Ovarian epithelial tumors

Last revised by Henry Knipe on 27 Jun 2023

Ovarian epithelial tumors account for the majority of all ovarian tumors (60-70%) and their malignant forms represent >90% of ovarian cancers 1. They can range from benign to highly malignant tumors.

There is a difference in the frequency of ovarian tumor subtypes depending on menopausal status 6:

  • premenopausal

    • serous (~60%)

    • mucinous (~20%)

    • endometrioid (~10%)

    • clear cell  (~5%)

    • other (~5%)

  • postmenopausal

    • serous (~60%)

    • endometrioid (~12.5%)

    • clear cell (~10%)

    • mucinous (~7.5%)

    • other (~10%)

The origin and pathogenesis of epithelial ovarian cancer are poorly understood 5. Despite extensive studies, no precursor lesions have been found 5.

Ovarian epithelial tumors are histologically classified according to:

  1. resemblance to normal gynecological cell line 7

    • serous: resembling epithelium lining the Fallopian tubes

    • mucinous: resembling epithelium lining endocervix, containing intracytoplasmic mucin

    • endometrioid: resembling epithelium/stroma of uterine corpus

    • clear cell: comprising clear cells and hobnail cells

  2. grade of aggressiveness 7,8

    • several grading systems exist, and grading may differ according to histologic type

    • e.g. three-tier FIGO system, two-tier MDACC system for serous tumors

A more complete list of ovarian epithelial tumors is as follows:

* sometimes classified as a separate category rather than under epithelial 

These can range from being cystic, to solid, to anything in between. As a crude rule, the likelihood of malignancy increases with increasing solid-tissue elements and thicker septae 2. While there are some common features, there are also many variations and it may be best to refer to subarticles for specific imaging features. 

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