Ovarian tumors

Last revised by Ashesh Ishwarlal Ranchod on 24 Sep 2023

Ovarian tumors are relatively common and account for ~6% of female malignancies. This article focuses on the general classification of ovarian tumors. For specific tumor features, please refer to the relevant subarticles.

Pathology

Subtypes
Primary ovarian tumors

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

* sometimes classified as a separate category rather than under epithelial 7

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 cancer14
    • BRCA1/BRCA2 mutations: particularly for serous types
    • Lynch syndrome-associated ovarian cancers most often have an endometrioid or serous type histology 14
  • smoking: especially for mucinous adenocarcinoma
  • previous history of breast, endometrial or colon cancer (Lynch II)
  • certain ethnic groups
Protective factors
  • oral contraceptives (OCP)
  • breastfeeding (however this is controversial)
Risk assessment

Staging

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

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.