1) Classification Criteria (non-epithelial tumours)
Sex Cord Stromal Tumours
Granulosa-Stromal Cell Tumours
| 1. Granulosa cell tumour |
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a) juvenile |
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b) adult |
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| 2. Tumours in the thecoma-fibroma group |
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a) thecoma |
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i) typical |
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ii) luteinized (a rare tumour has the features of luteinized thecoma and additionally, crystals of Reinke in the steroid cell component. This tumour has been called "stromal Leydig cell tumour". |
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b) fibroma |
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c) cellular fibroma |
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d) fibrosarcoma |
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e) stromal tumour with minor sex cord elements |
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f) sclerosing stromal tumour |
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g) (stromal luteoma) see Steroid (Lipid) Cell Tumours, stromal luteoma |
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h) unclassified (fibrothecoma) |
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i) others (This category includes the rare signet ring cell stromal tumour and the myxoma). |
Sertoli-Leydig Cell Tumours; Androblastomas
| 1. Well differentiated |
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a) Sertoli cell tumour (tubular androblastoma) |
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b) Sertoli-Leydig cell tumour |
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c) (Leydig cell tumour) - see Steroid (Lipid) Cell Tumours, Leydig cell tumour |
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| 2. Of intermediate differentiation |
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a) variant - with heterologous elements (specify type) |
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| 3. Poorly differentiated (sarcomatoid) |
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a) variant - with heterologous elements (specify type) |
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| 4. Retiform |
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a) variant - with heterologous elements (specify type) |
Sex Cord Tumour with Annular Tubules
Gynandroblastoma
Unclassified
Steroid (Lipid Cell Tumours)
| 1. |
Stromal luteoma |
| 2. |
Leydig cell tumour (hilus cell tumour). Some Leydig cell tumours do not arise from hilus cells but within the ovarian stroma. These tumours have been called "Leydig cell tumours, non-hilar type". |
Germ Cell Tumours
| 1. Dysgerminoma |
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1. Variant - with syncytiotrophoblast cells |
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| 2. Yolk Sac Tumour (Endodermal Sinus Tumour) |
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1. |
Variants |
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a) Polyvesicular vitelline tumour |
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b) Hepatoid |
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c) Glandular (some glandular yolk sac tumours resemble endometrioid adenocarcinoma and have been called "endometrioid-like". |
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| 3. Embryonal Carcinoma |
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| 4. Polyembryoma |
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| 5. Choriocarcinoma |
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| 6. Teratomas |
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1. |
Immature |
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2. |
Mature |
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a) solid |
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b) cystic (dermoid cyst) |
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c) with secondary tumour (specify type) |
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d) retiform (homunculus) |
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3. |
Monodermal and highly specialized |
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a) struma ovarii |
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- variant - with secondary tumour (specify type)
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b) carcinoid |
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c) struma carcinoid |
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d) mucinous carcinoid |
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e) neuroectodermal tumours (specify type) |
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f) sebaceous tumours |
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g) others |
7. Mixed (specify types)
Gonadoblastoma
1. Variant - with dysgerminoma or other term cell tumour
Germ Cell - Sex Cord-Stromal Tumour
1. Variant - with dysgerminoma or other term cell tumour
Tumours of Rete Ovarii
1. Adenomatoid tumour
2. Mesothelioma
Mesothelial Tumours
1. Adenomatoid tumour
2. Mesothelioma
Tumours of Uncertain Origin
| 1. |
Small cell carcinoma (This tumour is of two types - one that is usually associated with paraendocrine hypercalcemia and has been called "small cell carcinoma, hypercalcemic type", and the other that has neuroendocrine features and has been designated "small cell carcinoma, pulmonary type". Probably most of the latter type belong in the surface epithelial-stromal category.) |
| 2. |
Tumour of probable Wolffian origin |
| 3. |
Hepatoid carcinoma |
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Oncocytoma |
Soft Tissue Tumours not Specific to Ovary
Malignant Lymphomas and Leukemias
Unclassified Tumours
Secondary (Metastatic) Tumours
2) Diagnostic Pathology
Gross Description
Gross description of oophorectomy specimens should include:
- Size of the ovary (tumour)
- Unilateral or bilateral involvement
- Surface appearance
- Cut surface appearance (solid, cystic, necrotic, hemorrhagic)
- Sampling of the lesion should include one block per cubic centimeter of tumour
Microscopic Description
Microscopic description should include the following features:
| 1. Histologic type (if more than one pattern is seen, secondary pattern should be described) |
| 2. The histologic grade of tumour (I-III) |
| 3. If mucinous borderline tumour is diagnosed, it should be stated if it is of |
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a) |
Mullerian type (endocervical) |
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b) |
Intestinal type |
| 4. The presence or absence of lymphatic and/or venous invasion |
| 5. The presence or absence of serosal involvement |
| 6. The presence or absence of omental involvement |
| 7. Cytology of peritoneal fluid |
*DNA ploidy for all borderline lesions (representative block should be selected for flow cytometry studies).
3)Staging (Ovary-Non-Epithelial Carcinoma)
Staging Diagram
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Click image
for larger version |