Ovarian epithelial neoplasms

Ovarian epithelial neoplasms 

Updated:08/12/2022

© Jun Wang, MD, PhD

General feature
  • Most common type of ovarian tumor
  • Derived from surface epithelium (mesothelium)
  • Most important risk factor: Family history
  • Other risk factors: Excessive gonadotropins, androgen stimulation, pelvic inflammation, ovarian exposure to contaminants and carcinogens (talc and asbestos), nulliparity, refractory infertility, obesity
  • Subtypes
Serous
Mucinous
Endometrioid
Brenner (urothelial)
Clear cell
Seromucinous
Undifferentiated
Carcinogenesis
  • Type I: Low-grade
Associated with borderline tumors or endometriosis
Stepwise development from a lower grade tumor
Chromosomally stable
  • Type II: High-grade carcinomas
Rapidly growing
Usually wide spread at the time of diagnosis
No recognizable precursors
Largely variable DNA copy number
Clinical features
  • Commonly asymptomatic if benign
  • Abdominal enlargement, lower abdominal pain, etc
  • Acute abdominal pain if torsion occurs
  • Metastasis: Often contralateral ovary, pelvic peritoneum, umbilicus (Sister Joseph’s nodule)
Commonly used serum cancer markers

Molecular abnormalities
  • Type I: KRAS (mucinous and low-grade serous), BRAF (low-grade serous), HER2 (mucinous), PTEN (endometrioid, clear cell), etc
  • Type II (high-grade serous): p53, BRCA 1, BRCA 2
Syndromes associated with ovarian epithelial tumors

Reference: Tumor markers in ovarian malignancies 

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