Neoplasien des Ovars

Adulter
Granulosazelltumor des Ovars in der Computertomographie (sagittale Rekonstruktion) bei einer 78-jährigen. Sehr großer, zystischer, multiseptierter Tumor mit soliden Anteilen.
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Ovarian
granulosa cell tumour: MR imaging findings. Transverse T2-weighted image depicts inhomogeneous left adnexal mass (arrow), with signal intensity mainly similar to that of normal myometrium (not shown on this image), and small hyperintense areas, corresponding to internal cysts on pathology.
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Ovarian
granulosa cell tumour: MR imaging findings. Axial contrast-enhanced T1-weighted image obtained with fat saturation shows intense and heterogeneous mass enhancement (arrow).
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Ovary
mucinous cystoadenoma with components of a mucinous borderline tumor.
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Ovarian tumors are relatively common and account for ~6% of female malignancies. This article focuses on the general classification of ovarian tumors. For specific features, refer to the subarticles.

Pathology

Subtypes
Primary ovarian tumors

Surface epithelial-stromal ovarian tumors (60-70%):

* sometimes classified as a separate category rather than under epithelial

Germ cell ovarian tumors (~20%):

Sex cord / stromal ovarian tumors (8-10%):

Mixed

These are uncommon:

Other
Classification according to morphology
Predominantly cystic
Predominantly solid
Serological tests
  • CA-125 levels: elevated in most ovarian malignancies (~80% in general); some mucinous and germ cell tumors may not secrete this marker
  • AFP levels: elevated particularly with immature ovarian teratomas (~50% of cases) and ovarian yolk sac tumors
  • β HCG: in a small number of dysgerminomas
  • human epididymis protein 4 (HE4): elevated in malignant ovarian diseases, being helpful to complement the Ca-125 in premenopausal women 
Risk factors
General risk factors include
  • nulliparity
  • early menopause 
  • gonadal dysgenesis
  • family history: contributes to 24% of cases of epithelial ovarian cancer
    • BRCA1/BRCA2 mutations: particularly for serous types
    • Lynch syndrome-associated ovarian cancers most often have an endometrioid or serous type histology
  • smoking: especially for mucinous adenocarcinoma
  • previous history of breast, endometrial or colon cancer (Lynch II)
  • certain ethnic groups
Protective factors
  • oral contraceptives
  • breastfeeding (this is controversial)
Risk assessment

Staging

The FIGO staging system is used for almost all of the ovarian cancers: see ovarian cancer staging.

Siehe auch:
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