Epithelial Stromal Ovarian Tumors

Chapter 129 Epithelial Stromal Ovarian Tumors



INTRODUCTION



Description: The most common type of ovarian tumors (65% of ovarian tumors, 85% of ovarian malignancies), endometrial stromal tumors are derived from the surface (celomic) epithelium and the ovarian stroma and include serous (20% to 50%), mucinous (15% to 25%), endometrioid (5%), clear cell (<5%), and Brenner (2% to 3%) types. Epithelial tumors are categorized as benign (adenoma), malignant (adenocarcinoma), or of an intermediate form (borderline malignant adenocarcinoma or tumors of low malignant potential).

Prevalence: Two of three ovarian tumors and 85% of ovarian malignancies, 14.3 of 100,000 women.

Predominant Age: Benign tumors—age 20 to 29, malignant tumors—one half are in women older than 50.

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Unknown.

Risk Factors: Family history, high-fat diet, advanced age, nulliparity, early menarche, late menopause, white race, higher economic status, cigarette smoking (mucinous type only). Oral contraception, high parity, and breastfeeding reduce risk.


CLINICAL CHARACTERISTICS



Signs and Symptoms



• Asymptomatic

• Weight loss

• Increasing abdominal girth despite constant or reduced caloric intake

• Ascites

• Adnexal mass (multilocular or partly solid masses in patients older than 40 are likely to be malignant; the risk of a mass being malignant is one in three for women older than 45, versus <1% for women 20 to 45 years of age)

• Vague lower abdominal discomfort


DIAGNOSTIC APPROACH



Differential Diagnosis



• Functional cyst (corpus luteum, follicular)

• Endometriosis

• Hydrosalpinx

• Paratubal cyst

• Appendiceal abscess

• Ectopic pregnancy

• Pedunculated leiomyomata

• Pelvic or horseshoe kidney

• Gastrointestinal malignancy (colon, stomach)


Associated Conditions: None. In patients with advanced malignant disease, bowel obstruction, ascites, and inanition are common.


WORKUP AND EVALUATION


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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Epithelial Stromal Ovarian Tumors

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