Ovarian serous papillary cystadenocarcinoma
Summary
The most common malignant ovarian epithelial tumor, often bilateral, with characteristic psammoma bodies and a papillary architecture. Associated with BRCA1/2 mutations and p53 (TP53) mutations in high-grade lesions.
Detail
Serous tumors arise from the surface (mullerian) epithelium of the ovary or fallopian tube fimbriae (the now-favored origin of high-grade serous carcinoma). Grossly cystic with papillary projections; histologically, complex branching papillae lined by atypical cuboidal/columnar cells with frequent psammoma bodies (laminated calcifications). High-grade serous carcinomas almost universally harbor TP53 mutations and show 'SET' pattern (solid, endometrioid, transitional-like); low-grade serous tumors have KRAS/BRAF mutations. CA-125 is the classic tumor marker for monitoring. Bilaterality in ~65% of cases; presents late with abdominal distension, omental caking, and ascites. Boards classic: postmenopausal woman, BRCA1 carrier, bilateral ovarian masses + elevated CA-125.
Sources
- First Aid for USMLE Step 1 2024
- Robbins Basic Pathology 10th ed
- Pathoma
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