral – 5-20%. Tall columnar, apical mucin.
Mucinous cystadenoma Multilocular cyst lined by single layer of columnar cells with basally placed nuclei and apical mucin.
3-Endometrioid tumors most are unilateral (40% are bilateral) almost all are malignant about 20% of all ovarian tumors many are associated with endometrial cancer (30%) patient may have concurrent endometriosis
1-TERATOMA : Most common Germ Cell Tumor benign mature cystic teratomas (lined by skin & hairs, and filled with sebaceous secretion. there may be mature cartilage, bone, teeth & other structures. (10-15% are bilateral) *Immature teratoma –contain immature tissues. Grading is based on the amount of immature neuroepithelium. Uncommon * Specialized Teratomas: differentiate along the line of single tissue. Example:- Struma ovarii (mature thyroid tissue ). Rare
Cystic Teratoma Cyst with hair and cheesy material
2-Dysgerminoma The ovarian counterpart of the testicular seminoma 2% of all ovarian malignancy Most common malignant germ cell tumor It is the most ovarian malignancy in pregnancy An excellent prognosis. Highly radiosensitive.
Dysgerminoma Solid/ lobulated mass with foci of hemorrhage sheets of monotonous rounded cells with pale cytoplasm and central nuclei
3-Endodermal sinus tumor (Yolk sac carcinoma ) Tumor is a highly malignant and clinically aggressive neoplasm Most frequently in children and young females 20% of malignant germ cell tumors. Fatal within 2 years of diagnosis Schiller-Duval body
1-Granulosa Cell Tumor -Hormonally active tumor -The most common estrogenic ovarian neoplasm 2-Thecoma -Functional tumors producing estrogen
3- FIBROMA These tumors for about 2-5% of all ovarian tumors. These solid ovarian tumors may be associated with Meigs’ syndrome. Large firm fibrous mass Spindle shaped
D- Metastases to ovary About 3% of malignant tumors in the ovary are metastatic The primary tumors is from abdominal and breast tumors *Krukenberg tumor - It is applied to the uniform enlargement of the ovaries (usually bilaterally) due to diffuse infiltration of the ovarian stroma by metastatic signet-ring cell carcinoma. -The commonest primary site is the stomach followed by the colon.
Staging Stage I. growth limited to the pelvis 1- One ovary 2- both ovaries 3- 1 or 2 and ovarian surface tumor,rupture capsule, malignant ascites, peritoneal cytology positive. Stage II. Extension to the pelvis 1- extension to the uterus or fallopian tube 2- extension to the other pelvic tissues 3- 1 or 2 and ovarian surface tumor,rupture capsule, malignant ascites, peritoneal cytology positive. Stage III.Extension to abdominal cavity 1- abdominal peritoneal surfaces with microscopic metastases 2- tumor metastases <2cm in size 3- tumor metastases >2cm or metastatic disease in pelvic para aortic or inguinal lymph nodes Stage IV. Distant metastases Malignant pleural effusion Pulmonary parenchymal metastases Liver or splenic paranchyml metastases Metastases to thr supraclavicular lymph nodes or skin
prognosis Related to Response to chemotherapy Differentiation of tumor * 5-year survival in ovarian epithelial carcinoma is low because of the tumor become strong of late- stage disease at diagnosis.. Stage I and II: 80-100% Stage III: 15-20% Stage IV: 5% Patients under 50 in all stages have better 5-year survival than older patients (40% compared to 15%) Dysgerminomas treated by surgery and radiation have an excellent cure rate in both early and late-stage disease Endodermal sinus tumour has poor prognosis. Germ cell better than epithelial
Information Radner's death from ovarian cancer in 1989 helped to raise awareness of early detection and the connection to familial epidemiology