Ovary with serous cystadenoma with atypia (serous borderline tumor)
Clinical story
55 years old female with a palpable mass in the right flank. Ultrasound showed a large cyst measuring 20x20x16 cm. The cyst and the right ovary were removed.
Comments
Grossly, a 1.8 kg cyst with a hemorrhagic serous content. The surface was adherent to the omentum. On the inside of the cyst, several excrescences and some larger projections were found. Section from the cyst wall with
excrescences shows microscopically a thick, fibrous cyst wall. Areas of the cyst surface are covered mainly with simple cuboidal epithelium, but columnar epithelium of the serous type is also seen. In some areas, the epithelium is flattened. Papillary growth with a pseudostratified epithelium and varying degree of nuclear atypia is also found. Tumor infiltration into the stroma is not seen.
Learning goals
To recognize borderline serous tumor of the ovary. Additionally, to understand the division of epithelial tumors of the ovary by histological type and the degree of malignancy, as well as the potential of borderline tumors to become adenocarcinomas.