Ovarian serous tumors
Updates to Article Attributes
Ovarian serous neoplasms are the commonest subtypes of the epithelial ovarian tumours, being more prevalent than the mucinous ovarian tumours. They are subdivided according to their malignant potential and clinical behaviour into:
- benign
:serous cystadenoma / serous cystadenofibroma - borderline cystadenoma
- malignant serous cystadenocarcinoma
Epidemiology
Approximately 60% are benign and ~15% of borderline malignancy; These occur most commonly in women of reproductive age. The malignant tumours comprise of 25% of cases and tend to occur in older patients.
Pathology
Like all ovarian epithelial neoplasms, they are derived from coelomic mesothelium. In the case of the serous tumours, this differentiates into the tubal epithelium.
In contrast, the formation of mucinous tumours results from the coelomic mesothelium evolving into cervix epithelium, and the formation of endometrioid tumours – into endometrial epithelium.
Radiographic features
Imaging evaluation may be performed preferably with ultrasound or MRI, with CT usually reserved for staging purposes. In general, the cell type (e.g. serous, mucinous) often cannot be determined on the imaging basis of appearances.
Serous ovarian tumours are typically smaller than mucinous tumours on presentation. They are typically unilocular and homogeneous. They are often bilateral, and this is particularly so for the malignant subtypes. Psammomatous calcification is a feature of serous, but not mucinous subtypes.
Features that suggest a malignant over a benign cystic neoplasm include:
- large cystic mass
- thick irregular walls and septa
- papillary projections
- large soft tissue component
- ascites
- evidence of invasive spread or adenopathy
Differential diagnosis
Considerations include:
-
ovarian functional cyst
- usually smaller
- thin walls with no septations
- tend to change or resolve in the next menstrual cycle
-
paraovarian cyst
- ovaries can be individualised apart from the cyst
-
ovarian mucinous tumours
- tend to be multiseptated
- often larger than serous tumours
- monolateral rather than bilateral
- cystic loculi with variable signal intensities on MRI giving the appearances of "stained glass"
See also
-<li>benign: <a href="/articles/ovarian-serous-cystadenoma">serous cystadenoma</a> / <a href="/articles/serous-cystadenofibroma-of-ovary">serous cystadenofibroma</a>- +<li>benign <a href="/articles/ovarian-serous-cystadenoma">serous cystadenoma</a> / <a href="/articles/serous-cystadenofibroma-of-ovary">serous cystadenofibroma</a>
-<li>malignant <a href="/articles/ovarian-serous-cystadenocarcinoma">cystadenocarcinoma</a>- +<li>malignant <a href="/articles/ovarian-serous-cystadenocarcinoma">serous cystadenocarcinoma</a>
-</ul><h4>Epidemiology</h4><p>Approximately 60% are benign and ~15% of borderline malignancy; These occur most commonly in women of reproductive age. The malignant tumours comprise of 25% of cases and tend to occur in older patients. </p><h4>Pathology</h4><p>Like all ovarian epithelial neoplasms, they are derived from coelomic mesothelium. In the case of the serous tumours, this differentiates into tubal epithelium. </p><p>In contrast, the formation of mucinous tumours results from the coelomic mesothelium evolving into cervix epithelium, and the formation of<a href="/articles/endometrioid-carcinoma-of-the-ovary"> endometrioid tumours</a> – into endometrial epithelium.</p><h4>Radiographic features</h4><p>Imaging evaluation may be performed preferably with ultrasound or MRI, with CT usually reserved for staging purposes. In general, the cell type (e.g. serous, mucinous) often cannot be determined on the imaging basis of appearances. </p><p>Serous ovarian tumours are typically smaller than mucinous tumours on presentation. They are typically unilocular and homogeneous. They are often bilateral, and this is particularly so for the malignant subtypes. <a href="/articles/psammomatous-calcification">Psammomatous calcification</a> is a feature of serous, but not mucinous subtypes. </p><p>Features that suggest a malignant over a benign cystic neoplasm include: </p><ul>- +</ul><h4>Epidemiology</h4><p>Approximately 60% are benign and ~15% of borderline malignancy; These occur most commonly in women of reproductive age. The malignant tumours comprise of 25% of cases and tend to occur in older patients. </p><h4>Pathology</h4><p>Like all ovarian epithelial neoplasms, they are derived from coelomic mesothelium. In the case of the serous tumours, this differentiates into the tubal epithelium. </p><p>In contrast, the formation of mucinous tumours results from the coelomic mesothelium evolving into cervix epithelium, and the formation of<a href="/articles/endometrioid-carcinoma-of-the-ovary"> endometrioid tumours</a> – into endometrial epithelium.</p><h4>Radiographic features</h4><p>Imaging evaluation may be performed preferably with ultrasound or MRI, with CT usually reserved for staging purposes. In general, the cell type (e.g. serous, mucinous) often cannot be determined on the imaging basis of appearances. </p><p>Serous ovarian tumours are typically smaller than mucinous tumours on presentation. They are typically unilocular and homogeneous. They are often bilateral, and this is particularly so for the malignant subtypes. <a href="/articles/psammomatous-calcification">Psammomatous calcification</a> is a feature of serous, but not mucinous subtypes. </p><p>Features that suggest a malignant over a benign cystic neoplasm include: </p><ul>
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