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to single cells) should be over 5 mm in size to distinguish it from a borderline serous tumor. Calcifications often form psammoma bodies. Right picture shows higher magnification, including hobnailing which is individual cells protruding into the lumen of glands. Cells may have up to moderate atypia: They may have conspicuous nucleoli, and up to 3x variation in nuclear sizes compared to each other. More atypical features indicate a high-grade serous carcinoma.
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Histopathology of invasive low-grade serous carcinoma of ovary with typical features. H&E stain. The left image shows lower magnification, including inverted macropapillae which are with broad fibrovascular cores surrounded by clear (white) clefts. Invasion (characterized by small irregular nests
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The "low grade" classification of serous tumors includes benign and borderline tumors, as well as low grade malignant tumors. Benign serous tumors are distinguished from borderline tumors by the absence of cellular stratification. Stromal invasion distinguishes borderline tumors from low grade
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C and D. Immunohistochemistry of p53 shows that high-grade serous carcinoma cells are diffusely positive for p53, a pattern consistent with a missense TP53 mutation while the adjacent epithelial cells from the background serous borderline tumor are only focally and weakly positive, a pattern
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Beginning in the year 2000, the fallopian tube, specifically the fimbriated end, has emerged as an origin for many "ovarian" high-grade serous carcinomas. This discovery has been facilitated by pathology dissection protocols such as the
149:. On gross examination, the serous tumor may present as either a cystic lesion in which the papillary epithelium is contained within a few fibrous walled cysts, or the papillary projections may be away from the surface epithelium.
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Histopathology of serous cystadenoma of the ovary, which is benign. It shows admixed scattered ciliated cells. This case closely resembles normal surface endometrial epithelium of the uterus.
177:: Hierarchical branching, exfoliated cell clusters, calcifications, up to moderate atypia, and pseudostratified, crowded epithelium with hobnailing. H&E stain.
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A. Low-magnification view shows a focal high-grade serous carcinoma developing from the papillae (square) in a background of a typical serous borderline tumor.
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92:. They are common neoplasms with a strong tendency to occur bilaterally, and they account for approximately a quarter of all ovarian tumors.
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Benign serous tumors include serous cystadenomas, cystadenofibromas, and adenofibromas. Benign and borderline serous tumours are commonly
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B. Higher magnification demonstrates enlarged and atypical high-grade serous carcinoma cells that organize in a papillary architecture.
352:"Pulmonary papillary serous adenocarcinoma with intraperitoneal and ovarian tumors: identification of primary site. A case report"
255:, which play close attention to the distal fallopian tube and have revealed early serous cancers and precancers in this region.
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that typically has papillary to solid formations of tumor cells with crowded nuclei, and which typically arises on the modified
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190:, but stromal invasion is absent, and nuclear stratification is present. Approximately 15% of serous tumors are borderline.
321:. Unlike the more common low-grade endometrioid endometrial adenocarcinoma, uterine serous carcinoma does not develop from
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463:"Adenocarcinoma of Mullerian origin: review of pathogenesis, molecular biology, and emerging treatment paradigms"
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are often found. Serous psammocarcinoma is a low grade variant in which massive psammoma bodies are present.
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In borderline lesions, the cyst or surface is lined by papillary structures, which are often very complex.
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Cobb, Lauren
Patterson; Gaillard, Stephanie; Wang, Yihong; Shih, Ie-Ming; Secord, Angeles Alvarez (2015).
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malignant tumors. Surgery is curative for benign tumors, and likely curative for other low grade tumors.
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High grade serous tumors often involve both ovaries. The tumors are solid and cystic with
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Gründker C, Günthert AR, Emons G (2008). "Hormonal
Heterogeneity of Endometrial Cancer".
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Stage IV- Tumour involving one or both ovaries with presence of distant metastasis.
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Unsurprisingly, 5-year survival decreases as the stage increases. There is a 25%
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Stage III - Tumour involving one or both ovaries with implants outside pelvis.
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that typically arises in postmenopausal women. It is typically diagnosed on
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and is not hormone-sensitive. It arises in the setting of endometrial
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Stage II - Growth involving one or both ovaries with pelvic extension.
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Histopathology of the typical features of an ovarian serous
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Rarely, serous tumors arise from within the uterus, notably
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A high-grade serous carcinoma arising from a borderline
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have been identified as risk factors for the disease.
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Image by Mikael Häggström, MD. Source for findings:
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84:in females. Such ovarian tumors are part of the
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527:Robbins and Cotran Pathologic Basis of Disease
450:(11 ed.). Elsevier. pp. 1367–1431.
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262:with a stage III serous carcinoma. Staging:
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266:Stage I - Tumour growth limited to ovaries.
186:, stromal papillae are covered by atypical
529:(9 ed.). Elsevier. pp. 991–1042.
467:Gynecologic Oncology Research and Practice
350:Chen MY, Jung SM, Ng KK, Chang TC (2006).
220:consistent with a wild-type TP53 sequence.
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288:are serous tumors. Family history and
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542:Innovative Endocrinology of Cancer
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284:25% of ovarian tumors and 40% of
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368:10.1111/j.1525-1438.2006.00369.x
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428:Last staff update: 23 July 2020
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406:"Low grade serous carcinoma"
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331:type II endometrial cancer
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480:10.1186/s40661-015-0008-z
143:columnar epithelial cells
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319:post-menopausal bleeding
307:Uterine serous carcinoma
302:Uterine serous carcinoma
296:Uterine serous carcinoma
97:uterine serous carcinoma
329:and is classified as a
323:endometrial hyperplasia
309:is an uncommon form of
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115:Ovarian serous tumours
613:Gynaecological cancer
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356:Int J Gynecol Cancer
243:, and spread to the
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410:Pathology Outlines
362:(Suppl 1): 231–5.
315:endometrial biopsy
311:endometrial cancer
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80:that surround the
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241:metastases
234:peritoneal
201:High grade
139:unilocular
101:peritoneum
48:Micrograph
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120:Low grade
88:group of
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