Ovarian cancer classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

Overview

Ovarian cancer may be classified according to the histology of the tumor, obtained in a pathology report. Based on the classification, the management of ovarian cancer is directed and determined. The main four types of ovarian cancer are Surface epithelial-stromal tumour, Sex cord-stromal tumor, Germ cell tumor, and Mixed tumors.

Classification

Histology dictates many aspects of clinical treatment, management, and prognosis.^[1]^[2]^[3]^[4]
- Surface epithelial-stromal tumor, including serous and mucinous cystadenocarcinoma, is the most common type of ovarian cancer.
- Sex cord-stromal tumor, including estrogen-producing granulosa cell tumor and virilizing Sertoli-Leydig cell tumor or arrhenoblastoma, accounts for 8% of ovarian cancers.
- Germ cell tumor accounts for approximately 5% of ovarian cancers. It tends to occur in young women and girls, and has a better prognosis than other ovarian tumors.
- Mixed tumors, containing elements of more than one tumor histology

Ovarian cancer often is primary, but can also be secondary, the result of metastasis from a primary cancer elsewhere in the body. For example, from breast cancer, or from gastrointestinal cancer (in which case the ovarian cancer is a Krukenberg cancer). Surface epithelial-stromal tumor can originate in the lining of the abdominal cavity, in which case the ovarian cancer is secondary to primary peritoneal cancer, but treatment is basically the same as for primary ovarian cancer of this type. ^[1]^[2]^[3]^[4]^[5]^[6]

Ovarian cancer Types	Ovarian cancer subtypes
Surface epithelial-stromal tumour (60-70%)	Ovarian serous tumor
Ovarian serous cystadenoma: ~60% of serous tumor
Ovarian borderline serous cystadenoma: ~15% of serous tumor
Ovarian serous cystadenocarcinoma: ~25% of serous tumor; commonest malignant ovarian tumour
Ovarian mucinous tumor
Ovarian mucinous cystadenoma: ~80% of mucinous tumor
Ovarian borderline mucinous cystadenoma: 10-15% of mucinous tumor
Ovarian mucinous cystadenocarcinoma: ~5-10% of serous tumor
Ovarian endometrioid tumour
8-15% of all ovarian tumor
Brenner tumour
~2.5% of ovarian epithelial neoplasms
Squamous cell carcinoma of the ovary
~5% of ovarian cancer
Ovarian cystadenofibroma / ovarian adenofibroma
can be serous, mucinous, endometrioid, clear cell or mixed
Ovarian cystadenocarcinofibroma
extremely rare
Undifferentiated carcinoma of the ovary
~4% of all ovarian tumor
Germ cell ovarian tumor (~20%)	Ovarian teratoma: commonest primary benign tumour of ovary
Immature ovarian teratoma
Mature ovarian (cystic) teratoma
Specialised teratomas of the ovary
Struma ovarii tumour
Ovarian carcinoid tumor
Ovarian dysgerminoma
Ovarian yolk sac tumour
endodermal sinus tumour
Ovarian embryonal carcinoma
Ovarian choriocarcinoma
<1% of ovarian tumor
Pure primary ovarian choriocarcinoma
extremely rare
Malignant mixed germ cell tumour of the ovary
Sex cord / stromal ovarian tumor (8-10%)^[5]^[6]	Ovarian fibrothecoma
~5% of ovarian tumor
Ovarian fibroma
~4% of ovarian tumor
Sclerosing stromal tumour of the ovary
rare
Ovarian Sertoli-Leydig cell tumour – ovarian androblastoma
~0.5% of ovarian tumor
Granulosa cell tumour of ovary
commonest malignant sex cord tumour
Juvenile granulosa cell tumour of ovary
Adult granulosa cell tumour of ovary
Others	Ovarian carcinosarcoma <1%
Primary ovarian lymphoma
Secondary involvement of the ovary with lymphoma
Metastases to the ovary	Krukenburg tumour
Other metastatic lesions to ovary

References

↑ ^1.0 ^1.1 Heintz AP, Odicino F, Maisonneuve P, Beller U, Benedet JL, Creasman WT; et al. (2001). “Carcinoma of the ovary”. J Epidemiol Biostat. 6 (1): 107–38. PMID 11385772.
↑ ^2.0 ^2.1 Banks E (2001). “The epidemiology of ovarian cancer”. Methods Mol Med. 39: 3–11. doi:10.1385/1-59259-071-3:3. PMID 21340753.
↑ ^3.0 ^3.1 Singer G, Oldt R, Cohen Y, Wang BG, Sidransky D, Kurman RJ; et al. (2003). “Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma”. J Natl Cancer Inst. 95 (6): 484–6. doi:10.1093/jnci/95.6.484. PMID 12644542.
↑ ^4.0 ^4.1 Singer G, Stöhr R, Cope L, Dehari R, Hartmann A, Cao DF; et al. (2005). “Patterns of p53 mutations separate ovarian serous borderline tumors and low- and high-grade carcinomas and provide support for a new model of ovarian carcinogenesis: a mutational analysis with immunohistochemical correlation”. Am J Surg Pathol. 29 (2): 218–24. PMID 15644779.
↑ ^5.0 ^5.1 Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN (2003). “Pathology and classification of ovarian tumors”. Cancer. 97 (10 Suppl): 2631–42. doi:10.1002/cncr.11345. PMID 12733128.
↑ ^6.0 ^6.1 Young RH (2005). “Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems”. Mod Pathol. 18 Suppl 2: S81–98. doi:10.1038/modpathol.3800311. PMID 15502809.

Template:WikiDoc Sources

[pmid11385772-1] 1.0 ^1.1 Heintz AP, Odicino F, Maisonneuve P, Beller U, Benedet JL, Creasman WT; et al. (2001). “Carcinoma of the ovary”. J Epidemiol Biostat. 6 (1): 107–38. PMID 11385772.

[pmid21340753-2] 2.0 ^2.1 Banks E (2001). “The epidemiology of ovarian cancer”. Methods Mol Med. 39: 3–11. doi:10.1385/1-59259-071-3:3. PMID 21340753.

[pmid12644542-3] 3.0 ^3.1 Singer G, Oldt R, Cohen Y, Wang BG, Sidransky D, Kurman RJ; et al. (2003). “Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma”. J Natl Cancer Inst. 95 (6): 484–6. doi:10.1093/jnci/95.6.484. PMID 12644542.

[pmid15644779-4] 4.0 ^4.1 Singer G, Stöhr R, Cope L, Dehari R, Hartmann A, Cao DF; et al. (2005). “Patterns of p53 mutations separate ovarian serous borderline tumors and low- and high-grade carcinomas and provide support for a new model of ovarian carcinogenesis: a mutational analysis with immunohistochemical correlation”. Am J Surg Pathol. 29 (2): 218–24. PMID 15644779.

[pmid12733128-5] 5.0 ^5.1 Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN (2003). “Pathology and classification of ovarian tumors”. Cancer. 97 (10 Suppl): 2631–42. doi:10.1002/cncr.11345. PMID 12733128.

[pmid15502809-6] 6.0 ^6.1 Young RH (2005). “Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems”. Mod Pathol. 18 Suppl 2: S81–98. doi:10.1038/modpathol.3800311. PMID 15502809.

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Ovarian cancer classification

Overview

Classification

References

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