Ovarian Tumors: Classification
Ovarian tumors are categorized by their origin: Surface Epithelium (most common), Germ Cells, and Sex Cord-Stromal. Differentiation is critical for boards.
1. Surface Epithelial Tumors
| Tumor | Key Features |
|---|---|
| Serous | Most common: cystadenoma (benign) vs. cystadenocarcinoma (malignant). Often bilateral. |
| Mucinous | Multiloculated, mucin-filled cysts. |
| Brenner | Bladder-like transitional epithelium; solid, firm mass. |
2. Germ Cell & Sex Cord Tumors
- Germ Cell:
- Dysgerminoma: Highly radiosensitive, elevated hCG/LDH.
- Teratoma: Mature (benign, “dermoid cyst”) vs. Immature (malignant).
- Yolk Sac: Schiller-Duval bodies; elevated AFP.
- Sex Cord-Stromal:
- Granulosa cell: Secretes estrogen; Call-Exner bodies. Risk of endometrial hyperplasia/cancer.
- Sertoli-Leydig: Secretes androgens; leads to virilization.
3. Exam Must-Knows
- Krukenberg Tumor: Bilateral metastatic mucinous carcinoma (typically gastric origin) to the ovaries.
- Tumor Markers:
- CA-125 (epithelial tumors),
- hCG (dysgerminoma/choriocarcinoma),
- AFP (yolk sac tumor).
Pathology Board Hint: For test questions, remember: Call-Exner bodies = Granulosa; Schiller-Duval bodies = Yolk Sac; Psammoma bodies = Serous papillary carcinoma. If you see signs of hyperestrogenism in a postmenopausal patient with an ovarian mass, think Granulosa Cell Tumor.