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Diseases of ovary

Cystic follicles • Distention of atretic follicles > 2.5 cm = Follicular cysts • infancy - menopause • children - precocious puberty • adults - endometrial hyperplasia

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Corpus luteum cyst • luteinizing cell linings • bloody contents • rupture : pain, hemoperitoneum

Ovary

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Polycystic ovary • multiple cystic follicles • understood pathogenesis Stein-Leventhal syndrome : amenorrhea : infertility : endometrial hyperplasia

Polycystic ovary

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Ovarian neoplasms • palpable mass • pain • pressure symptoms : GI, urinary • abnormal uterine bleeding • incidental findings

Ovarian neoplasms • Surface epithelium 70% • Germ cells 20% • Sex cord and stromal cells 10%

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Ovarian neoplasms

Epithelial neoplasms embryonic coelomic epithelium • Mucinous tumors : endocervix • Serous tumors : tubal epithelium • Endometrioid / Clear cell carcinoma : endometrium • Brenner tumor : urothelium

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Serous / Mucinous tumors • Cystadenoma • Borderline malignancy • Cystadenocarcinoma

Cystadenomas

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Cystadenocarcinomas

Epithelial cell linings

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Carcinomas

Mucinous cystadenocarcinoma Endometrioid carcinoma

Germ cell tumors • 95% mature cystic teratomas • 8% mixed germ cell tumors The younger the patient, the more

germ cell tumor be malignant

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Germ cell tumors • Dysgerminoma (Seminoma) • Embryonal carcinoma • Yolk sac tumor (Endodermal sinus tumor) • Choriocarcinoma

Histogenesis

Dysgerminoma(Seminoma)

Extraembryonic tissueYolk sac tumor

Choriocarcinoma

Embryonic tissueMature teratoma

Immature teratoma

Totipotential cellsEmbryonal carcinoma

Primitive germ cells

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Teratomas Mature cystic teratoma (Dermoid cyst) • malignant change : SCC, adenocarcinoma,

carcinoid tumor Mature solid teratoma (grade 0 immature

teratoma) Monodermal teratoma Immature teratoma

Mature cystic teratoma

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Mature cystic teratoma

Struma ovarii

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Fetiform teratoma

Homunculus

Immature teratoma

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Malignant germ cell tumor

Stromal sex-cord tumors • Fibroma • Thecoma • Granulosa cell tumor

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Fibroma • solid tumor • fibroblastic proliferation • Meigs’ syndrome + ascites + right-sided pleural effusion

Fibroma

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Granulosa cell tumor • 2/3 menopause • estrogen production : precocious puberty : endometrial hyperplasia

Granulosa cell tumor

Call-Exner body

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Metastatic tumor • adenocarcinoma • stomach, colon, appendix, breast,

uterus, lung • Krukenberg’s tumor : bilateral : signet ring cells

Krukenberg’s tumor

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Men are born to succeed, not to fail.

Henry David Thoreau, 1817-1862, poet and philosopher, American

Thank you