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{{Ovarian cancer}}
{{Ovarian cancer}}
{{CMG}}
{{CMG}}; {{AE}} {{Hudakarman}}


==Overview==
==Overview==
Ovarian cancer is classified according to the [[histology]] of the tumor, obtained in a [[pathology]] report.   
[[Ovarian cancer]] may be classified according to the [[histology]] of the [[tumor]], obtained in a [[pathology]] report. Based on the classification, the management of ovarian cancer is directed and determined. The main four types of ovarian cancer are [[Surface epithelial-stromal tumour]], [[Sex cord-stromal tumour|Sex cord-stromal tumor]], [[Germ cell tumor]], and Mixed tumors.   


==Classification==
==Classification==
Histology dictates many aspects of clinical treatment, management, and [[prognosis]].
*Histology dictates many aspects of clinical treatment, management, and [[prognosis]].<ref name="pmid11385772">{{cite journal| author=Heintz AP, Odicino F, Maisonneuve P, Beller U, Benedet JL, Creasman WT et al.| title=Carcinoma of the ovary. | journal=J Epidemiol Biostat | year= 2001 | volume= 6 | issue= 1 | pages= 107-38 | pmid=11385772 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11385772  }} </ref><ref name="pmid21340753">{{cite journal| author=Banks E| title=The epidemiology of ovarian cancer. | journal=Methods Mol Med | year= 2001 | volume= 39 | issue=  | pages= 3-11 | pmid=21340753 | doi=10.1385/1-59259-071-3:3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21340753  }} </ref><ref name="pmid12644542">{{cite journal| author=Singer G, Oldt R, Cohen Y, Wang BG, Sidransky D, Kurman RJ et al.| title=Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma. | journal=J Natl Cancer Inst | year= 2003 | volume= 95 | issue= 6 | pages= 484-6 | pmid=12644542 | doi=10.1093/jnci/95.6.484 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12644542  }} </ref><ref name="pmid15644779">{{cite journal| author=Singer G, Stöhr R, Cope L, Dehari R, Hartmann A, Cao DF et al.| title=Patterns of p53 mutations separate ovarian serous borderline tumors and low- and high-grade carcinomas and provide support for a new model of ovarian carcinogenesis: a mutational analysis with immunohistochemical correlation. | journal=Am J Surg Pathol | year= 2005 | volume= 29 | issue= 2 | pages= 218-24 | pmid=15644779 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15644779  }} </ref>
**[[Surface epithelial-stromal tumor]], including serous and mucinous [[cystadenocarcinoma]], is the most common type of ovarian cancer.
**[[Sex cord-stromal tumour|Sex cord-stromal tumor]], including [[estrogen]]-producing [[granulosa cell tumor]] and '''virilizing''' [[Sertoli-Leydig cell tumor]] or [[arrhenoblastoma]], accounts for 8% of ovarian cancers.
**[[Germ cell tumor]] accounts for approximately 5% of ovarian cancers. It tends to occur in young women and girls, and has a better prognosis than other ovarian tumors.
**'''Mixed''' [[tumor]]<nowiki/>s, containing elements of more than one tumor histology
 
*Ovarian cancer often is '''primary''', but can also be '''secondary''', the result of [[metastasis]] from a primary cancer elsewhere in the body.  For example, from [[breast cancer]], or from [[gastrointestinal cancer]] (in which case the ovarian cancer is a [[Krukenberg cancer]]).  Surface epithelial-stromal tumor can originate in the lining of the abdominal cavity, in which case the ovarian cancer is secondary to [[primary peritoneal cancer]], but treatment is basically the same as for primary ovarian cancer of this type. <ref name="pmid11385772" /><ref name="pmid21340753" /><ref name="pmid12644542" /><ref name="pmid15644779" /><ref name="pmid12733128" /><ref name="pmid15502809" />


*[[Surface epithelial-stromal tumour]], including serous and mucinous [[cystadenocarcinoma]], is the most common type of ovarian cancer.
*[[Sex cord-stromal tumour|Sex cord-stromal tumor]], including [[estrogen]]-producing [[granulosa cell tumor]] and '''virilizing''' [[Sertoli-Leydig cell tumor]] or [[arrhenoblastoma]], accounts for 8% of ovarian cancers.
*[[Germ cell tumor]] accounts for approximately 5% of ovarian cancers. It tends to occur in young women and girls, and has a better prognosis than other ovarian tumors.
* '''mixed''' tumors, containing elements of more than one tumor histology


Ovarian cancer often is '''primary''', but can also be '''secondary''', the result of [[metastasis]] from a primary cancer elsewhere in the body.  For example, from [[breast cancer]], or from [[gastrointestinal cancer]] (in which case the ovarian cancer is a [[Krukenberg cancer]]).  Surface epithelial-stromal tumor can originate in the lining of the abdominal cavity, in which case the ovarian cancer is secondary to [[primary peritoneal cancer]], but treatment is basically the same as for primary ovarian cancer of this type.
{| style="border: 0px; font-size: 90%; margin: 4px;" align="center"
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF| Ovarian cancer Types}}
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF| Ovarian cancer subtypes }}
|-
| rowspan="20;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |[[Surface epithelial-stromal tumour]] (60-70%)
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian serous tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Ovarian serous cystadenoma]]: ~60% of serous tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Ovarian borderline serous cystadenoma: ~15% of serous tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Ovarian serous cystadenocarcinoma: ~25% of serous tumor; commonest malignant ovarian tumour
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian mucinous tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Ovarian mucinous cystadenoma: ~80% of mucinous tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Ovarian borderline mucinous cystadenoma: 10-15% of mucinous tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Ovarian mucinous cystadenocarcinoma: ~5-10% of serous tumor
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian endometrioid tumour
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* 8-15% of all ovarian tumor
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Brenner tumour
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* ~2.5% of ovarian epithelial neoplasms
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Squamous cell carcinoma of the ovary
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* ~5% of ovarian cancer
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian cystadenofibroma / ovarian adenofibroma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* can be serous, mucinous, endometrioid, clear cell or mixed
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian cystadenocarcinofibroma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* extremely rare
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Undifferentiated carcinoma of the ovary
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* ~4% of all ovarian tumor
|-
| rowspan="15;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" | Germ cell ovarian tumor (~20%)
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian teratoma: commonest primary benign tumour of ovary
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Immature ovarian teratoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Mature ovarian (cystic) teratoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Specialised teratomas of the ovary
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Struma ovarii tumour
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Ovarian carcinoid tumor
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian dysgerminoma
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian yolk sac tumour
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* endodermal sinus tumour
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian embryonal carcinoma
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian choriocarcinoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* <1% of ovarian tumor
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Pure primary ovarian choriocarcinoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* extremely rare
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Malignant mixed germ cell tumour of the ovary
|-
| rowspan="12;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" | Sex cord / stromal ovarian tumor (8-10%)<ref name="pmid12733128">{{cite journal| author=Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN| title=Pathology and classification of ovarian tumors. | journal=Cancer | year= 2003 | volume= 97 | issue= 10 Suppl | pages= 2631-42 | pmid=12733128 | doi=10.1002/cncr.11345 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12733128 }} </ref><ref name="pmid15502809">{{cite journal| author=Young RH| title=Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems. | journal=Mod Pathol | year= 2005 | volume= 18 Suppl 2 | issue=  | pages= S81-98 | pmid=15502809 | doi=10.1038/modpathol.3800311 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15502809  }} </ref>
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian fibrothecoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* ~5% of ovarian tumor
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian fibroma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* ~4% of ovarian tumor
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Sclerosing stromal tumour of the ovary
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* rare
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian Sertoli-Leydig cell tumour - ovarian androblastoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* ~0.5% of ovarian tumor
|-
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Granulosa cell tumour of ovary
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* commonest malignant sex cord tumour
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Juvenile granulosa cell tumour of ovary
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Adult granulosa cell tumour of ovary
|-
| rowspan="3;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |[[Others]]
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Ovarian carcinosarcoma <1%
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Primary ovarian lymphoma
|-
| style="padding: 5px 5px; background: #F5F5F5;" |
* Secondary involvement of the ovary with lymphoma
|-
| rowspan="2;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |[[Metastases to the ovary]]
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Krukenburg tumour
|-
| rowspan="1;" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;" |Other metastatic lesions to ovary
|-


Cellular Classification of Ovarian tumor http://radiopaedia.org/articles/ovarian-tumours
|}


==ovarian tumor==
:*[[Category:Up-To-Date]] [[Category:Oncology]] [[Category:Medicine]] [[Category:Gynecology]] [[Category:Surgery]]
* '''Surface epithelial stromal ovarian tumor''' (60-70%)
:* ovarian serous tumor
::* ovarian serous cystadenoma: ~60% of serous tumor
::* ovarian borderline serous cystadenoma: ~15% of serous tumor
::* ovarian serous cystadenocarcinoma: ~25% of serous tumor; commonest malignant ovarian tumour
:* ovarian mucinous tumor: ~20% of all ovarian tumor
::* ovarian mucinous cystadenoma: ~80% of mucinous tumor
::* ovarian bordeline mucinous cystadenoma: 10-15% of mucinous tumor
::* ovarian mucinous cystadenocarcinoma: 5-10% of mucinous tumor
:* ovarian endometrioid tumour: 8-15% of all ovarian tumor
:* clear cell ovarian carcinoma: ~5% of ovarian cancer
:* Brenner tumour: ~2.5% of ovarian epithelial neoplasms
:* squamous cell carcinoma of the ovary
:* ovarian cystadenofibroma / ovarian adenofibroma: can be serous, mucinous, endometrioid, clear cell or mixed
:* ovarian cystadenocarcinofibroma: extremely rare
:* undifferentiated carcinoma of the ovary: ~4% of all ovarian tumor
* '''Germ cell ovarian tumor''' (~20%)
:* ovarian teratoma: commonest primary benign tumour of ovary
::* mature ovarian (cystic) teratoma
::* immature ovarian teratoma
::* specialised teratomas of the ovary
::* struma ovarii tumour
::* ovarian carcinoid tumor
:* ovarian dysgerminoma
:* ovarian yolk sac tumour: endodermal sinus tumour
:* ovarian embryonal carcinoma
:* ovarian choriocarcinoma: <1% of ovarian tumor
:* pure primary ovarian choriocarcinoma: extremely rare
:* malignant mixed germ cell tumour of the ovary
* '''Sex cord / stromal ovarian tumor''' (8-10%)
:* ovarian fibrothecoma: ~5% of ovarian tumor
:* ovarian fibroma: ~4% of ovarian tumor
:* ovarian thecoma: ~1% of ovarian tumor
:* sclerosing stromal tumour of the ovary: rare
:* ovarian Sertoli-Leydig cell tumour - ovarian androblastoma: ~0.5% of ovarian tumor
:* granulosa cell tumour of ovary: commonest malignant sex cord tumour
:* juvenile granulosa cell tumour of ovary
:* adult granulosa cell tumour of ovary
:* Mixed
* uncommon:
* ovarian carcinosarcoma <1%
* Other
:* ovarian lymphoma
:* primary ovarian lymphoma
:* secondary involvement of the ovary with lymphoma
* metastases to the ovary
:* Krukenburg tumour
:* other metastatic lesions to ovary


==References==
==References==

Latest revision as of 16:55, 4 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

Overview

Ovarian cancer may be classified according to the histology of the tumor, obtained in a pathology report. Based on the classification, the management of ovarian cancer is directed and determined. The main four types of ovarian cancer are Surface epithelial-stromal tumour, Sex cord-stromal tumor, Germ cell tumor, and Mixed tumors.

Classification


Ovarian cancer Types Ovarian cancer subtypes
Surface epithelial-stromal tumour (60-70%) Ovarian serous tumor
  • Ovarian borderline serous cystadenoma: ~15% of serous tumor
  • Ovarian serous cystadenocarcinoma: ~25% of serous tumor; commonest malignant ovarian tumour
Ovarian mucinous tumor
  • Ovarian mucinous cystadenoma: ~80% of mucinous tumor
  • Ovarian borderline mucinous cystadenoma: 10-15% of mucinous tumor
  • Ovarian mucinous cystadenocarcinoma: ~5-10% of serous tumor
Ovarian endometrioid tumour
  • 8-15% of all ovarian tumor
Brenner tumour
  • ~2.5% of ovarian epithelial neoplasms
Squamous cell carcinoma of the ovary
  • ~5% of ovarian cancer
Ovarian cystadenofibroma / ovarian adenofibroma
  • can be serous, mucinous, endometrioid, clear cell or mixed
Ovarian cystadenocarcinofibroma
  • extremely rare
Undifferentiated carcinoma of the ovary
  • ~4% of all ovarian tumor
Germ cell ovarian tumor (~20%) Ovarian teratoma: commonest primary benign tumour of ovary
  • Immature ovarian teratoma
  • Mature ovarian (cystic) teratoma
  • Specialised teratomas of the ovary
  • Struma ovarii tumour
  • Ovarian carcinoid tumor
Ovarian dysgerminoma
Ovarian yolk sac tumour
  • endodermal sinus tumour
Ovarian embryonal carcinoma
Ovarian choriocarcinoma
  • <1% of ovarian tumor
Pure primary ovarian choriocarcinoma
  • extremely rare
Malignant mixed germ cell tumour of the ovary
Sex cord / stromal ovarian tumor (8-10%)[5][6] Ovarian fibrothecoma
  • ~5% of ovarian tumor
Ovarian fibroma
  • ~4% of ovarian tumor
Sclerosing stromal tumour of the ovary
  • rare
Ovarian Sertoli-Leydig cell tumour - ovarian androblastoma
  • ~0.5% of ovarian tumor
Granulosa cell tumour of ovary
  • commonest malignant sex cord tumour
Juvenile granulosa cell tumour of ovary
Adult granulosa cell tumour of ovary
Others Ovarian carcinosarcoma <1%
  • Primary ovarian lymphoma
  • Secondary involvement of the ovary with lymphoma
Metastases to the ovary Krukenburg tumour
Other metastatic lesions to ovary

References

  1. ↑ 1.0 1.1 Heintz AP, Odicino F, Maisonneuve P, Beller U, Benedet JL, Creasman WT; et al. (2001). "Carcinoma of the ovary". J Epidemiol Biostat. 6 (1): 107–38. PMID 11385772.
  2. ↑ 2.0 2.1 Banks E (2001). "The epidemiology of ovarian cancer". Methods Mol Med. 39: 3–11. doi:10.1385/1-59259-071-3:3. PMID 21340753.
  3. ↑ 3.0 3.1 Singer G, Oldt R, Cohen Y, Wang BG, Sidransky D, Kurman RJ; et al. (2003). "Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma". J Natl Cancer Inst. 95 (6): 484–6. doi:10.1093/jnci/95.6.484. PMID 12644542.
  4. ↑ 4.0 4.1 Singer G, Stöhr R, Cope L, Dehari R, Hartmann A, Cao DF; et al. (2005). "Patterns of p53 mutations separate ovarian serous borderline tumors and low- and high-grade carcinomas and provide support for a new model of ovarian carcinogenesis: a mutational analysis with immunohistochemical correlation". Am J Surg Pathol. 29 (2): 218–24. PMID 15644779.
  5. ↑ 5.0 5.1 Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (10 Suppl): 2631–42. doi:10.1002/cncr.11345. PMID 12733128.
  6. ↑ 6.0 6.1 Young RH (2005). "Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems". Mod Pathol. 18 Suppl 2: S81–98. doi:10.1038/modpathol.3800311. PMID 15502809.


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