A. Serous Cystadenoma
D. Pelvic Inflammatory Disease
Image shows:Mature cystic teratoma (dermoid cyst) of the ovary. A ball of hair (bottom) and a mixture of tissues are evident.
- Tumors may arise from epithelium,sex cord–stromal cells, or germ cells.
- Epithelial tumors are the most common malignant ovarian tumors and are more common in women older than 40 years of age.
- The major types of epithelial tumors are serous,mucinous, and endometrioid. Each has a benign, malignant, and borderline (low malignant potential) counterpart.
- Sex cord–stromal tumors may display differentiation toward granulosa, Sertoli, Leydig, or ovarian stromal cell type. Depending on differentiation, they may produce estrogens or androgens.
- Germ cell tumors (mostly cystic teratomas) are the most common ovarian tumor in young women; a majority are benign.
- Germ cell tumors may differentiate toward oogonia (dysgerminoma), primitive embryonal tissue (embryonal), yolk sac (endodermal sinus tumor), placental tissue (choriocarcinoma), or multiple fetal tissues (teratoma).
Benign (Mature) Cystic Teratomas .
- Almost all benign (mature) cystic teratomas are marked by the presence of mature tissues derived from all three germ cell layers: ectoderm, endoderm, and mesoderm.
- Usually these tumors contain cysts lined by epidermis replete with adnexal appendages—hence the common designation dermoid cysts.
- Most are discovered in young women as ovarian masses or are found incidentally on abdominal radiographs or scans because they contain foci of calcification produced by tooth-like structures contained within the tumor. About 90% are unilateral, with the right side more commonly affected.
- Rarely do these cystic masses exceed 10 cm in diameter.
- On cut section, they often are filled with sebaceous secretion and matted hair that, when removed, reveal a hair-bearing epidermal lining.
- Sometimes there is a nodular projection from which teeth protrude. Occasionally, foci of bone and cartilage, nests of bronchial or gastrointestinal epithelium, and other tissues also are present.
Immature Malignant Teratomas .
- Malignant (immature) teratomas are found early in life, the mean age at clinical detection being 18 years.
- They differ strikingly from benign mature teratomas insofar as they often are bulky, predominantly solid on cut section, and punctuated by areas of necrosis; uncommonly, cystic foci are present that contain sebaceous secretion, hair, and other features similar to those of mature teratomas.
- On microscopic examination, the distinguishing feature is presence of immature elements or minimally differentiated cartilage, bone, muscle, nerve, or other tissues.