Ovarian serous cystadenocarcinoma
Updates to Article Attributes
Ovarian serous cystadenocarcinoma is an ovarian epithelial tumortumour at the malignant end of the spectrum of ovarian serous tumours.
Epidemiology
Serous ovarian cystadenocarcinomas account for ~25% of serous tumours ref.
They account for the largest proportion of malignant ovarian tumours 1, representing over 50-80% of all malignant epithelial ovarian tumours 4. The prevalence peaks around the 6th to 7th decades of life 2.
Risk factors
Recognised risk factors include:
- nulliparity
- early menarche
- late menopause
- positive
familiyfamily history - infertility
Pathology
Macroscopically serous cystadenocarcinoma appear as multilocular cystic ovarian tumour with papillary projections. Due to this reason it can also be termed a papillary serous cystadenocarcinoma of the ovary. Psammomatous bodies may be present in ~30% of cases on histology.
Markers
Elevated serum CA-125 (in more than 90% of cases 6)
Radiographic features
General
Lesions are typically mixed solid/cystic masses, which are frequently bilateral.
General features of advanced malignancy such as ascites, peritoneal nodularity and lymphadenopathy may be present. Often the amount of ascites is disproportionately large 3.
Ultrasound
- more heterogeneous in appearance than a serous cystadenoma
- papillary projections, thick septations, and/or solid components
- presence of ascites
- concerning for peritoneal metastatic spread
- discrete peritoneal deposits may be seen
- colour Doppler is useful to confirm vascularity of the solid components
- quantitative parameters (resistive index and pulsatility index) do not reliably predict malignancy.
CT
In addition to general features may show calcifications which may beCalcification is detected in approximately 12% of tumours on CT 4. These, however, are a nonspecific finding, since they are alsobut is non-specific as calcification can also be seen in benign serous tumors as well astumours and other neoplasms.
CT can be used for preoperative staging, to to look for lyphadenopathylymphadenopathy, peritoneal, and distant metastases.
MRI
MRI is the superior modalitymodality of choice in the characterisation characterisation of ovarian malignancy and in the detection of lymphatic, peritoneal, and distant metastases, both for preoperative planning and post treatment follow up.
The cystic components are high T2, low T1 signal, unless there has been intralesional haemorrage (c.f. mucinous cystadenocarcinoma, where there is typically slightly increased T1 signal of the cystic component)
Solid malignant components demonstrate intermediate T1 and T2 signal, restricted diffusion, and gadolinium enhancement.
DWI is useful for detection of distant metastases.
Staging
See also
-<p><strong>Ovarian serous cystadenocarcinoma</strong> is an <a title="Ovarian epithelial tumors" href="/articles/epithelial-ovarian-tumours">ovarian epithelial tumor</a> at the malignant end of the spectrum of <a href="/articles/ovarian-serous-tumours">ovarian serous tumours</a>.</p><h4>Epidemiology</h4><p>Serous ovarian cystadenocarcinomas account for ~25% of serous tumours <sup>ref</sup>. </p><p>They account for the largest proportion of malignant ovarian tumours <sup>1</sup>, representing over 50-80% of all malignant epithelial ovarian tumours <sup>4</sup>. The prevalence peaks around the 6<sup>th</sup> to 7<sup>th</sup> decades of life <sup>2</sup>.</p><h5>Risk factors</h5><p>Recognised risk factors include:</p><ul>- +<p><strong>Ovarian serous cystadenocarcinoma</strong> is an <a href="/articles/epithelial-ovarian-tumours">ovarian epithelial tumour</a> at the malignant end of the spectrum of <a href="/articles/ovarian-serous-tumours">ovarian serous tumours</a>.</p><h4>Epidemiology</h4><p>Serous ovarian cystadenocarcinomas account for ~25% of serous tumours <sup>ref</sup>. </p><p>They account for the largest proportion of malignant ovarian tumours <sup>1</sup>, representing over 50-80% of all malignant epithelial ovarian tumours <sup>4</sup>. The prevalence peaks around the 6<sup>th</sup> to 7<sup>th</sup> decades of life <sup>2</sup>.</p><h5>Risk factors</h5><p>Recognised risk factors include:</p><ul>
-<li>positive familiy history</li>- +<li>positive family history</li>
-</ul><h4>Pathology</h4><p>Macroscopically serous cystadenocarcinoma appear as multilocular cystic ovarian tumour with papillary projections. Due to this reason it can also be termed a <strong>papillary serous cystadenocarcinoma of the ovary</strong>. Psammomatous bodies may be present in ~30% of cases on histology.</p><h5>Markers</h5><p><a title="Elevation of CA-125 level" href="/articles/ca-125-elevation-2">Elevated serum CA-125</a> (in more than 90% of cases <sup>6</sup>)</p><h4>Radiographic features</h4><h5>General</h5><p>Lesions are typically mixed solid/cystic masses, which are frequently bilateral.</p><p>General features of advanced malignancy such as ascites, peritoneal nodularity and lymphadenopathy may be present. Often the amount of ascites is disproportionately large <sup>3</sup>.</p><h5>Ultrasound</h5><ul>-<li>more heterogeneous in appearance than a <a title="Ovarian serous cystadenoma" href="/articles/ovarian-serous-cystadenoma">serous cystadenoma</a>- +</ul><h4>Pathology</h4><p>Macroscopically serous cystadenocarcinoma appear as multilocular cystic ovarian tumour with papillary projections. Due to this reason it can also be termed a <strong>papillary serous cystadenocarcinoma of the ovary</strong>. Psammomatous bodies may be present in ~30% of cases on histology.</p><h5>Markers</h5><p><a href="/articles/ca-125-elevation-2">Elevated serum CA-125</a> (in more than 90% of cases <sup>6</sup>)</p><h4>Radiographic features</h4><h5>General</h5><p>Lesions are typically mixed solid/cystic masses, which are frequently bilateral.</p><p>General features of advanced malignancy such as ascites, peritoneal nodularity and lymphadenopathy may be present. Often the amount of ascites is disproportionately large <sup>3</sup>.</p><h5>Ultrasound</h5><ul>
- +<li>more heterogeneous in appearance than a <a href="/articles/ovarian-serous-cystadenoma">serous cystadenoma</a>
-</ul><h5>CT</h5><p>In addition to general features may show calcifications which may be detected in approximately 12% of tumours on CT <sup>4</sup>. These, however, are a nonspecific finding, since they are also seen in benign serous tumors as well as other neoplasms. </p><p>CT can be used for preoperative staging, to look for lyphadenopathy, peritoneal and distant metastases. </p><h5>MRI</h5><p>MRI is the superior modality in the characterisation of ovarian malignancy and in the detection of lymphatic, peritoneal, and distant metastases, both for preoperative planning and post treatment follow up.</p><p>The cystic components are high T2, low T1 signal, unless there has been intralesional haemorrage (c.f. mucinous cystadenocarcinoma, where there is typically slightly increased T1 signal of the cystic component)</p><p>Solid malignant components demonstrate intermediate T1 and T2 signal, restricted diffusion, and gadolinium enhancement.</p><p>DWI is useful for detection of distant metastases.</p><h5>Staging</h5><p>See: <a href="/articles/ovarian-cancer-staging">ovarian cancer staging</a></p><h4>See also</h4><ul><li><a href="/articles/ovarian-tumours">ovarian tumours</a></li></ul>- +</ul><h5>CT</h5><p>Calcification is detected in approximately 12% of tumours on CT <sup>4 </sup>but is non-specific as calcification can also be seen in benign serous tumours and other neoplasms. </p><p>CT can be used for preoperative staging to look for lymphadenopathy, peritoneal, and distant metastases. </p><h5>MRI</h5><p>MRI is the modality of choice in the characterisation of ovarian malignancy and in the detection of lymphatic, peritoneal, and distant metastases, both for preoperative planning and post treatment follow up.</p><p>The cystic components are high T2, low T1 signal, unless there has been intralesional haemorrage (c.f. mucinous cystadenocarcinoma, where there is typically slightly increased T1 signal of the cystic component)</p><p>Solid malignant components demonstrate intermediate T1 and T2 signal, restricted diffusion, and gadolinium enhancement.</p><p>DWI is useful for detection of distant metastases.</p><h5>Staging</h5><p>See: <a href="/articles/ovarian-cancer-staging">ovarian cancer staging</a></p><h4>See also</h4><ul><li><a href="/articles/ovarian-tumours">ovarian tumours</a></li></ul>
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