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| Papillary Serous Cystadenocarcinoma |
| Etiology • 10% of patients have evidence of ovarian or ovarian-breast cancer syndrome (see pathogenesis) • remainder sporadic |
| Pathogenesis • may be associated with mutations in BRCA1, |
| Epidemiology • peri- or post-menopausal women of low parity • gonadal dysgenesis • ovarian epithelial cancer = 6% of female cancer; and 50% of female cancer deaths due to late detection and failure to determine high risk group • serous = 40% of ovarian cancers; 2/3 are bilateral |
| General Gross Description • capsule may be smooth or irregular or show papillary projections • partially cystic partially solid neoplasm • interior papillae are soft and tan over firm dense stroma • cyst fluid is clear, colorless and thin |
| General Microscopic Description • "finger like" papillae with fibrovascular core • covered by multilayered cuboidal or columnar epithelium • nuclei are hyperchromatic with prominent nucleoli • mitoses frequent • psammomma bodies (concentric lamellated calcifications) • invasion of stroma with fibrosis: "desmoplasia" |
| Clinical Correlation • early symptoms vague, late abdominal distension with ascites and pain • rarely detected on routine examination • Stage I confined to ovary(ies), II confined to pelvis, III with extension to abdominal cavity, IV distant metasases • most women Stage III or IV at presentation • spread across serosal surfaces and to lymph nodes • removal of bulk of tumor and chemotherapy are major therapy |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1065-1068 |
| Papillary Serous Cystadenocarcinoma |
| Synopsis by: Melinda Sanders M.D. (T87000M84413)[38] |
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