A short note of epithelial ovarian tumors Part3: Endometrioid ovarian tumors
Epithelium ovarian tumor that microscopic component resembles endometrial glands
10-15% of all ovarian cancers
15-30% of endomatrioid ovarian carcinoma associated with carcinoma of endometrium
Some of endometrial carcinoma coexist with endometriosis
PI3K/AKT pathway alteration + MMR mutation (TP53 mutation may present in poorly diff tumors)
Elevate CA-125
FIGO grading for ovarian endometrioid carcinoma (like endometrial adenocarcinoma): 5% solid part* = grade I, 6-50% solid part* = grade II, >50% solid part* = grade III (If severe nuclear atypia, Overall FIGO grading will increased by one, ie. 1->2 and 2->3)
Gross🔎: more likely unilateral
| types | Gross description |
|---|---|
| Cystadenoma | uniloculate cyst |
| Adenofibroma | firm, white nodule with honeycomb appearance |
| Carcinoma | Solid and cystic growth ± hemorrhage |
- Microscopic finding🔬
| types | Microscopic description |
|---|---|
| Cystadenoma | cyst lined by endometrioid epithelium ± background endometriosis |
| Adenofibroma | Endometrial glands + fibromatous stroma |
| Carcinoma | Tubular gland resembling malignant endometrium gland (complex gland, Back-to-back gland, stromal invasion) ± background endometriosis (may ddx. with pseudoglandular pattern serous carcinoma which likely to present with discordance of architecture and nucleus atypia) |
*Solid part = regions of tumor where malignant cells grow in sheets, instead of glands and these areas should not be confused with squamous differentiation.
Reference
- Robbins & Cotran Pathologic Basis of Disease 10th Edition
- https://www.pathologyoutlines.com/topic/ovarytumorendometrioidcarcinoma.html