Ovarian serous tumours
Ovarian serous neoplasm is one of two commonest subtypes of epithelial ovarian tumour, the other being a mucinous ovarian tumour.
They are subdivided according to their malignant potential and clinical behaviour into:
- benign: serous cystadenoma / serous cystadenofibroma
- borderline cystadenoma
- malignant cystadenocarcinoma
Approximately 60% are benign and ~15% of borderline malignancy; These occur most commonly in women or reproductive age. The malignant tumours comprise of 25% of cases and tend to occur in older patients.
Like all ovarian epithelial neoplasms, they are derived from coelomic mesothelium. In the case of the serous tumours, this differentiates into tubal epithelium.
In contrast, the formation of mucinous tumours results from the coelomic mesothelium evolving into cervix epithelium, and the formation of endometrioid tumours – into endometrial epithelium.
In general, the cell type (e.g. serous, mucinous) often cannot be determined on the basis of appearance at MR imaging, CT, or ultrasound 3.
Imaging evaluation may be performed with ultrasound, CT or MRI.
Serous ovarian tumours are typically smaller than mucinous tumours on presentation. They are typically unilocular and homogeneous. They are often bilateral, and this is particularly so for the malignant subtypes. Psammomatous calcification is a feature of serous, but not mucinous subtypes.
Features that suggest a malignant over a benign cystic neoplasm include:
- thick irregular walls and septa
- papillary projections
- large soft tissue component
- evidence of invasive spread or adenopathy
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- 2. Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
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- 4. Kim KA, Park CM, Lee JH et-al. Benign ovarian tumors with solid and cystic components that mimic malignancy. AJR Am J Roentgenol. 2004;182 (5): 1259-65. AJR Am J Roentgenol (full text) - Pubmed citation