WHAT IS FEMALE GENITAL SYSTEM PATHOLOGY?

FEMALE GENITAL SYSTEM PATHOLOGY
Endometrial tumour prolapsing into the cervical canal, without invasion of the cervical stroma and myometrium. The tumour extends bilaterally through the lumen of the tubes to the parametrial tissues (arrows). A left obturator lymph node is also seen (arrowhead). H&E section of the tumour with a solid pattern composed of large cells with pleomorphic nuclei, mitoses and scarce cytoplasm (c). These cells have small chromogranin-positive granules (d) and small synaptophysin granules in the cytoplasm (not shown) and are strongly positive for pan-cytokeratin CAM 5.2 (not shown). Neuroendocrine tumours of the female genital tract: a case-based imaging review with pathological correlation: Lopes Dias J, Cunha TM, Gomes FV, Callé C, Félix A - Insights into imaging (2015). Not altered. CC.

Pathology of the female genital system is study of causes and effects of diseases related to the female reproductive system.

What are Infections of the Female Genital System?

Infections of the female genital system are the diseases caused by microbes including bacteria, fungi, viruses etc. in the reproductive organs of females.  

What are Infections of the Lower Genital Tract?

Infections of the lower genital tract are those which occur in the lower part of reproductive system including vagina and ectocervix.

Infections of the lower genital tract include:

  • Chlamydia trachomatis
  • Fungal infections
  • Gardenela vaginalis
  • Herpes simplex virus
  • Molluscum contagiosum
  • Trichomonas vaginalis
  • Ureaplasma urelyticum

What are Infections Involving the Upper and Lower Genital Tract?

Infections involving the upper and lower genital tract include endometritis, salpingitis, peritonitis, pelvic abscess and septicemia of the upper tract, bacterial vaginosis, vaginal candidiasis, etc of lower genital tract.  

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease is an infection of a woman’s reproductive organs involving one or two parts of reproductive system like the uterus or fallopian tubes.

What is Vulvar Pathology?

Vulva pathology is the disease of the vulva which includes infections such as yeast infection or the sexually transmitted infectious diseases. 

Examples of vulvar pathology include:

  • Bartholin cyst
  • Benign epithelial disorders of the vulva
  • Benign exophytic lesions of the vulva
  • Neoplastic squamous lesions of the vulva
  • Neoplastic glandular lesions of the vulva

What is Bartholin Cyst?

Bartholin cyst is the swelling at the opening of the Bartholin glands due to which openings of these glands become obstructed, causing fluid to back up into the gland.   

What is the Pathology of Bartholin Cyst?

The pathology of Bartholin cyst is:

-Etiology: The cause of bartholin cyst is: infection, thick mucus, or swelling blocking the Bartholin gland duct.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to bartholin cyst involve ostium of the duct becomes blocked, leading to distention of the gland or duct with fluid causing cysts.  

-Morphology: The morphology associated with bartholin cyst shows round bumps under the skin.

-Histology: The histology associated with bartholin cyst shows cysts lined by transitional or squamous epithelium or mucinous columnar epithelium.

How does Bartholin Cyst Present?

Patients with bartholin cyst typically females present at 20 to 30 years of age. The symptoms, features, and clinical findings associated with Bartholin cyst include tender or painful lump at vaginal opening, discomfort, or fever. 

How is Bartholin Cyst Diagnosed?

Bartholin cyst is diagnosed by physical examination of the pelvis, and potential biopsy.

How is Bartholin Cyst Treated?

Bartholin cyst is treated by surgical drainage, Sitz baths, antibiotics, and possible marsupialization.

What is the Prognosis of Bartholin Cyst?

The prognosis of Bartholin cyst is good.  

What are Benign Epithelial Disorders of the Vulva?

Benign epithelial disorders of the vulva are the non-cancerous mostly characterized by genital skin and mucosal tissue degeneration and pigmentation change. 

Examples of benign epithelial disorders of the vulva include:

  • Lichen sclerosus of the vulva
  • Squamous cell hyperplasia of the vulva

What is Lichen Sclerosus of the Vulva?

Lichen sclerosus of the vulva is chronic inflammatory dermatosis distinguished by ivory-white plaques or patches with glistening surface usually affecting the vulva and anus.

What is the Pathology of Vulvar Lichen Sclerosus?

The pathology of vulvar lichen sclerosus is:

-Etiology: The cause of vulvar lichen sclerosus is might the overreactive immune system or the hormonal imbalance.

-Genes involved: p53, CDKN2A, galectin-7.

-Pathogenesis: The sequence of events that lead to vulvar lichen sclerosus is: inflammation of papillary dermis causes fibrosis of upper dermis causing lichen sclerosus of vulva.   

-Morphology: The morphology associated with vulvar lichen sclerosus shows inflammatory lesions and small ivory-coloured slightly raised areas.

-Histology: The histology associated with vulvar lichen sclerosus shows hyperkeratosis, follicular infundibulae plugging.

How does Vulvar Lichen Sclerosus Present?

Patients with vulvar lichen sclerosus typically in females at any age. The symptoms, features, and clinical findings associated with vulvar lichen sclerosus include discomfort, pain, itching, redness, bleeding, painful sex.

How is Vulvar Lichen Sclerosus Diagnosed?

Vulvar lichen sclerosus is diagnosed by physical examination, or biopsy. 

How is Vulvar Lichen Sclerosus Treated?

Vulvar lichen sclerosus is treated by corticosteroid ointments, calcineurin inhibitors for patients who respond poorly to steroids. 

What is the Prognosis of Vulvar Lichen Sclerosus?

The prognosis of vulvar lichen sclerosus is  good. There is no associated mortality until the malignancy is developed. 

What is Squamous Cell Hyperplasia of the Vulva?

Squamous cell hyperplasia of the vulva is an abnormal growth of vulvar skin which mostly occurs before menopause.  

What is the Pathology of Vulvar Squamous Cell Hyperplasia?

The pathology of vulvar squamous cell hyperplasia is:

-Etiology: The cause of vulvar squamous cell hyperplasia is chronic irritation results due to detergents, fabric conditioners, clothes, perfumed soaps.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to vulvar squamous cell hyperplasia are: increased numbers of squamous cells causing increased thickness of the squamous epithelium, which might be diffused or form blunt papillary projections.

-Morphology: The morphology associated with vulvar squamous cell hyperplasia shows thick, enlarged swollen skin.

-Histology: The histology associated with vulvar squamous cell hyperplasia shows hyperkeratosis and acanthosis.

How does Vulvar Squamous Cell Hyperplasia Present?

Patients with vulvar squamous cell hyperplasia typically in females before age of 40 to 50 years. The symptoms, features, and clinical findings associated with vulvar squamous cell hyperplasia include itching, redness, thick and hard patches on vulva.

How is Vulvar Squamous Cell Hyperplasia Diagnosed?

Vulvar squamous cell hyperplasia is diagnosed by biopsy. 

How is Vulvar Squamous Cell Hyperplasia Treated?

Vulvar squamous cell hyperplasia is treated by steroid creams twice daily. 

What is the Prognosis of Vulvar Squamous Cell Hyperplasia?

The prognosis of vulvar squamous cell hyperplasia is good. Since it is a non-malignant condition so no mortality is associated with it.

What are Benign Exophytic Lesions of the Vulva?

Benign exophytic lesions of the vulva are solid organ lesions arising from the outer surface of vulva.

An example of a benign exophytic lesions of the vulva is condyloma acuminatum of the vulva.

What is Condyloma Acuminatum of the Vulva?

Condyloma acuminatum of the vulva is a sexually transmitted infection which causes anogenital warts due to human papillomavirus.  

What is the Pathology of Vulvar Condyloma Acuminatum?

The pathology of vulvar condyloma acuminatum is:

-Etiology: The cause of vulvar condyloma acuminatum is human papilloma virus HPV of subtype 6 and 11.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to vulvar condyloma acuminatum are: the HPV invades the basal layer cells of epidermis which then penetrates to ski causing mucosal microabrasions hence causing the disease. 

-Morphology: The morphology associated with vulvar condyloma acuminatum shows anogenital warts or atypical koilocytosis.

-Histology: The histology associated with vulvar condyloma acuminatum shows lesion of squamous epithelium.

How does Vulvar Condyloma Acuminatum Present?

Patients with vulvar condyloma acuminatum typically in females mostly at 17-33 years of age.  The symptoms, features, and clinical findings associated with vulvar condyloma acuminatum include: red colored round bumps, bleeding ad painful intercourse.

How is Vulvar Condyloma Acuminatum Diagnosed?

Vulvar condyloma acuminatum is diagnosed by: visual examinations by magnifying glass, hybridization and PCR techniques for the diagnosis of virus, pap smear test, biopsy. 

How is Vulvar Condyloma Acuminatum Treated?

Vulvar condyloma acuminatum is treated by cryotherapy, trichloroacetic acid solution and surgical modality. 

What is the Prognosis of Vulvar Condyloma Acuminatum?

The prognosis of vulvar condyloma acuminatum is good. The warts may go on their own after treatment.

What are Neoplastic Squamous Lesions of the Vulva?

Neoplastic squamous lesions of the vulva are an unusual growth on skin or area of abnormal cells that forms on the surface of vulva.  

Examples of neoplastic squamous lesions of the vulva include: 

  • Vulvar intraepithelial neoplasia 
  • Vulvar carcinoma

What is Vulvar Intraepithelial Neoplasia?

Vulvar intraepithelial neoplasia is precancerous skin condition on the vulva. It happens when there are changes in the cells of the skin covering the vulva.

What is the Pathology of Vulvar Intraepithelial Neoplasia?

The pathology of vulvar intraepithelial neoplasia is:

-Etiology: The cause of vulvar intraepithelial neoplasia is not known exactly but herpes simplex virus and Human papilloma virus are linked with it.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to vulvar intraepithelial neoplasia are: viral DNA integrates into the cells causing production of oncoprotein which affects normal functions of cells hence the cell evades apoptosis and promotes instability.

-Morphology: The morphology associated with vulvar intraepithelial neoplasia shows increased numbers of mitotic bodies.

-Histology: The histology associated with vulvar intraepithelial neoplasia shows enlarged nuclei, hyperchromasia, and pleomorphic cells.

How does Vulvar Intraepithelial Neoplasia Present?

Patients with vulvar intraepithelial neoplasia typically in women mostly at their 40 years age. The symptoms, features, and clinical findings associated with vulvar intraepithelial neoplasia include: tingling or burning in vulva, soreness, redness, painful sex. 

How is Vulvar Intraepithelial Neoplasia Diagnosed?

Vulvar intraepithelial neoplasia is diagnosed by: physical exam, biopsy, and coloposcopy. 

How is Vulvar Intraepithelial Neoplasia Treated?

Vulvar intraepithelial neoplasia is treated by: excision of affected area, laser ablation topical imiquimod treatment.

What is the Prognosis of Vulvar Intraepithelial Neoplasia?

The prognosis of vulvar intraepithelial neoplasia is good. The untreated disease causes severe complications progressing towards invasive carcinoma.  

What is Vulvar Carcinoma?

Vulvar carcinoma is type of cancer that occurs on the outer surface area of the female genitalia. It commonly forms as a lump or sore on the vulva. 

What is the Pathology of Vulvar Carcinoma?

The pathology of vulvar carcinoma is:

-Etiology: The cause of vulvar carcinoma is human papillomavirus and lichen sclerosus.

-Genes involved: p53 mutations.

-Pathogenesis: The sequence of events that lead to vulvar carcinoma are: the growing infected cells cause mutations in genes resulting in even more abnormal growth subsequently causing malignancy and cancer in vulva.

-Morphology: The morphology associated with vulvar carcinoma shows elevated white, pink, or red bumps.

-Histology: The histology associated with vulvar carcinoma shows ulcerated, exophytic, or indurated mass.

How does Vulvar Carcinoma Present?

Patients with vulvar carcinoma typically in females mostly at age more than 50 years. The symptoms, features, and clinical findings associated with vulvar carcinoma include: itching, color changes, bleeding, pain or burning sensation, rough skin and sores.

How is Vulvar Carcinoma Diagnosed?

Vulvar carcinoma is diagnosed by physical pelvic exam, biopsy, positron emission tomography, and x-ray. 

How is Vulvar Carcinoma Treated?

Vulvar carcinoma is treated by excision, vulvectomy, sentinel node biopsy, chemotherapy, immunotherapy, and radiotherapy. 

What is the Prognosis of Vulvar Carcinoma?

The prognosis of vulvar carcinoma is good and survival rate is 90%.   

What are Neoplastic Glandular Lesions of the Vulva?

Neoplastic glandular lesions of the vulva are intraepithelial neoplasia affecting the glandular epithelium of the vulva. 

Neoplastic Glandular Lesions of the Vulva include:

  • Extramammary paget disease of the vulva
  • Papillary hidradenoma  of the vulva

What is Extramammary Paget Disease of the Vulva?

Extramammary paget disease of the vulva is an unusual kind of skin cancer that arises from glandular cells or very rare malignancy originating in vulvar apocrine-gland-bearing skin cells. 

What is the Pathology of Vulvar Extramammary Paget Disease?

The pathology of vulvar extramammary paget disease is:

-Etiology: The cause of vulvar extramammary paget disease is unknown but could arise from intraepidermal neoplasm from the apocrine gland ducts or pluripotent keratinocyte stem cells.

-Genes involved: TP53, ERBB2, and PIK3CA mutations.

-Pathogenesis: The sequence of events that lead to vulvar extramammary paget disease are: epidermis becomes infiltrated with neoplastic cells causing glandular differentiation due to which the tumor cells arise from these glands. 

-Morphology: The morphology associated with vulvar extramammary paget disease shows eczema, with red, scaly patches.

-Histology: The histology associated with vulvar extramammary paget disease shows polyhedral intraepithelial cells.

How does Vulvar Extramammary Paget Disease Present?

Patients with vulvar extramammary paget disease typically women from 50 to 80 years age. The symptoms, features, and clinical findings associated with vulvar extramammary paget disease include: vulvar pain, itching, irritation, burning and scaly plaques on vulva. 

How is Vulvar Extramammary Paget Disease Diagnosed?

Vulvar extramammary paget disease is diagnosed by biopsy, cystoscopy, sigmoidoscopy, physical examination. 

How is Vulvar Extramammary Paget Disease Treated?

Vulvar extramammary paget disease is treated by surgery, radiation therapy, photodynamic therapy, laser therapy and application of imiquimod cream.

What is the Prognosis of Vulvar Extramammary Paget Disease?

The prognosis of vulvar extramammary paget disease is good. The 5-year survival rate is 75–95%.

What is Papillary Hidradenoma  of the Vulva?

Papillary hidradenoma of the vulva is a rare, benign neoplasm arising from apocrine glands on skin of vulva. It is usually a benign tumor. 

What is the Pathology of Vulvar Papillary Hidradenoma?

The pathology of vulvar papillary hidradenoma is:

-Etiology: The cause of vulvar papillary hidradenoma is unknown.

-Genes involved: PIP gene, PI3K-AKT gene.

-Pathogenesis: The sequence of events that lead to vulvar papillary hidradenoma proliferation of atypical cells.

-Morphology: The morphology associated with vulvar papillary hidradenoma shows papillary folds, tubules.

-Histology: The histology associated with vulvar papillary hidradenoma shows solitary dermal or subcutaneous nodule.

How does Vulvar Papillary Hidradenoma Present?

Patients with vulvar papillary hidradenoma typically females with 30-80 years age. The symptoms, features, and clinical findings associated with vulvar papillary hidradenoma include: pain, pruritus, bleeding ulceration and discharge.

How is Vulvar Papillary Hidradenoma Diagnosed?

Vulvar papillary hidradenoma is diagnosed biopsy, physical examination.

How is Vulvar Papillary Hidradenoma Treated?

Vulvar papillary hidradenoma is treated by surgical excision.

What is the Prognosis of Vulvar papillary hidradenoma?

The prognosis of vulvar papillary hidradenoma is excellent if excision completely done. Can very rarely transform into malignant carcinoma. 

What is Pathology of the Vagina?

Pathology of the Vagina is the study and diagnosis of disease associated with female reproductive system organ vagina. 

Pathology of the vagina includes: 

  • Developmental anomalies of the vagina
  • Premalignant neoplasms of the vagina
  • Vaginal intraepithelial neoplasia
  • Malignant neoplasms of the vagina
  • Embryonal rhabdomyosarcoma of the vagina
  • Squamous cell carcinoma of the vagina

What are Developmental Anomalies of the Vagina?

Developmental anomalies of the vagina are those diseased conditions associated with vagina which are present at the conception time. These include vaginal agenesis, obstruction, duplication, and fusion.

What is the Pathology of Vaginal Developmental Anomalies?

The pathology of vaginal developmental anomalies is:

-Etiology: The cause of vaginal developmental anomalies is gene defects, using certain drugs during pregnancy.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to vaginal developmental anomalies are when the normal developmental pattern is disturbed it causes fusion defects which ultimately causes malformations from duplication of vagina to gynatresias or atresia.

-Morphology: The morphology associated with vaginal developmental anomalies shows either longitudinal nonobstructing vaginal septum,  longitudinal obstructing vaginal septum, transverse vaginal septum and/or imperforate hymen or vaginal aplasia.

How does Vaginal Developmental Anomalies Present?

Patients with vaginal developmental anomalies typically females at birth or during infancy. The symptoms, features, and clinical findings associated with vaginal developmental anomalies include: vaginal obstruction, failure to have periods, abdominal pain, pelvic mass, difficulty during intercourse.

How is Vaginal Developmental Anomalies Diagnosed?

Vaginal developmental anomalies is diagnosed by: pelvic examination by gynecologist, pelvic ultrasound, MRI, vaginoscopy 

How is Vaginal Developmental Anomalies Treated?

Vaginal developmental anomalies is treated by: vaginoplasty, Vaginal dilation, surgery with a graft, excision of the obstruction  

What is the Prognosis of Vaginal Developmental Anomalies?

The prognosis of vaginal developmental anomalies is good and depends on the type of anomaly and type of treatment.

What are Premalignant Neoplasms of the Vagina?

Premalignant neoplasms of the vagina are the abnormal mass of tissues on vagina which are not cancerous but have the potential become malignant or cancerous. 

What is the Pathology of Vaginal Premalignant Neoplasms?

The pathology of vaginal premalignant neoplasms is:

-Etiology: The cause of vaginal premalignant neoplasms is human papillomavirus.

-Genes involved: CDKN2A, TP53 

-Pathogenesis: The sequence of events that lead to vaginal premalignant neoplasms are: the different stages of histological differentiation effected by the virus causing the uncontrolled growth of cells hence forming the tissue mass.

-Morphology: The morphology associated with vaginal premalignant neoplasms shows alterations in cell structures, differential changes.

-Histology: The histology associated with vaginal premalignant neoplasms shows atypia.

How does Vaginal Premalignant Neoplasms Present?

Patients with vaginal premalignant neoplasms in females from infancy to 60 years age. The symptoms, features, and clinical findings associated with vaginal premalignant neoplasms include: pelvic pain, constipation, abnormal vaginal discharge, noticeable mass in vagina, painful urination.

How is Vaginal Premalignant Neoplasms Diagnosed?

Vaginal premalignant neoplasms is diagnosed by physical examination palpation, and biopsy.

How is Vaginal Premalignant Neoplasms Treated?

Vaginal premalignant neoplasms is treated by partial vaginectomy, laser treatment, excision of the abnormal tissue mass.

What is the Prognosis of Vaginal Premalignant Neoplasms?

The prognosis of vaginal premalignant neoplasms is good.  

What is Vaginal Intraepithelial Neoplasia?

Vaginal intraepithelial neoplasia is that when there are abnormal cells in the inner lining of the vagina which is not cancer.

What is the Pathology of Vaginal Intraepithelial Neoplasia?

The pathology of vaginal intraepithelial neoplasia is:

-Etiology: The cause of vaginal intraepithelial neoplasia is human papillomavirus.

-Genes involved: HLA-G.

-Pathogenesis: The sequence of events that lead to vaginal intraepithelial neoplasia is proliferation of atypical cells.

-Morphology: The morphology associated with vaginal intraepithelial neoplasia shows cervical Pap smear, abnormal cytology.

-Histology: The histology associated with vaginal intraepithelial neoplasia shows 3 to 4 times enlarged nuclei, cytopathic changes including distinct cytoplasmic halo and binucleation or multinucleation, immature cytoplasm and greater nuclear pleomorphism. 

How does Vaginal Intraepithelial Neoplasia Present?

Patients with vaginal intraepithelial neoplasia typically in females with 22 – 80 years age.  The symptoms, features, and clinical findings associated with vaginal intraepithelial neoplasia include postcoital spotting or vaginal discharge, abnormal vaginal bleeding.

How is Vaginal Intraepithelial Neoplasia Diagnosed?

Vaginal intraepithelial neoplasia is diagnosed by coloposcopic assessment and biopsy of the vagina, and physical examination.

How is Vaginal Intraepithelial Neoplasia Treated?

Vaginal intraepithelial neoplasia is treated by surgical excision, CO2 laser therapy, medical therapy using Imiquimod 5% cream, and radiation treatment.

What is the Prognosis of Vaginal Intraepithelial Neoplasia?

The prognosis of vaginal intraepithelial neoplasia is excellent. Women with stage 1 vaginal intraepithelial neoplasia do not need treatment.

What are Malignant Neoplasms of the Vagina?

Malignant neoplasms of the vagina are also known as vaginal cancer. The vaginal cancer most commonly occurs in the cells that line the surface of your vagina, which is sometimes called the birth canal.

Malignant neoplasms of the vagina include: 

  • Embryonal rhabdomyosarcoma
  • Squamous cell carcinoma of the vagina

What is Embryonal Rhabdomyosarcoma of the Vagina?

Embryonal rhabdomyosarcoma of the vagina with Botryoid type’ is a rare soft tissue tumor that arises within the wall of the bladder or vagina and seen almost exclusively in infants.

What is the Pathology of Vaginal Embryonal Rhabdomyosarcoma?

The pathology of vaginal embryonal rhabdomyosarcoma is:

-Etiology: The cause of vaginal embryonal rhabdomyosarcoma is changes in the genetic material in cells DNA.

-Genes involved: IGF2, ATR, PTCH, CDKN2A P16 INK4A, CDKN2B, and TP53

-Pathogenesis: The sequence of events that lead to vaginal embryonal rhabdomyosarcoma are disruption of skeletal muscle progenitor cell growth and related differentiation may cause rhabdomyosarcoma.

-Morphology: The morphology associated with vaginal embryonal rhabdomyosarcoma shows small, round tumor cells with hyperchromatic nuclei.

-Histology: The histology associated with vaginal embryonal rhabdomyosarcoma shows large, polygonal-shaped tumor cells with abundant eosinophilic cytoplasm.

How does Vaginal Embryonal Rhabdomyosarcoma Present?

Patients with vaginal embryonal rhabdomyosarcoma typically females at the neonatal age. The symptoms, features, and clinical findings associated with vaginal embryonal rhabdomyosarcoma include swelling, pain, urination trouble, feeling of a mass in the introitus, vaginal bleeding and pelvic pain, leucorrhea and malodorous discharge.

How is Vaginal Embryonal Rhabdomyosarcoma Diagnosed?

Vaginal embryonal rhabdomyosarcoma is diagnosed by: biopsy, genetic tests for tumor tissues, immunocytochemistry tests. 

How is Vaginal Embryonal Rhabdomyosarcoma Treated?

Vaginal embryonal rhabdomyosarcoma is treated by combination of surgery with adjuvants chemotherapy and radiotherapy.

What is the Prognosis of Vaginal Embryonal Rhabdomyosarcoma?

The prognosis of vaginal embryonal rhabdomyosarcoma is good. 

What is Squamous Cell Carcinoma of the Vagina?

Squamous cell carcinoma of the vagina is cancer that forms in the thin, flat cells lining the inside of the vagina.

What is the Pathology of Vaginal Squamous Cell Carcinoma?

The pathology of vaginal squamous cell carcinoma is:

-Etiology: The cause of vaginal squamous cell carcinoma is infection with the human papillomavirus, or HPV.

-Genes involved: Mutations in TP53, CDKN2A, PIK3CA, NOTCH1, and KMT2D.

-Pathogenesis: The sequence of events that lead to vaginal squamous cell carcinoma is metaplasia and proliferation of atypical cells.

 Morphology: The morphology associated with vaginal squamous cell carcinoma shows Exophytic or ulcerative with necrosis.

-Histology: The histology associated with vaginal squamous cell carcinoma shows cells from well differentiated to undifferentiated tumors.

How does Vaginal Squamous Cell Carcinoma Present?

Patients with vaginal squamous cell carcinoma typically females from 58 to 68 years of median age. The symptoms, features, and clinical findings associated with vaginal squamous cell carcinoma include: Unusual vaginal bleeding, watery discharge, lumps in vagina, frequent and painful urination, pelvic pain. 

How is Vaginal Squamous Cell Carcinoma Diagnosed?

Vaginal squamous cell carcinoma is diagnosed by biopsy, physical examination, colposcopy, radiological imaging required to determine extent of disease and to look for distant metastasis.

How is Vaginal Squamous Cell Carcinoma Treated?

Vaginal squamous cell carcinoma is treated by radiation therapy, interstitial brachytherapy, intracavitary brachytherapy, chemotherapy and surgical resection.

What is the Prognosis of Vaginal Squamous Cell Carcinoma?

The prognosis of vaginal squamous cell carcinoma is fair. Overall, the 5-year survival rate for women with vaginal cancer is 49%. The cancer diagnosed at early stages is more likely to be cured. 

What is Cervix Pathology?

Cervix pathology is the study and diagnosis of disease of a cylinder-shaped neck of tissue that connects the vagina and uterus called cervix.

Examples of cervix pathology include:

  • Inflammations of the cervix
  • Endocervical polyps
  • Premalignant neoplasms of the cervix
  • Cervical intraepithelial neoplasia
  • Malignant neoplasms of the cervix
  • Cervical carcinoma

What are Inflammations of the Cervix?

Inflammations of the cervix are also called as cervicitis which is caused due to infections and the infected tissues red, swollen and ooze mucus. 

Inflammations of the cervix include:

  • Acute cervicitis
  • Chronic cervicitis

What is Acute Cervicitis?

Acute cervicitis usually caused by an infection from the introduction of staphylococcus or streptococcus bacteria into the cervix.

What is the Pathology of Acute Cervicitis?

The pathology of acute cervicitis is:

-Etiology: The cause of acute cervicitis is common sexually transmitted infections STIs.

-Genes involved: SCARF1.

-Pathogenesis: The sequence of events that lead to acute cervicitis are: The endocervix is lined by columnar epithelium which is susceptible to infectious agents leading to cervicitis.

-Morphology: The morphology associated with acute cervicitis shows swelling and tenderness.

-Histology: The histology associated with acute cervicitis shows inflammation.

How does Acute Cervicitis Present?

Patients with acute cervicitis typically females at young age. The symptoms, features, and clinical findings associated with acute cervicitis include: abnormal vaginal bleeding, grey or white discharge, pain during intercourse, pelvic and back pains, open sores.

How is Acute Cervicitis Diagnosed?

Acute cervicitis is diagnosed by physical examination, pap smear test, microscopic examination for bacterial infections, Bimanual pelvic exam, cervical biopsy, culturing of cervical discharge.  

How is Acute Cervicitis Treated?

Acute cervicitis is treated by antibiotics to kill infections, laser therapy or surgery.

What is the Prognosis of Acute Cervicitis?

The prognosis of acute cervicitis is good. However, untreated cervicitis caused by gonorrhea or chlamydia can move to the uterine lining and fallopian tubes, causing pelvic inflammatory disease. 

What is Chronic Cervicitis?

Chronic cervicitis is an inflammation of the cervical tissue that has persisted despite attempts at treatment with various antibiotic regimens.

What is the Pathology of Chronic Cervicitis?

The pathology of chronic cervicitis is:

-Etiology: The cause of chronic cervicitis are allergy, irritation, pregnancy, cancer or treatment of cancer.

-Genes involved: 4977 bp deletion in mitochondrial genes.

-Pathogenesis: The sequence of events that lead to chronic cervicitis.

-Morphology: The morphology associated with chronic cervicitis shows pale uniform chromatin, lymphocytes of varying stages of maturation, scattered plasma cells.

-Histology: The histology associated with chronic cervicitis shows lymphoplasmacytic inflammation, ulceration, necrosis, and multinucleated cells.

How does Chronic Cervicitis Present?

Patients with chronic cervicitis typically females from young age to postmenopausal age. The symptoms, features, and clinical findings associated with chronic cervicitis include red and inflamed cervix, irritation, pelvic pain, purulent discharge, urinary problems, bleeding abnormally.

How is Chronic Cervicitis Diagnosed?

Chronic cervicitis is diagnosed by cervical biopsy, cervical discharge culture, physical examination, and pap smear. 

How is Chronic Cervicitis Treated?

Chronic cervicitis is treated by antibiotics for infections, surgery, and laser treatment.

What is the Prognosis of Chronic Cervicitis?

The prognosis of chronic cervicitis is good. It will go away a few days to a week after you start taking antibiotics or other treatments.

What are Endocervical Polyps?

Endocervical polyps are common benign proliferations composed of a fibrovascular core and endocervical glandular or metaplastic squamous epithelium.

What is the Pathology of Endocervical Polyps?

The pathology of endocervical polyps is:

-Etiology: The cause of endocervical polyps is unknown and is thought to be resulted from infections.

-Genes involved: DES.

-Pathogenesis: The sequence of events that lead to endocervical polyps are: abnormal response to increased levels of estrogen, chronic inflammation, and cogged blood vessels in cervix cause polyps.

-Morphology: The morphology associated with endocervical polyps shows flesh-colored, single finger-like growth.

-Histology: The histology associated with endocervical polyps shows fibrovascular core, variable stromal cellularity, multinucleated stromal cells.

How does Endocervical Polyps Present?

Patients with endocervical polyps typically in females at any age but most common among patients with more than 40 years age. The symptoms, features, and clinical findings associated with endocervical polyps include: heavy menstrual periods, vaginal bleeding after intercourse, white yellow discharge.  

How is Endocervical Polyps Diagnosed?

Endocervical polyps is diagnosed by: physical gynecologic examination or colposcopy, cervical pap smear test, biopsy.

How is Endocervical Polyps Treated?

Endocervical polyps is treated by excision of polyps, polypectomy, acetaminophen to treat pain.

What is the Prognosis of Endocervical Polyps?

The prognosis of endocervical polyps is good. Most cervical polyps are benign, cause no problems, and don’t come back once they’re removed.

What are Premalignant Neoplasms of the Cervix?

Premalignant neoplasms of the cervix are the mass of cells in cervix which are not yet cancerous, but they have the potential to become malignant. 

An example of a premalignant neoplasms of the cervix is cervical intraepithelial neoplasia.

What is Cervical Intraepithelial Neoplasia?

Cervical Intraepithelial Neoplasia is precancerous condition in which abnormal cells grow on the surface of the cervix.

Squamous intraepithelial lesions of the cervix are the abnormal growth of squamous cells on the surface of the cervix.

What is the Pathology of Cervical Intraepithelial Neoplasia?

The pathology of cervical intraepithelial neoplasia is:

-Etiology: The cause of cervical intraepithelial neoplasia is infection with the human papilloma virus HPV

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to cervical intraepithelial neoplasia: the HPV infection causes cellular changes like koilocytes. Causing lesions in the epithelial cells hence developing the disease. 

-Morphology: The morphology associated with cervical intraepithelial neoplasia shows nuclear atypia in all epithelial layers.

-Histology: The histology associated with cervical intraepithelial neoplasia shows differentiation, maturation and stratification of cells and nuclear abnormalities.

How does Cervical Intraepithelial Neoplasia Present?

Patients with cervical intraepithelial neoplasia typically in females with 25 to 35 years age. The symptoms, features, and clinical findings associated with cervical intraepithelial neoplasia include abnormal or post-menopausal bleeding, abnormal discharge, changes in bladder function, abnormal appearance or palpation of cervix, pelvic pain

How is Cervical Intraepithelial Neoplasia Diagnosed?

Cervical intraepithelial neoplasia is diagnosed by pap smear test, colposcopy, HPV testing, and biopsy.

How is Cervical Intraepithelial Neoplasia Treated?

Cervical intraepithelial neoplasia is treated by: Loop electrosurgical excision procedure LEEP, conization biopsy, hysterectomy, cryocautery. 

What is the Prognosis of Cervical Intraepithelial Neoplasia?

The prognosis of cervical intraepithelial neoplasia is good. Most of the time, it can be treated successfully. Ablation and resection are effective in about 90% of all cases, with a 10% chance of recurrence after treatment.

What are Malignant Neoplasms of the Cervix?

Malignant neoplasms of the cervix are cancerous tumors in cervix with an abnormal growth that can grow uncontrolled and spread to other parts of the body.

Cervical carcinoma of the cervix is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

What is the Pathology of Cervical Carcinoma?

The pathology of cervical carcinoma is:

-Etiology: The cause of cervical carcinoma is long-lasting infection with certain types of human papillomavirus HPV.

-Genes involved: MED1, ERBB3, CASP8, HLA-A, and TGFBR2.

-Pathogenesis: The sequence of events that lead to cervical carcinoma are proliferation of malignant cells.

-Morphology: The morphology associated with cervical carcinoma shows ulcerating, exophytic mucosa of cervix.

-Histology: The histology associated with cervical carcinoma shows tumor cells with non keratinizing cytoplasm, vascular lesions.

How does Cervical Carcinoma Present?

Patients with cervical carcinoma typically females most frequently in between the ages of 35 and 44, but rarely develops at 20s. The symptoms, features, and clinical findings associated with cervical carcinoma include bleeding between periods and after intercourse, discomfort during intercourse, pelvic pain, and vaginal discharge.

How is Cervical Carcinoma Diagnosed?

Cervical carcinoma is diagnosed by colposcopy, pap test, DNA test for HPV, and biopsy.

How is Cervical Carcinoma Treated?

Cervical carcinoma is treated by surgery, chemotherapy, and radiation therapy

What is the Prognosis of Cervical Carcinoma?

The prognosis of cervical carcinoma is good but depends on stages of the cancer. the 5-year survival rates for stage 1 are: >90%, stage 2: 60-80%, stage 3: 50%, stage 4: <30%.  

What is Cervical Cancer Screening and Prevention?

Cervical cancer screening and prevention is done by:  

Pap smears which is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix. It involves collecting cells from your cervix.  

Gardasil is an HPV vaccine approved by the U.S. FDA, and can be used for both girls and boys. This vaccine can prevent most cases of cervical cancer if the vaccine is given before girls or women are exposed to the virus. 

What is Uterus Pathology?

Uterus pathology is the study and diagnosis of disease of uterus which is a hollow muscular organ located in the female pelvis between the bladder and rectum. 

Examples of uterus pathology include:

  • Functional endometrial disorders
  • Inflammatory disorders of the endometrium
  • Adenomyosis
  • Endometriosis
  • Endometrial polyps
  • Endometrial hyperplasia
  • Malignant tumors of the endometrium
  • Tumors of endometrial stroma
  • Tumors of the myometrium

What are Functional Endometrial Disorders?

Functional endometrial disorders are irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. 

Functional endometrial disorders include:

  • Anovulatory cycle
  • Inadequate luteal phase

What is an Anovulatory Cycle?

Anovulatory cycle is a menstrual cycle in which ovulation, or the release of an egg from the ovaries, does not occur. 

What is the Pathology of Anovulatory Cycle?

The pathology of anovulatory cycle is:

-Etiology: The cause of anovulatory cycle is hormonal imbalances that can be the result of using hormonal birth control, being underweight or overweight, exercising excessively, or experiencing significant stress.

-Genes involved: GNRH1 gene.

-Pathogenesis: The sequence of events that lead to anovulatory cycle are: the imbalance in hormones released from hypothalamo-pituitary axis which controls egg release via the ovarian cycle, or other endocrine abnormalities, to the ovary itself.

-Morphology: The morphology associated with anovulatory cycle shows disordered and unstable uterine lining. 

-Histology: The histology associated with anovulatory cycle shows characteristic endometrial tissue.

How does Anovulatory Cycle Present?

Patients with anovulatory cycle typically females who are close to menopause or 40 to 50 years old. The symptoms, features, and clinical findings associated with anovulatory cycle include no periods, no cervical mucus, excessive bleeding in periods, irregular basal body temperature, infertility, inability to get pregnant.

How is Anovulatory Cycle Diagnosed?

Anovulatory cycle is diagnosed by testing blood progesterone levels, thyroid and prolactin levels, ultrasound, testing for certain antibodies, uterine lining testing.  

How is Anovulatory Cycle Treated?

Anovulatory cycle is treated by lifestyle changes, nutritional improvements, weight loss, clomiphene citrate to trigger release of egg.

What is the Prognosis of Anovulatory Cycle?

The prognosis of anovulatory cycle is good. Because many different factors influence a woman’s hormones and menstrual cycle, there is no one solution for treating anovulation.

What is an Inadequate Luteal Phase?

Inadequate luteal phase is a condition which happens if the ovaries do not release enough progesterone, or if the lining of the uterus doesn’t respond to the hormone.

What is the Pathology of Inadequate Luteal Phase?

The pathology of inadequate luteal phase is:

-Etiology: The cause of inadequate luteal phase is anorexia or endometriosis

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to inadequate luteal phase are: diminished FSH secretion in the early follicular phase is induced by administration of porcine follicular fluid rich in inhibin led to inadequate luteal progesterone secretion.

-Morphology: The morphology associated with inadequate luteal phase shows abdominal pain.

-Histology: The histology associated with inadequate luteal phase shows small glands.

How does Inadequate Luteal Phase Present?

Patients with inadequate luteal phase typically females of any age. However, progesterone levels drop as women are closer to menopause. The symptoms, features, and clinical findings associated with inadequate luteal phase include spotting, bloating, weight gain, and mood changes.

How is Inadequate Luteal Phase Diagnosed?

Inadequate luteal phase is diagnosed by blood tests for follicle-stimulating hormone (FSH) and luteinizing hormone (LH). 

How is Inadequate Luteal Phase Treated?

Inadequate luteal phase is treated by: clomiphene citrate to stimulate follicular growth, progesterone injection, human chorionic gonadotropin to help ovulation.  

What is the Prognosis of Inadequate Luteal Phase?

The prognosis of inadequate luteal phase is good. No morbidity or mortality has been associated with this condition.

What are Inflammatory Disorders of the Endometrium?

Inflammatory disorders of the endometrium are those conditions which are caused by an inflammation of the inner lining of the uterus or endometrium  

Inflammatory disorders of the endometrium include:

  • Acute endometritis
  • Chronic endometritis

What is Acute Endometritis?

Acute endometritis is an inflammation or irritation of the lining of the uterus which is usually from an infection that passes through the cervix.

What is the Pathology of Acute Endometritis?

The pathology of acute endometritis is:

-Etiology: The cause of acute endometritis is infection due to chlamydia, gonorrhea, tuberculosis, more often after miscarriage or childbirth.

-Genes involved: NPSR1, ARID1A gene.

-Pathogenesis: The sequence of events that lead to acute endometritis is unknown.

-Morphology: The morphology associated with acute endometritis shows abdominal symptoms.

-Histology: The histology associated with acute endometritis shows neutrophils infiltrating and destroying endometrial epithelium.

How does Acute Endometritis Present?

Patients with acute endometritis typically females who are close to menopause. The symptoms, features, and clinical findings associated with acute endometritis include abnormal vaginal bleeding, swelling of the abdomen, bowel movement discomfort, and pelvic pain.

How is Acute Endometritis Diagnosed?

Acute endometritis is diagnosed by endometrial biopsy, bacterial cultures tests, laparoscopic procedures, blood tests for WBCs and RBCs. 

How is Acute Endometritis Treated?

Acute endometritis is treated by antibiotics.

What is the Prognosis of Acute Endometritis?

The prognosis of acute endometritis is good. Endometritis usually goes away with antibiotics without any further problems. However, problems with reproduction and severe infections can occur if the condition isn’t treated. These can lead to infertility.  

What is Chronic Endometritis?

Chronic endometritis a condition involving the breakdown of the peaceful co-existence between microorganisms and the host immune system in the endometrium.

What is the Pathology of Chronic Endometritis?

The pathology of chronic endometritis is:

-Etiology: The cause of chronic endometritis is microbiological origin or a mechanical–chemical origin.

-Genes involved: NPSR1.

-Pathogenesis: The sequence of events that lead to chronic endometritis are: obstetric population is usually associated with retained products of conception after delivery or elective abortion leads to chronic endometritis.  

-Morphology: The morphology associated with chronic endometritis shows thickening of spiral arteries, muscular hypertrophy, endometrial stromal-epithelial impairement.

-Histology: The histology associated with chronic endometritis shows chronic changes.

How does Chronic Endometritis Present?

Patients with chronic endometritis typically females of childbearing age. The symptoms, features, and clinical findings associated with chronic endometritis include pelvic pain, abnormal uterine bleeding, dyspareunia painful intercourse, leukorrhea increased vaginal discharge, cystitis, recurrent vaginitis or mild intestinal discomfort.

How is Chronic Endometritis Diagnosed?

Chronic endometritis is diagnosed by hysteroscopy of the uterine cavity, endometrial biopsy.

How is Chronic Endometritis Treated?

Chronic endometritis is treated by antibiotics.

What is the Prognosis of Disease With First Letters Capitalized?

The prognosis of chronic endometritis is good.  

What is Adenomyosis?

Adenomyosis is occurred when the tissue that normally lines the uterus endometrial tissue grows into the muscular wall of the uterus. The displaced tissue continues to act normally thickening, breaking down and bleeding, during each menstrual cycle.

What is the Pathology of Adenomyosis?

The pathology of adenomyosis is:

-Etiology: The cause of adenomyosis is unknown. However, it is believed to be estrogen-dependent or hormone-sensitive.

-Genes Involved: CYP1A1 gene, CYP1A2 gene, CYP19 gene

-Pathogenesis: The sequence of events that lead to adenomyosis are poorly understood.

-Morphology: The morphology associated with adenomyosis shows benign condition by a proliferation of endometrial glands and stroma.

-Histology: The histology associated with adenomyosis shows glandular tissue within the smooth muscle of the myometrium.

How does Adenomyosis Present?

Patients with adenomyosis typically females between the ages of 35 and 50 years. The symptoms, features, and clinical findings associated with adenomyosis include: heavy prolonged menstrual bleeding, severe cramping, pelvic pain during menstruation, painful intercourse 

How is Adenomyosis Diagnosed?

Adenomyosis is diagnosed by: histologic microscopic examination, hysterectomy, pelvic examination, transvaginal ultrasonography TVUS and magnetic resonance imaging

How is Adenomyosis Treated?

Adenomyosis is treated by anti-inflammatory drugs, hormone medications and surgery to remove uterus. 

What is the Prognosis of Adenomyosis?

The prognosis of adenomyosis is good. After menopause, symptoms go away on their own. It is not generally life-threatening. 

What is Endometriosis?

Endometriosis is an often-painful disorder in which tissue similar to the tissue that normally lines the inside of the uterus — the endometrium — grows outside the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes and the tissue lining your pelvis. 

What is the Pathology of Endometriosis?

The pathology of endometriosis is:

-Etiology: The cause of endometriosis is retrograde menstrual flow.

-Genes involved:  P450 CYP gene, GSTT-1 gene, GSTM1 gene. 

-Pathogenesis: The sequence of events that lead to endometriosis are: endometrial cells are transported from the uterine cavity during menstruation and subsequently become implanted at ectopic sites leading to this condition.

-Morphology: The morphology associated with endometriosis shows powder burn” or “gunshot” lesions on the ovaries, serosal surfaces and peritoneum—black, dark-brown, or bluish puckered lesions. 

-Histology: The histology associated with endometriosis shows endometrial tissue.

How does Endometriosis Present?

Patients with endometriosis typically females at any age but most commonly in reproductive age which is 25-35 years. The symptoms, features, and clinical findings associated with endometriosis include: menstrual cramps pain, pain during intercourse, abnormal menstrual flow, infertility, painful urination, painful bowel movements.

How is Endometriosis Diagnosed?

Disease in sentence case is diagnosed by pelvic exam, ultrasound, MRI, and laparoscopy.

How is Endometriosis Treated?

Endometriosis is treated by hormone therapy, medication for pain, conservative surgery, fertility treatment, Hysterectomy with removal of the ovaries. 

What is the Prognosis of Endometriosis?

The prognosis of endometriosis is good. In extremely rare instances, however, complications of endometriosis can cause potentially life-threatening problems.

What are Endometrial Polyps?

Endometrial polyps are small, soft growths on the inside of a woman’s uterus, or womb. They come from the tissue that lines the uterus, called the endometrium.

What is the Pathology of Endometrial Polyps?

The pathology of endometrial polyps is:

-Etiology: The cause of endometrial polyps is not exactly known but it tend to grow when there is more of the hormone estrogen in the body.

-Genes involved: RAS gene mutations.

-Pathogenesis: The sequence of events that lead to endometrial polyps are unknown.

-Morphology: The morphology associated with endometrial polyps shows smooth, spherical or cylindrical in structure and is tan to yellow in color.

-Histology: The histology associated with endometrial polyps shows atrophic surface epithelium, angulated, tubular or cystically dilated glands.

How does Endometrial Polyps Present?

Patients with endometrial polyps typically females between 40 and 50 years old, but rarely occurs at younger age. The symptoms, features, and clinical findings associated with endometrial polyps include: irregular menstrual bleeding, excessively heavy periods, infertility. 

How is Endometrial Polyps Diagnosed?

Endometrial polyps is diagnosed by hysteroscopy, endometrial biopsy, ultrasound, saline sonogram. 

How is Endometrial Polyps Treated?

Endometrial polyps is treated by hormonal medications, surgical removal, and curettage.

What is the Prognosis of Endometrial Polyps?

The prognosis of endometrial polyps is good. Treatment of small polyps is unnecessary unless you’re at risk of uterine cancer.

What is Endometrial Hyperplasia?

Endometrial hyperplasia is a condition of the female reproductive system. The lining of the uterus endometrium becomes unusually thick because of having too many cells hyperplasia. It’s not cancer, but in certain women, it raises the risk of developing endometrial cancer, a type of uterine cancer

What is the Pathology of Endometrial Hyperplasia?

The pathology of endometrial hyperplasia is:

-Etiology: The cause of endometrial hyperplasia is excess estrogen without progesterone.

-Genes involved: K-ras,B-raf, Her2/neu, -catenin, AKT genes.

-Pathogenesis: The sequence of events that lead to endometrial hyperplasia are: If ovulation does not occur, progesterone is not made, and the lining is not shed. The endometrium may continue to grow in response to estrogen. The cells that make up the lining may crowd together and may become abnormal.

-Morphology: The morphology associated with endometrial hyperplasia shows Florid to pseudopolypoid endometrium.

-Histology: The histology associated with endometrial hyperplasia shows Reminiscent of normal proliferative endometrium with pseudostratified, mitotically active, elongated columnar cells.

How does Endometrial Hyperplasia Present?

Patients with endometrial hyperplasia typically in women with 50-54 years age and is rarely present in age 35 years or less. The symptoms, features, and clinical findings associated with endometrial hyperplasia include: bleeding after menopause, no periods premenopause, menstrual cycles shorter than 21 days, heavier or long lasting menstrual bleeding.  

How is Endometrial Hyperplasia Diagnosed?

Endometrial hyperplasia is diagnosed by ultrasound to measure thickness, biopsy, dilation and curettage, hysteroscopy. 

How is Endometrial Hyperplasia Treated?

Endometrial hyperplasia is treated by hysterectomy, hormonal therapy. 

What is the Prognosis of Endometrial Hyperplasia?

The prognosis of endometrial hyperplasia is good. Atypical endometrial hyperplasia raises the risk of endometrial cancer and uterine cancer. The condition tends to occur during or after menopause.

What are Malignant Tumors of the Endometrium?

Malignant tumors of the endometrium are cancer cells formed inside the tissues of endometrium. 

Malignant tumors of the endometrium include:

  • Carcinoma of the endometrium
  • Malignant mixed mullerian tumors

What is Carcinoma of the Endometrium?

Carcinoma of the endometrium or endometrial cancer is a type of uterine cancer that starts in the inner lining of the uterus called endometrium. 

What is the Pathology of Endometrium Carcinoma?

The pathology of endometrium carcinoma is:

-Etiology: The cause of endometrium carcinoma is DNA mutations which turns normal, healthy cells into abnormal cells. 

-Genes involved: MLH1, MSH2, MSH6, PMS2, BRCA1, BRCA2, MUTYH, CHEK2, TP53, and POLD1 EPCAM genes.  

-Pathogenesis: The sequence of events that lead to endometrium carcinoma

-Morphology: The morphology associated with endometrium carcinoma shows small tufts and papillae, greater cytological atypia.

-Histology: The histology associated with endometrium carcinoma shows aty

How does Endometrium Carcinoma Present?

Patients with endometrium carcinoma typically females with average age 60, and uncommon in women under 45 years age. The symptoms, features, and clinical findings associated with endometrium carcinoma include pain, mass in pelvic area, pain during intercourse, painful urination, and postmenopausal bleeding.

How is Endometrium Carcinoma Diagnosed?

Endometrium carcinoma is diagnosed by endometrial biopsy, hysteroscopy, dilation and curettage.

How is Endometrium Carcinoma Treated?

Endometrium carcinoma is treated by: radiation therapy, surgery to remove uterus, hormone therapy, chemotherapy, 

What is the Prognosis of Endometrium Carcinoma?

The prognosis of endometrium carcinoma is good the 5 years survival rate on average is 81% for all the stages of the endometrial cancer.  

What are Malignant Mixed Mullerian Tumors?

Malignant mixed mullerian tumors are also called a carcinosarcoma, is a cancer which contains two types of cancer cells i.e., carcinoma and sarcoma cells. These tumors usually develop in tissues of the female genital tract.

What is the Pathology of Malignant Mixed Mullerian Tumors?

The pathology of malignant mixed mullerian tumors is:

-Etiology: The cause of malignant mixed mullerian tumors is unclear but accumulation of genetic mutations could be a factor.

-Genes involved:  BRCA2 gene mutation.

-Pathogenesis: The sequence of events that lead to malignant mixed mullerian tumors are unknown however, it appears to have epithelial origin.

-Morphology: The morphology associated with malignant mixed mullerian tumors shows Soft and fleshy mass, often with bleeding and necrosis.

-Histology: The histology associated with malignant mixed mullerian tumors shows epithelial and sarcomatous elements which could be homologous or heterologous, rarely trophoblastic tissues. 

How does Malignant Mixed Mullerian Tumors Present?

Patients with malignant mixed mullerian tumors typically females mostly postmenopausal specially at their 60s. The symptoms, features, and clinical findings associated with malignant mixed mullerian tumors include: vaginal bleeding, abnormal vaginal cytology and polypoidal cervical mass. 

How is Malignant Mixed Mullerian Tumors Diagnosed?

Malignant mixed mullerian tumors is diagnosed by: pelvic ultrasound, CT scan.

How is Malignant Mixed Mullerian Tumors Treated?

Malignant mixed mullerian tumors is treated by surgical cytoreduction with adjuvant chemotherapy, radiation therapy. 

What is the Prognosis of Malignant Mixed Mullerian Tumors?

The prognosis of malignant mixed mullerian tumors is poor. The 5 years survival rate is only 12-20%.  

What are Tumors of Endometrial Stroma

Tumors of endometrial stroma are rare mesenchymal tumors occurring primarily in the uterine corpus.

Examples of tumors of endometrial stroma include: 

  • Adenosarcomas of endometrial stroma
  • Endometrial stromal tumors

What are Adenosarcomas of Endometrial Stroma?

Adenosarcomas of endometrial stroma are are a group of mixed mesenchymal tumors most commonly arising from the endometrium, benign glandular epithelium and low-grade sarcoma.

What is the Pathology of Endometrial Stroma Adenosarcomas?

The pathology of endometrial stroma adenosarcomas is:

-Etiology: The cause of endometrial stroma adenosarcomas is presence of benign epithelial elements combined with a malignant mesenchymal component.

-Genes involved: ZC3H7B–BCOR, JAZF1-SUZ12 gene.

-Pathogenesis: The sequence of events that lead to endometrial stroma adenosarcomas are malignant proliferation.

-Morphology: The morphology associated with endometrial stroma adenosarcomas shows broad leaflike architecture.

-Histology: The histology associated with endometrial stroma adenosarcomas shows malignant cells.

How does Endometrial Stroma Adenosarcomas Present?

Patients with endometrial stroma adenosarcomas typically females of any age. The symptoms, features, and clinical findings associated with endometrial stroma adenosarcomas include: Abnormal vaginal bleeding, menorrhagia, menstrual disorder. 

How is Endometrial Stroma Adenosarcomas Diagnosed?

Endometrial stroma adenosarcomas is diagnosed by: dilation and curettage, hysterectomy to remove uterus.  

How is Endometrial Stroma Adenosarcomas Treated?

Endometrial stroma adenosarcomas is treated by: total hysterectomy and bilateral ovariectomy

What is the Prognosis of Endometrial Stroma Adenosarcomas?

The prognosis of endometrial stroma adenosarcomas is fair. The Five-year survival rates are 58.18%

What are Endometrial Stromal Tumors?

Endometrial Stromal Tumors are very rare mesenchymal malignant tumors in the uterus, resemble endometrial stromal cells of the proliferative endometrium.  

What is the Pathology of Endometrial Stromal Tumors?

The pathology of endometrial stromal tumors is:

-Etiology: The cause of endometrial stromal tumors is unknown.

-Genes involved: JAZF1-SUZ12 JJAZ1 genes fusion

-Pathogenesis: The sequence of events that lead to endometrial stromal tumors is stromal proliferation of neoplastic cells.

-Morphology: The morphology associated with endometrial stromal tumors shows stromal atypia.

-Histology: The histology associated with endometrial stromal tumors shows stromal atypia.

How does Endometrial Stromal Tumors Present?

Patients with endometrial stromal tumors typically in females at any age. The median age is 47 years and most commonly in postmenopausal women. The symptoms, features, and clinical findings associated with endometrial stromal tumors include: Abnormal uterine bleeding, Pelvic or abdominal pain, distension and frequent urination.

How is Endometrial Stromal Tumors Diagnosed?

Endometrial stromal tumors is diagnosed by: light microscopy, biopsy and subsequent hysterectomy.

How is Endometrial Stromal Tumors Treated?

Endometrial stromal tumors is treated by: Total abdominal hysterectomy and bilateral salpingo-oophorectomy and debulking of any visible tumor, Radiation or hormonal treatment as adjuvant treatment or for recurrent or metastatic tumor.

What is the Prognosis of Endometrial Stromal Tumors?

The prognosis of endometrial stromal tumors is excellent. The prognosis with no recurrences if completely excised. 5-year survival rate of approximately 60–80% for low grade tumors. 

What are Tumors of the Myometrium?

Tumors of the myometrium are cancer that starts in the muscular wall of the uterus myometrium

Tumors of the myometrium include:

  • Leiomyomas
  • Leiomyosarcomas

What are Leiomyomas?

Leiomyomas are benign tumors that originate in smooth muscle cells of the myometrium, which is the thick middle layer of the uterine wall.

What is the Pathology of Leiomyomas?

The pathology of leiomyomas is:

-Etiology: The cause of leiomyomas is genetic mutations in the smooth muscle cells.

-Genes involved: HMGA1 and HMGA2, RAD 51L1, PCPE gene.

-Pathogenesis: The sequence of events that lead to leiomyomas are not well understood. However, Genetic predisposition, environmental factors, steroid hormones, and growth factors involved in fibrotic processes and angiogenesis all play a role in the formation and growth of uterine fibroids hence forming the leiomyomas.

-Morphology: The morphology associated with leiomyomas shows dense, well-circumscribed nodules with white to tan colored cut surfaces. 

-Histology: The histology associated with leiomyomas shows monoclonal neoplasms surrounded by a thin pseudocapsule of areolar tissue and compressed muscle fibers.

How does Leiomyomas Present?

Patients with leiomyomas typically females with increased incidence up to menopause. The symptoms, features, and clinical findings associated with leiomyomas include: Heavy menstrual bleeding, pelvic pain, periods lasting more than a week, infertility, abnormal bleeding, large masses, pain.  

How is Leiomyomas Diagnosed?

Leiomyomas is diagnosed by comprehensive physical examination, ultrasound, and biopsy.  

How is Leiomyomas Treated?

Leiomyomas is treated by surgical removal, hysterectomy, or myomectomy. Medications may be used for pain management.

What is the Prognosis of Leiomyomas?

The prognosis of leiomyomas is excellent. Intraperitoneal hemorrhage caused by uterine leiomyomas can be a life-threatening condition.

What are Leiomyosarcomas?

Leiomyosarcomas are rare type of cancer that begins in smooth muscle tissue of uterus. 

What is the Pathology of Leiomyosarcomas?

The pathology of leiomyosarcomas is:

-Etiology: The cause of leiomyosarcomas is not exactly known. However, genetic mutation might be one of the causes.

-Genes involved: TP53, RB1, ATRX, PTEN, and MAP2K4 mutations.

-Pathogenesis: The sequence of events that lead to leiomyosarcomas are: Oncogenes control cell growth; tumor suppressor genes control cell division and ensure that cells die at the proper time, abnormal changes in the structure and orientation of these genes result in abnormal growth hence causing leiomyosarcomas.

-Morphology: The morphology associated with leiomyosarcomas shows spindle cell proliferation forming rough bundles and fascicles.

-Histology: The histology associated with leiomyosarcomas shows spindle cells with cigar shaped nuclei with prominent cytologic atypia and mitotic figures.

How does Leiomyosarcomas Present?

Patients with leiomyosarcomas typically in females around age of 50 years. The symptoms, features, and clinical findings associated with leiomyosarcomas include: bloating, fever, pain, nausea, vomiting, weight loss, swelling of skin. 

How is Leiomyosarcomas Diagnosed?

Leiomyosarcomas is diagnosed by MRI, CT scan, physical examinations, and biopsy.

How is Leiomyosarcomas Treated?

Leiomyosarcomas is treated by: surgery to remove tumor, radiotherapy, chemotherapy, immunotherapy.

What is the Prognosis of Leiomyosarcomas?

The prognosis of leiomyosarcomas is poor. It is an aggressive cancer that is often diagnosed at later stages, when it has spread to other parts of the body. The 5-year overall survival rate is about 24%.

What is Fallopian Tube Pathology?

Fallopian tube pathology is the study and diagnosis of diseases related to the fallopian tubes which are muscular tubes present in female reproductive system and have function to transport the ova from the ovary to the uterus

Fallopian tube pathology includes: 

  • Fallopian Tube Inflammation
  • Fallopian Tube Cysts
  • Fallopian Tube Tumors

What is Fallopian Tube Inflammation?

Fallopian tube inflammation is redness, swelling, and pain of the fallopian tube due to inflammation. 

Examples of Fallopian Tube Inflammation include:

  • Suppurative salpingitis
  • Tuberculosis salpingitis

What is Suppurative salpingitis?

Suppurative salpingitis is an infection and inflammation in the Fallopian tubes with pus formation.

What is the Pathology of Suppurative salpingitis?

The pathology of suppurative salpingitis is:

-Etiology: The cause of suppurative salpingitis is bacterial infection

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to suppurative salpingitis is inflammation.

-Morphology: The morphology associated with suppurative salpingitis shows inflammation.

-Histology: The histology associated with suppurative salpingitis shows inflammatory infiltrate.

How does Suppurative Salpingitis Present?

Patients with suppurative salpingitis typically females of reproductive age. The symptoms, features, and clinical findings associated with suppurative salpingitis include abnormal bleeding, worse abdominal pain during periods, frequent urination, creamy white discharge. 

How is Suppurative Salpingitis Diagnosed?

Suppurative salpingitis is diagnosed by physical examination, bacterial culture tests, pelvic examination, blood tests, and biopsy.

How is Suppurative Salpingitis Treated?

Suppurative salpingitis is treated by antibiotics, sometimes surgery in acute cases. 

What is the Prognosis of Suppurative Salpingitis?

The prognosis of suppurative salpingitis is good. The positive endocervical culture for N gonorrhoeae in the patient have relatively high frequency in the pregnant population. Therefore, routine endocervical cultures should be obtained in all pregnant patients on initial evaluation. 

What is Tuberculosis salpingitis?

Tuberculosis salpingitis is an infection in human’s body, caused by bacteria which develops hematogenously in the reproductive system of females.

What is the Pathology of Tuberculosis Salpingitis?

The pathology of tuberculosis salpingitis is:

-Etiology: The cause of tuberculosis salpingitis is bacterial infections usually by Mycobacterium tuberculosis acquired via vaginal intercourse.

-Genes involved: IFNGR2 gene.

-Pathogenesis: The sequence of events that lead to tuberculosis salpingitis are: infectious agent from an extragenital source like hematogenous or via lymphatic vessels or from the peritoneal cavity spreads in the body and reaches the fallopian tube causing infection or inflammation.

-Morphology: The morphology associated with tuberculosis salpingitis shows solid-cystic formations with irregular lining.

-Histology: The histology associated with tuberculosis salpingitis shows granulomas.

How does Tuberculosis Salpingitis Present?

Patients with tuberculosis salpingitis typically females, reproductive age from 20 to 40 years. The symptoms, features, and clinical findings associated with tuberculosis salpingitis include low grade fever, pelvic pain, menstrual irregularities, infertility, secondary amenorrhoea, lower abdominal pain, vaginal bleeding.  

How is Tuberculosis Salpingitis Diagnosed?

Tuberculosis salpingitis is diagnosed by hysterosalpingography, radiograph, MRI, PCR to identify M. tuberculosis, blood tests and biopsy.

How is Tuberculosis Salpingitis Treated?

Tuberculosis salpingitis is treated by: antimicrobial agents for up to 18 to 24 months, chemotherapy, sometimes excision of effected parts in severe cases.  

What is the Prognosis of Tuberculosis Salpingitis?

The prognosis of tuberculosis salpingitis is good. However, cases of advanced tuberculosis with extensive adhesions in pelvis and uterus are usually untreatable with very poor prognosis for fertility

What are Fallopian Tube Cysts?

Fallopian Tube Cysts are fluid-filled sacs which are benign and very small., but they can grow larger, can become >15 cm.

Examples of fallopian tube cysts include:

  • Paratubal cysts
  • Hydatids of morgagni

What are Paratubal cysts?

Paratubal cysts are encapsulated, fluid-filled sacs which are sometimes referred to as paraovarian cysts. These cysts form near an ovary or fallopian tube, and won’t adhere to any internal organ.

What is the Pathology of Paratubal Cysts?

The pathology of paratubal cysts is:

-Etiology: The cause of paratubal cysts is mesothelium or the remnant of Müllerian duct

-Genes involved: if any just mention the genes here.

-Pathogenesis: The sequence of events that lead to paratubal cysts unknown.

-Morphology: The morphology associated with paratubal cysts shows Simple fluid filled cysts near fallopian tube.

-Histology: The histology associated with paratubal cysts shows focal papillary projections, ciliated tubal type epithelium.

How does Paratubal Cysts Present?

Patients with paratubal cysts typically females at all ages. Most common in females from 30s to 50s age. The symptoms, features, and clinical findings associated with paratubal cysts include: no symptoms but the larger cysts show symptoms of abnormal uterine bleeding, and dyspareunia, compression of the bladder, uterus or bowel, pelvic tenderness, abdominal pain. 

How is Paratubal Cysts Diagnosed?

Paratubal cysts is diagnosed by: pelvic ultrasound, laparoscopy, biopsy transvaginal sonography, MRI, CT scan. 

How is Paratubal Cysts Treated?

Paratubal cysts is treated by: surgery if cysts become large, laparoscopic cystectomy, Salpingectomy or Oophorectomy, medications with birth control pills.  

What is the Prognosis of Paratubal Cysts?

The prognosis of paratubal cysts is good. They are benign and rarely gives rise to serous borderline tumor or even more rarely malignancy.  

What are Hydatids of Morgagni?

Hydatids of morgagni are benign, pedunculated, cystic structures arising from müllerian vestiges below the fallopian tube near the fimbria.

What is the Pathology of Hydatids of Morgagni?

The pathology of hydatids of morgagni is:

-Etiology: The cause of hydatids of morgagni is embryonal remnants of the müllerian duct.

-Genes involved: RET, CCDC6, TAS2R38, PTCH1, F9.

-Pathogenesis: The sequence of events that lead to hydatids of morgagni.

-Morphology: The morphology associated with hydatids of morgagni shows appendiceal mucocel, mucinous mass.

-Histology: The histology associated with hydatids of morgagni shows embryonal remnants.

How does Hydatids of Morgagni Present?

Patients with hydatids of morgagni typically females of all age groups. The symptoms, features, and clinical findings associated with hydatids of morgagni include: abdominal pain, a palpable abdominal mass, nausea/vomiting, fevers, or leukocytosis.

How is Hydatids of Morgagni Diagnosed?

Hydatids of morgagni is diagnosed by diagnostic laparoscopy, CT scan. 

How is Hydatids of Morgagni Treated?

Hydatids of morgagni is treated by laparoscopic removal, and surgical excision. 

What is the Prognosis of Hydatids of Morgagni?

The prognosis of hydatids of morgagni is good. They are generally related with unexplained infertility. The removal of hydatid cysts of Morgangi leads to a higher rate of spontaneous pregnancy.  

What are Fallopian Tube Tumors?

Fallopian tube tumors are a solid mass of tissue that forms when abnormal cells group together in the fallopian tubes.

Examples of fallopian tube tumors include:

  • Adenomatoid tumors aka mesotheliomas
  • Adenocarcinoma of the fallopian Tube

What are Adenomatoid Tumors aka Mesotheliomas?

Adenomatoid tumors aka mesotheliomas are benign or malignant neoplasm of mesothelial origin involving the fallopian tubes. 

What is the Pathology of Adenomatoid Tumors?

The pathology of adenomatoid tumors is:

-Etiology: The cause of adenomatoid tumors is somatic missense mutations.

-Genes involved: TRAF7 mutation.

-Pathogenesis: The sequence of events that lead to adenomatoid tumors.

-Morphology: The morphology associated with adenomatoid tumors shows small, well-circumscribed, solitary masses that are tan-yellow, and solid mass.

-Histology: The histology associated with adenomatoid tumors shows tubular spaces of varying size, eosinophilic cytoplasm, lymphocytic follicles. 

How does Adenomatoid Tumors Present?

Patients with adenomatoid tumors typically females between 26 to 55 years age. The symptoms, features, and clinical findings associated with adenomatoid tumors include: abnormal vaginal bleeding, polymenorrhea, and menorrhagia.

How is Adenomatoid Tumors Diagnosed?

Adenomatoid tumors is diagnosed by: physical examination, trans-abdominal and trans-vaginal ultrasound, CT scan. 

How is Adenomatoid Tumors Treated?

Adenomatoid tumors is treated by hysterectomy and bilateral salpingectomy, and surgical removal. 

What is the Prognosis of Adenomatoid Tumors?

The prognosis of adenomatoid tumors is good. The surgical excision of benign tumors has no cases of recurrence reported till date.  

What is Adenocarcinoma of the Fallopian Tube?

Adenocarcinoma of the fallopian tube is a type of cancer which develops on the fallopian tubes tissues. 

What is the Pathology of Fallopian Tube Adenocarcinoma?

The pathology of fallopian tube adenocarcinoma is:

-Etiology: The cause of fallopian tube adenocarcinoma is Post menopause, no children, Inherited gene mutations.

-Genes involved: BRCA1 or BRCA2 mutations.

-Pathogenesis: The sequence of events that lead to fallopian tube adenocarcinoma are not fully understood.

-Morphology: The morphology associated with fallopian tube adenocarcinoma shows crowding and a disorganized piling up of cells, frequent mitotic figures, nuclear atypia and necrosis.

-Histology: The histology associated with fallopian tube adenocarcinoma shows malignant glands.

How does Fallopian Tube Adenocarcinoma Present?

Patients with fallopian tube adenocarcinoma typically females present between 50 and 60 years. The symptoms, features, and clinical findings associated with fallopian tube adenocarcinoma include: bleeding from vagina without periods, pain and pressure in lower body, white or pink discharge from vagina, lump and swelling in lower body. 

How is Fallopian Tube Adenocarcinoma Diagnosed?

Fallopian tube adenocarcinoma is diagnosed by: Pelvic Exam test, ultrasound, MRI, CT scan, biopsy, CA125 test.

How is Fallopian Tube Adenocarcinoma Treated?

Fallopian tube adenocarcinoma is treated by: Surgery, chemotherapy, radiotherapy, salpingo-oophorectomy, and hysterectomy.  

What is the Prognosis of Fallopian Tube Adenocarcinoma?

The prognosis of fallopian tube adenocarcinoma is good. The 5-year survival rate for women younger than 65 is 61%, compared with 32% for women age 65 and older.

What is Ovary Pathology?

Ovary Pathology is the study and diagnosis of the diseases associated with the ovum producing organ of female reproductive system called as ovary. 

Examples of ovary pathology include:

  • Nonneoplastic and functional cysts
  • Ovarian tumors
  • Epithelial tumors
  • Germ cell tumors
  • Sex cord stromal tumors
  • Metastatic tumors

What are Nonneoplastic and Functional Cysts of the Ovary?

Nonneoplastic and functional cysts of the ovary are sac that forms on the surface of a woman’s ovary during or after ovulation and cause ovary enlargement.

Nonneoplastic and functional cysts of the ovary include:

  • Follicle cysts of the ovary 
  • Luteal cysts of the ovary
  • Polycystic ovaries
  • Stromal hyperthecosis

What are Follicle Cysts of the Ovary?

Follicle cysts of the ovary are small fluid-filled sacs that develop in a woman’s ovaries and can range from small as a pea, to larger than an orange and are generally functional in nature and harmless.

What is the Pathology of Ovarian Follicle Cysts?

The pathology of ovarian follicle cysts is:

-Etiology: The cause of ovarian follicle cysts is hormonal imbalance, and genetic causes.

-Genes involved: RPL15 gene upregulation, MAP1B down regulation.

-Pathogenesis: The sequence of events that lead to ovarian follicle cysts are: lack of physiologic release of the ovum due to excessive FSH stimulation hormone or lack of the normal LH surge at midcycle just before ovulation, cause cysts to grow.  

-Morphology: The morphology associated with ovarian follicle cysts shows thin-walled cyst with smooth inner surface containing hemorrhagic fluid.

-Histology: The histology associated with ovarian follicle cysts shows dystrophic calcifications.

How does Ovarian Follicle Cysts Present?

Patients with ovarian follicle cysts typically females at any age but most commonly in nonpregnant women of reproductive age, especially near menarche or menopause. The symptoms, features, and clinical findings associated with ovarian follicle cysts include: pressure and pain in lower abdomen, pelvic pain, nausea vomiting, Pain during sex, weigh gain, periods pain, breast tenderness.  

How is Ovarian Follicle Cysts Diagnosed?

Ovarian follicle cysts is diagnosed by: pelvic examination, ultrasound, hormones level test, CA125 blood test.

How is Ovarian Follicle Cysts Treated?

Ovarian follicle cysts is treated by: hormonal contraceptives, surgery, small cysts don’t need generally medicines. 

What is the Prognosis of Ovarian Follicle Cysts?

The prognosis of ovarian follicle cysts is good. Most cysts disappear within a few months. However, recurrent ovarian cysts can occur in premenopausal women and women with hormone imbalances. If left untreated, some cysts can decrease fertility.

What are Luteal Cysts of the Ovary?

Luteal cysts are a type of functional ovarian cyst that results when a corpus luteum fails to regress following the release of an ovum. 

What is the Pathology of Ovarian Luteal Cysts?

The pathology of ovarian luteal cysts is:

-Etiology: The cause of ovarian luteal cysts is hormonal imbalance, pregnancy, endometriosis, previous cysts, and pelvic infection. 

-Genes involved: CGB5 gene.

-Pathogenesis: The sequence of events that lead to ovarian luteal cysts are: The ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. If a pregnancy doesn’t occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood, causing the corpus luteum to expand into a cyst, and stay in the ovary.

-Morphology: The morphology associated with ovarian luteal cysts shows serous or hemorrhagic contents.

-Histology: The histology associated with ovarian luteal cysts shows convoluted cystic lining, polygonal shaped Granulosa cells.

How does Ovarian Luteal Cysts Present?

Patients with ovarian luteal cysts typically females at reproductive age or during pregnancy.  The symptoms, features, and clinical findings associated with ovarian luteal cysts include: pelvic pain, bloating, weight gain, painful intercourse, painful menstruation, breast tenderness. 

How is Ovarian Luteal Cysts Diagnosed?

Ovarian luteal cysts is diagnosed by: pelvic ultrasound, hormonal tests, laparoscopic procedures.  

How is Ovarian Luteal Cysts Treated?

Ovarian luteal cysts is treated by: hormonal contraceptives, prostaglandin F2α, surgical removal.

What is the Prognosis of Ovarian Luteal Cysts?

The prognosis of ovarian luteal cysts is good. They will go away on their own without treatment.    

What are Polycystic Ovaries?

Polycystic ovaries are conditions in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts.

What is the Pathology of Polycystic Ovaries?

The pathology of polycystic ovaries is:

-Etiology: The cause of polycystic ovaries is not well known. However abnormal function of the hypothalamic-pituitary gland might be the cause.

-Genes involved: DENND1A gene variations.

-Pathogenesis: The sequence of events that lead to polycystic ovaries are not precisely known.

-Morphology: The morphology associated with polycystic ovaries shows Large ovaries with numerous subcortical cysts.

-Histology: The histology associated with polycystic ovaries shows cystic follicles covered by a dense fibrous capsule, hyperthecosis.

How does Polycystic Ovaries Present?

Patients with polycystic ovaries typically females between 15- and 44-years age or during reproductive age. The symptoms, features, and clinical findings associated with polycystic ovaries include: light irregular or missed periods, excessive body hairs, weight gain, acne, thinning of hair, infertility.   

How is polycystic ovaries Diagnosed?

Polycystic ovaries is diagnosed by: blood tests, pelvic exam, ultrasound.  

How is Polycystic Ovaries Treated?

Polycystic ovaries is treated by: starting with lifestyles changes and weight loss, hormonal medications such as Clomiphene which is anti-estrogen.   

What is the Prognosis of Polycystic Ovaries?

The prognosis of polycystic ovaries is bad because it can only be managed not cured. It has significant reproductive implications for women, including increased risk of anovulatory infertility, miscarriage, and pregnancy-related complications.

What is Stromal Hyperthecosis?

Stromal hyperthecosis are presence of nests of luteinized theca cells in the ovarian stroma due to differentiation of the ovarian interstitial cells into steroidogenically active luteinized stromal cells.

What is the Pathology of Stromal Hyperthecosis?

The pathology of stromal hyperthecosis is:

-Etiology: The cause of stromal hyperthecosis is unknown. However, it may be due to genetic transmission.

-Genes involved: CDH1 gene. 

-Pathogenesis: The sequence of events that lead to stromal hyperthecosis is unknown.

-Morphology: The morphology associated with stromal hyperthecosis shows uniform enlargement of both ovaries,

-Histology: The histology associated with stromal hyperthecosis shows scattered nests of luteinized theca cells

How does Stromal Hyperthecosis Present?

Patients with stromal hyperthecosis typically females in 60-70 years age and less common in reproductive age. The symptoms, features, and clinical findings associated with stromal hyperthecosis include: slowly progressive acne, hirsutism, virilization, obesity with striking virilization and insulin resistance.

How is Stromal Hyperthecosis Diagnosed?

Stromal hyperthecosis is diagnosed by histological examination of ovaries, sonography. 

How is Stromal Hyperthecosis Treated?

Stromal hyperthecosis is treated by: antiandrogen therapy, Possibly excision, leuprolide if poor surgical candidate.   

What is the Prognosis of Stromal Hyperthecosis?

The prognosis of stromal hyperthecosis is good. However an increased risk for metabolic complications of hyperlipidemia and type 2 diabetes is there.

What are Ovarian Tumors?

Ovarian tumors are solid mass of tissue that are formed when abnormal cells group together in ovaries

Examples of ovarian tumors include: 

  • Epithelial tumors
  • Germ cell tumors
  • Sex cord stromal tumors
  • Metastatic tumors

What are Epithelial Tumors?

Epithelial tumors are benign tumors present on the outer surface of ovaries  

Examples of epithelial tumors include:

  • Clear cell carcinoma
  • Cystadenofibroma
  • Endometrioid ovarian tumors
  • Mucinous tumors
  • Serous tumors
  • Transitional cell tumors

What is Clear Cell Carcinoma of the Ovary?

Clear cell carcinoma of the ovary is a distinct entity of epithelial ovarian cancer which is Malignant epithelial tumor composed of clear, eosinophilic or hobnail cells with tubulocystic, papillary and solid growth patterns.

What is the Pathology of Clear Cell Carcinoma of the Ovary?

The pathology of clear cell carcinoma of the ovary is:

-Etiology: The cause of clear cell carcinoma of the ovary is endometriosis or clear cell adenofibroma, mutations in genes.

-Genes involved:  ESPL1 and CDC25C genes.

-Pathogenesis: The sequence of events that lead to clear cell carcinoma of the ovary are malignant proliferation.

-Morphology: The morphology associated with clear cell carcinoma of the ovary shows cysts with chocolate colored fluid, spongy appearance of cysts.

-Histology: The histology associated with clear cell carcinoma of the ovary shows Nuclear pseudoinclusions, uniform nuclear atypia, Peritumoural infiltrate.

How does Clear Cell Carcinoma of the Ovary Present?

Patients with clear cell carcinoma of the ovary typically females with mean age of 55 -56 years age. The symptoms, features, and clinical findings associated with clear cell carcinoma of the ovary include: pelvic mass, lump in the abdomen or pain or discomfort. 

How is Clear Cell Carcinoma of the Ovary Diagnosed?

Clear cell carcinoma of the ovary is diagnosed by: microscopic examination, blood test for CA-125, ultrasound, CT scan, MRI.   

How is Clear Cell Carcinoma of the Ovary Treated?

Clear cell carcinoma of the ovary is treated by: total abdominal hysterectomy and bilateral salpingo-oophorectomy and omentectomy, Adjuvant chemoradiation, cytoreductive surgery.

What is the Prognosis of Clear Cell Carcinoma of the Ovary?

The prognosis of clear cell carcinoma of the ovary is excellent for first or second stage cancers. But for 3rd or 4th stage the overall survival is 52%.   

What is Cystadenofibroma of the Ovary?

Cystadenofibroma of the Ovary is a relatively rare benign ovarian tumor that contains both epithelial and fibrous stromal components which often appears complex; cystic- to solid-appearing masses and it often resembles a malignant tumor.

What is the Pathology of Cystadenofibroma of the Ovary?

The pathology of cystadenofibroma of the ovary is:

-Etiology: The cause of cystadenofibroma of the ovary is unknown.

-Genes involved: CALB2 gene.

-Pathogenesis: The sequence of events that lead to cystadenofibroma of the ovary is unknown.

-Morphology: The morphology associated with cystadenofibroma of the ovary shows Varied solid areas with knobby papillae to firm confluent areas.

-Histology: The histology associated with cystadenofibroma of the ovary shows fibrous stroma.

How does Cystadenofibroma of the Ovary Present?

Patients with cystadenofibroma of the ovary typically females of adult reproductive age. The symptoms, features, and clinical findings associated with cystadenofibroma of the ovary include: ovarian mass, lower discomfort, nausea and poor appetite.

How is Cystadenofibroma of the Ovary Diagnosed?

Cystadenofibroma of the ovary is diagnosed by blood tests for CA125, pelvic ultrasound, CT scan, MRI.

How is Cystadenofibroma of the Ovary Treated?

Cystadenofibroma of the ovary is treated by: Surgery cystectomy or oophorectomy.  

What is the Prognosis of Cystadenofibroma of the Ovary?

The prognosis of cystadenofibroma of the ovary is excellent with prompt and appropriate treatment. May recur after incomplete excision.  

What are Endometrioid Ovarian Tumors?

Endometrioid ovarian tumors is ovarian carcinoma resembling endometrioid adenocarcinoma of the endometrium.

What is the Pathology of Endometrioid Ovarian Tumors?

The pathology of endometrioid ovarian tumors is:

-Etiology: The cause of endometrioid ovarian tumors is unknown.

-Genes involved: PTEN, CTNNB1, PIK3CA, KMT2D, KMT2B, PIK3R1, ARID1A and TP53.

-Pathogenesis: The sequence of events that lead to endometrioid ovarian tumors are: the molecular alterations cause changings in pathways especially beta catenin signaling pathway or PI3K pathway due to which the cell cycle s disturbed hence causing tumors. 

-Morphology: The morphology associated with endometrioid ovarian tumors shows Cystic with solid component and areas of hemorrhage.

-Histology: The histology associated with endometrioid ovarian tumors shows Stromal invasion. 

How does Endometrioid Ovarian Tumors Present?

Patients with endometrioid ovarian tumors typically are females with mean age of 50 years. The symptoms, features, and clinical findings associated with endometrioid ovarian tumors include abdominal distention and pain, pelvic pain, gastrointestinal symptoms, palpable mass, vaginal bleeding, dysmenorrhea and dyspareunia.

How is Endometrioid Ovarian Tumors Diagnosed?

Endometrioid ovarian tumors is diagnosed by blood tests for CA125, MRI, histological examinations. 

How is Endometrioid Ovarian Tumors Treated?

Endometrioid ovarian tumors is treated by: surgery, chemotherapy for stage 1 and 2, platinum based therapy for advanced stages.  

What is the Prognosis of Endometrioid Ovarian Tumors?

The prognosis of endometrioid ovarian tumors is good but depends on stages. 95% for stage 1 and 2 and 51% for stage 3 and 4. 

What are Mucinous Tumors of the Ovary?

Mucinous Tumors of the Ovary are epithelial ovarian tumors that arise from the transformed cells of the coelomic epithelium that look like the cells of the endocervical epithelium endocervical or müllerian type. 

What is the Pathology of Mucinous Ovarian Tumors?

The pathology of mucinous ovarian tumors is:

-Etiology: The cause of mucinous ovarian tumors is genetic mutations.

-Genes involved: KRAS, BRAF, TP53 and CDKN2A genes/

-Pathogenesis: The sequence of events that lead to mucinous ovarian tumors is malignant proliferation.

-Morphology: The morphology associated with mucinous ovarian tumors shows endocervical-type differentiation.

-Histology: The histology associated with mucinous ovarian tumors shows stromal invasion, intestinal type glands, signet ring cells.

How does Mucinous Ovarian Tumors Present?

Patients with mucinous ovarian tumors typically are females in 20s and 40s years of age. The symptoms, features, and clinical findings associated with mucinous ovarian tumors include: large ovarian mass felt in belly, bloating, fatigue, pain.

How is Mucinous Ovarian Tumors Diagnosed?

Mucinous ovarian tumors is diagnosed by: blood tests for CA125, trans-vaginal ultrasound, CT scan, MRI.  

How is Mucinous Ovarian Tumors Treated?

Mucinous ovarian tumors is treated by surgery, chemotherapy, platinum-based chemotherapy drugs.

What is the Prognosis of Mucinous Ovarian Tumors?

The prognosis of mucinous ovarian tumors is good. Most women are cured and have no further problems. There is a small risk of the tumor returning.

What are Serous Tumors of the Ovary?

Serous Tumors of the Ovary is the tumor arose from the serous membrane, in the epithelial layer in the abdominopelvic cavity.

What is the Pathology of Serous Ovarian Tumors?

The pathology of serous ovarian tumors is:

-Etiology: The cause of serous ovarian tumors is nulliparity. 

-Genes involved: BRCA1 and BRCA2 genes.

-Pathogenesis: The sequence of events that lead to serous ovarian tumors normal fimbrial epithelium implanted on the denuded ovarian surface at the site of rupture when ovulation occurs, this tubal epithelium can result in the formation of a cortical inclusion cyst that can then undergo malignant transformation, hence resulting in disease.

-Morphology: The morphology associated with serous ovarian tumors shows cystic, papillary, and solid growth.

-Histology: The histology associated with serous ovarian tumors shows malignant cells.

How does Serous Ovarian Tumors Present?

Patients with serous ovarian tumors typically females mostly at the age 45 to 60 years, The symptoms, features, and clinical findings associated with serous ovarian tumors include: pain, bloating, nausea, constipation, anorexia, difficulty eating and bowel and urinary changes.

How is Serous Ovarian Tumors Diagnosed?

Serous ovarian tumors is diagnosed by transvaginal ultrasonography, serum CA125 levels, biopsy, and genetic tests for BRCA mutations.  

How is Serous Ovarian Tumors Treated?

Serous ovarian tumors is treated by: surgical cytoreduction for resection of tumors, adjuvant chemotherapy, platinum-taxane based chemotherapy.

What is the Prognosis of Serous Ovarian Tumors?

The prognosis of serous ovarian tumors is good if detected at early stages. Those patients who are diagnosed with advanced-stage disease will develop treatment resistance, which inevitably heralds eventual mortality.

What are Transitional Cell Tumors of the Ovary?

Transitional cell tumors of the ovary resemble urothelium rather than ovarian surface epithelium, described as a primary ovarian carcinoma in which definite urothelial features are present, but no benign, metaplastic and/or proliferating.

What is the Pathology of Transitional Cell Tumors of the Ovary?

The pathology of transitional cell tumors of the ovary is:

-Etiology: The cause of transitional cell tumors of the ovary is unknown.

-Genes involved: UPK3A gene.

-Pathogenesis: The sequence of events that lead to transitional cell tumors of the ovary is malignant proliferation.

-Morphology: The morphology associated with transitional cell tumors of the ovary shows papillary structures with a fibro-vascular core, covered by a transitional epithelium, and the absence of stromal infiltration.

-Histology: The histology associated with transitional cell tumors of the ovary shows malignant cells.

How does Transitional Cell Tumors of the Ovary Present?

Patients with transitional cell tumors of the ovary typically females of any age but most predominantly in 30-70 years of age. The symptoms, features, and clinical findings associated with transitional cell tumors of the ovary include: no symptoms if tumor is small. The larger tumors show abdominal pain, abdominal swelling or distension, uterine bleeding, back pain, bowel or urinary symptoms, and weight loss. 

How is Transitional Cell Tumors of the Ovary Diagnosed?

Transitional cell tumors of the ovary is diagnosed by: physical examination, Microscopic examination, abdominal ultrasound, MRI, blood tests for CA72-4 and CA125 levels.

How is Transitional Cell Tumors of the Ovary Treated?

Transitional cell tumors of the ovary is treated by: surgical resectability, cisplatin-based chemotherapy.  

What is the Prognosis of Transitional Cell Tumors of the Ovary?

The prognosis of transitional cell tumors of the ovary is better. The predominance of these tumors has a favorable prognostic factor and patients with higher clinical stages has poorer prognoses.

What are Germ Cell Tumors of the Ovary?

Germ cell tumors of the ovary are malignant cancer cells formed in the germ egg cells of the ovary. 

Germ cell tumors of the ovary include: 

  • Choriocarcinoma of the ovary
  • Dysgerminoma of the ovary
  • Yolk sac tumor of the ovary
  • Mixed germ cell tumors of the ovary
  • Embryonal carcinoma of the ovary
  • Polyembryoma of the ovary
  • Teratomas of the ovary

What is Choriocarcinoma of the Ovary?

Choriocarcinoma of the o.vary is highly malignant ovarian tumor which is characterized by the presence of trophoblastic malignant cells, and the production of the pregnancy hormone human chorionic gonadotrophin hCG in the absence of an ongoing pregnancy.

What is the Pathology of Ovarian Choriocarcinoma?

The pathology of ovarian choriocarcinoma is:

-Etiology: The cause of ovarian choriocarcinoma is hydatidiform mole, spontaneous abortion.

-Genes involved:  CSH1 gene.

-Pathogenesis: The sequence of events that lead to ovarian choriocarcinoma is malignant proliferation.

-Morphology: The morphology associated with ovarian choriocarcinoma shows circumscribed hemorrhagic mass, hemorrheage and necrosis and tumor cells resembling placental trophoblastic cell.

-Histology: The histology associated with ovarian choriocarcinoma shows malignant cells.

How does Ovarian Choriocarcinoma Present?

Patients with ovarian choriocarcinoma typically in females at young age. Women over the age of 40 are at increased risk for gestational choriocarcinoma. The symptoms, features, and clinical findings associated with ovarian choriocarcinoma include: lower abdominal pain, atypical genital bleeding, amenorrhea, nausea, and vomiting.

How is Ovarian Choriocarcinoma Diagnosed?

Ovarian choriocarcinoma is diagnosed by: pelvic exam for lumps, blood test for hCG levels, ultrasound, x-ray, CT scan, MRI. 

How is Ovarian Choriocarcinoma Treated?

Ovarian choriocarcinoma is treated by: methotrexate-based chemotherapy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, conservative surgery.

What is the Prognosis of Ovarian Choriocarcinoma?

The prognosis of ovarian choriocarcinoma is good. The survival rate is 96.4%. It is important to clarify whether the tumor arose from a gestational or nongestational origin in order to understand the prognosis of this disease accurately.

What is Dysgerminoma of the Ovary?

Dysgerminoma of the ovary is a malignant germ cell tumor of the ovary believed to arise from primordial germ cells. 

What is the Pathology of Ovarian Dysgerminoma?

The pathology of ovarian dysgerminoma is:

-Etiology: The cause of ovarian dysgerminoma is not been determined but molecular causes are thought to be.  

-Genes involved: TRC8, RNF139 gene.

-Pathogenesis: The sequence of events that lead to ovarian dysgerminoma are: usually the germ cells are encapsulated at birth within the primordial follicle but if they somehow escape encapsulation, cell death occurs and if the germ cells survive, rapid growth ensues, owing to the lack of normal contact inhibition, hence germ cell tumors are formed.

-Morphology: The morphology associated with ovarian dysgerminoma shows large round cells with a high nuclear to cytoplasmic ratio and many mitoses.

-Histology: The histology associated with ovarian dysgerminoma shows malignant cells.

How does Ovarian Dysgerminoma Present?

Patients with ovarian dysgerminoma typically in females who are adults or at adolescent age. The symptoms, features, and clinical findings associated with ovarian dysgerminoma include: Abdominal pain, abdominal distention, presence of a palpable mass. 

How is Ovarian Dysgerminoma Diagnosed?

Ovarian dysgerminoma is diagnosed by: histological examinations, Serum LDH levels, placental alkaline phosphatase levels, ultrasound.  

How is Ovarian Dysgerminoma Treated?

Ovarian dysgerminoma is treated by: cisplatin based chemotherapy, fertility sparing surgery, radiation therapy.

What is the Prognosis of Ovarian Dysgerminoma?

The prognosis of ovarian dysgerminoma is excellent with treatment. The 5-year actuarial survival rate for all patients is 76% with low recurrence rate. 

What is Yolk Sac Tumor of the Ovary?

Yolk Sac Tumor of the Ovary are a rare, malignant tumor of cells that line the yolk sac of the embryo. They are mostly benign.  

What is the Pathology of Ovarian Yolk Sac Tumor?

The pathology of ovarian yolk sac tumor is:

-Etiology: The cause of ovarian yolk sac tumor is unknown.

-Genes involved: RUNX3 gene mutation.

-Pathogenesis: The sequence of events that lead to ovarian yolk sac tumor is malignant cell proliferation.

-Morphology: The morphology associated with ovarian yolk sac tumor shows large, complex pelvic mass that extends into the abdomen and contains both solid and cystic components.

-Histology: The histology associated with ovarian yolk sac tumor shows Schiller Duval bodies.

How does Ovarian Yolk Sac Tumor Present?

Patients with ovarian yolk sac tumor typically  females at 25-30 years age. The symptoms, features, and clinical findings associated with ovarian yolk sac tumor include: distended abdomen with a palpable adnexal mass, abdominal pain followed by abdominal enlargement. fever, and distended intra-abdominal fluid. 

How is Ovarian Yolk Sac Tumor Diagnosed?

Ovarian yolk sac tumor is diagnosed by immunohistochemical staining, urine pregnancy test, blood tests for CA-125, lactate dehydrogenase LDH, and α-fetoprotein AFP levels, CT scan.  

How is Ovarian Yolk Sac Tumor Treated?

Ovarian yolk sac tumor is treated by: radical surgery or conservative surgery, chemotherapy 

What is the Prognosis of Ovarian Yolk Sac Tumor?

The prognosis of ovarian yolk sac tumor is excellent if diagnosed at early stages. The 5-year survival rate of 95% or more is present after surgery and chemotherapy. 

What are Mixed Germ Cell Tumors of the Ovary?

Mixed germ cell tumors of the ovary is a rare type of cancer that is made up of at least two different types of germ cell tumors.

What is the Pathology of Ovarian Mixed Germ Cell Tumors?

The pathology of ovarian mixed germ cell tumors is:

-Etiology: The cause of ovarian mixed germ cell tumors is multiple causes.

-Genes involved: CD117, CD133, SALL4, OCT4, TCL1 genes.

-Pathogenesis: The sequence of events that lead to ovarian mixed germ cell tumors is malignant proliferation.

-Morphology: The morphology associated with ovarian mixed germ cell tumors shows solid and cystic variegated cut surface. 

-Histology: The histology associated with ovarian mixed germ cell tumors shows mixed germ cell tumors and possibly teratomas.

How does Ovarian Mixed Germ Cell Tumors Present?

Patients with ovarian mixed germ cell tumors typically females at young adolescent age. The symptoms, features, and clinical findings associated with ovarian mixed germ cell tumors include vaginal bleeding, fever, pallor, and edema. A palpable mass is often present.

How is Ovarian Mixed Germ Cell Tumors Diagnosed?

Ovarian mixed germ cell tumors is diagnosed by ultrasonography, measurement of AFP, beta hCG LDH, and CA125 levels in blood, physical examination, and biopsy.

How is Ovarian Mixed Germ Cell Tumors Treated?

Ovarian mixed germ cell tumors is treated by cisplatin combination chemotherapy with etoposide, salpingo-oophorectomy with adjunctive chemotherapy, radiation therapy, and surgical removal. 

What is the Prognosis of Ovarian Mixed Germ Cell Tumors?

The prognosis of ovarian mixed germ cell tumors is good after treatment.  

What are Embryonal Carcinoma of the Ovary?

Embryonal carcinoma of the ovary is one of the most malignant cancers arising in the ovary and is an aggressive tumor due to its tendency to early hematogenous spread. 

What is the Pathology of Ovarian Embryonal Carcinoma?

The pathology of ovarian embryonal carcinoma is:

-Etiology: The cause of ovarian embryonal carcinoma is not clear but genetic and environmental factors are possible factors.

-Genes involved: DNMT3B, DPPA4, GAL, GPC4, POU5F1, and TERF1.

-Pathogenesis: The sequence of events that lead to ovarian embryonal carcinoma is unknown.

-Morphology: The morphology associated with ovarian embryonal carcinoma shows ill-defined masses, smooth or lobulated cut surfaces.

-Histology: The histology associated with ovarian embryonal carcinoma shows solid, tubular, or glandlike, and papillary histological patterns.

How does Ovarian Embryonal Carcinoma Present?

Patients with ovarian embryonal carcinoma typically females at 20-30 years of age. The symptoms, features, and clinical findings associated with ovarian embryonal carcinoma include: abdominal pain, irregular bleeding or dysmenorrhea, vaginal bleeding, abdominal mss and distention.  

How is Ovarian Embryonal Carcinoma Diagnosed?

Ovarian embryonal carcinoma is diagnosed by urine tests for β-hCG levels, sonography, ultrasound, Color Doppler imaging, CT scan.   

How is Ovarian Embryonal Carcinoma Treated?

Ovarian embryonal carcinoma is treated by: laparotomy and salpingo-oophorectomy, chemotherapy, fertility-sparing surgical treatment.  

What is the Prognosis of Ovarian Embryonal Carcinoma?

The prognosis of ovarian embryonal carcinoma is good if treated at early stages. Embryonal carcinoma has the highest rate of lymphovascular invasion and extension into paratesticular tissue. 

What are Polyembryoma of the Ovary?

Polyembryoma of the ovary is a type of tumor that develops from the cells of the gonads i.e., ovary in women. They have a distinctive look because they are composed of many parts that are shaped like embryo.  

What is the Pathology of Ovarian Polyembryoma?

The pathology of ovarian polyembryoma is:

-Etiology: The cause of ovarian polyembryoma is not known.

-Genes involved: AFP gene.

-Pathogenesis: The sequence of events that lead to ovarian polyembryoma is unknown.

-Morphology: The morphology associated with ovarian polyembryoma shows amniotic cavity-like structure.

-Histology: The histology associated with ovarian polyembryoma shows atypia.

How does Ovarian Polyembryoma Present?

Patients with ovarian polyembryoma typically in females. The symptoms, features, and clinical findings associated with ovarian polyembryoma include: unusual bump or mass in the abdomen, abdominal pain, precocious puberty, irregularities in a female’s menstruation.

How is Ovarian Polyembryoma Diagnosed?

Ovarian polyembryoma is diagnosed by ultrasound, CT scan, sonography, and biopsy.

How is Ovarian Polyembryoma Treated?

Ovarian polyembryoma is treated by: surgery to remove tumors, chemotherapy, and radiation therapy.

What is the Prognosis of Ovarian Polyembryoma?

The prognosis of ovarian polyembryoma is not known because of its rarity.

What are Teratomas of the Ovary?

Teratomas of the ovary are the most common germ cell neoplasm and comprised of a number of histologic types of tumors, all of which contain mature or immature tissues of pluripotent cells.

Teratomas of the ovary include: 

  • Mature teratomas
  • Immature teratomas
  • Struma ovarii teratomas
  • Primary ovarian carcinoid tumors within a cystic teratoma

What are Mature Teratomas?

Mature teratomas also called as dermatoid cysts, are a type of germ cell tumor that is usually made up of several different types of tissue, such as hair, muscle, and bone and have ability to make enzymes or hormones that may cause signs and symptoms of disease. They are benign and usually occur in the sacrum or tailbone in newborns or in the testicles or ovaries at the start of puberty. 

What is the Pathology of Mature Teratomas?

The pathology of mature teratomas is:

-Etiology: The cause of mature teratomas is complications in the cell differentiation and specialization processes.

-Genes involved: PTEN gene.

-Pathogenesis: The sequence of events that lead to mature teratomas are: single germ cell after the first meiotic division develops into teratoma and matured.

-Morphology: The morphology associated with mature teratomas shows unilocular, sebaceous material.

-Histology: The histology associated with mature teratomas shows raised protuberance projecting into the cyst cavity.

How does Mature Teratomas Present?

Patients with mature teratomas typically females of younger age group till 30 years. The symptoms, features, and clinical findings associated with mature teratomas include abdominal pain, mass or swelling, and abnormal uterine bleeding, back pain, gastrointestinal disturbances.  

How is Mature Teratomas Diagnosed?

Mature teratomas is diagnosed by ultrasonography, MRI, CT scan, and biopsy. 

How is Mature Teratomas Treated?

Mature teratomas is treated by removal by laparoscopic surgery, oophorectomy, and cystectomy.

What is the Prognosis of Mature Teratomas?

The prognosis of mature teratomas is good.

What are Immature Teratomas?

Immature teratomas are composed of tissues derived from the three germ layers and demonstrate clinically malignant behavior and are distinguished by the presence of immature or embryonic tissues.

What is the Pathology of Immature Teratomas?

The pathology of immature teratomas is:

-Etiology: The cause of immature teratomas is complications in differentiation.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to immature teratomas shows different tissues.

-Morphology: The morphology associated with immature teratomas shows cysts with serous or mucinous fluid.

-Histology: The histology associated with immature teratomas shows neurotubules or rosettes with different types of tissues.

How does Immature Teratomas Present?

Patients with immature teratomas typically in females at any age but mostly in first two decades of life. The symptoms, features, and clinical findings associated with immature teratomas include: Painful abdominal mass, bleeding.

How is Immature Teratomas Diagnosed?

Immature teratomas is diagnosed by blood test to estimate levels of AFP, CA-125, CA 19-9, and CEA, MRI, CT scan, ultrsonography.

How is Immature Teratomas Treated?

Immature teratomas is treated by surgery and chemotherapy.

What is the Prognosis of Immature Teratomas?

The prognosis of immature teratomas is good.

What are Struma Ovarii Teratomas?

Struma ovarii teratomas are specialized or monodermal teratoma predominantly composed of mature thyroid tissue. 

What is the Pathology of Struma Ovarii Teratomas?

The pathology of struma ovarii teratomas is:

-Etiology: The cause of struma ovarii teratomas is unknown.

-Genes involved: BRAF gene.

-Pathogenesis: The sequence of events that lead to struma ovarii teratomas is unknown.

-Morphology: The morphology associated with struma ovarii teratomas shows peritoneal or pleural effusion mass.

-Histology: The histology associated with struma ovarii teratomas shows thyroid microfollicles with a single cell lining, overlapping nuclei, rare mitotic figures.

How does Struma Ovarii Teratomas Present?

Patients with struma ovarii teratomas typically females between 40-60 years age. The symptoms, features, and clinical findings associated with struma ovarii teratomas include: pain and/or a pelvic mass and less frequently with ascites, hyperthyroidism, absence of thyroid gland enlargement, an elevated thyroglobulin level. 

How is Struma Ovarii Teratomas Diagnosed?

Struma ovarii teratomas is diagnosed by: thyroid function tests, ultrasound, CT scan.

How is Struma Ovarii Teratomas Treated?

Struma ovarii teratomas is treated by: surgery, laparoscopy, hysterectomy with bilateral salpingo-oophorectomy in post menopausal women. 

What is the Prognosis of Struma Ovarii Teratomas?

The prognosis of struma ovarii teratomas is excellent. The prognosis of malignant type disease is not well-characterized, given the rarity of this disease.

What is a Primary Ovarian Carcinoid Tumors within a cystic teratoma?

Primary ovarian carcinoid tumors within a cystic teratoma are relatively rare tumors that resemble well-differentiated neuroendocrine tumors of the gastrointestinal tract. 

What is the Pathology of Primary Ovarian Carcinoid Tumors within a Cystic Teratoma?

The pathology of primary ovarian carcinoid tumors within a cystic teratoma is:

-Etiology: The cause of primary ovarian carcinoid tumors within a cystic teratoma is unknown.

-Genes involved: CDX2.

-Pathogenesis: The sequence of events that lead to primary ovarian carcinoid tumors within a cystic teratoma.

-Morphology: The morphology associated with primary ovarian carcinoid tumors within a cystic teratoma shows multicystic masses containing viscous sebaceous material and hairs.

-Histology: The histology associated with primary ovarian carcinoid tumors within a cystic teratoma shows cysts with different tissue types.

How does Primary Ovarian Carcinoid Tumors within a Cystic Teratoma Present?

Patients with primary ovarian carcinoid tumors within a cystic teratoma typically females at intra- or postmenopause or >40 years age. The symptoms, features, and clinical findings associated with primary ovarian carcinoid tumors within a cystic teratoma include: pelvic mass, abdominal distension and pelvic pain, abnormal uterine bleeding.

How is Primary Ovarian Carcinoid Tumors within a Cystic Teratoma Diagnosed?

Primary ovarian carcinoid tumors within a cystic teratoma is diagnosed by CT scan, MRI, ultrasonography, blood tests for CA125 levels, physical examination, and biopsy.

How is Primary Ovarian Carcinoid Tumors within a Cystic Teratoma Treated?

Primary ovarian carcinoid tumors within a cystic teratoma is treated by: hysterectomy with bilateral salpingo-oophorectomy, and fertility-sparing surgery.

What is the Prognosis of Primary Ovarian Carcinoid Tumors within a Cystic Teratoma?

The prognosis of primary ovarian carcinoid tumors within a cystic teratoma is good. Generally most of the patients remain clear of tumour recurrence or metastasis during follow-up.

What are Sex Cord Stromal Tumors? 

Sex cord stromal tumors are groups of tumors composed of granulosa cells, theca cells, sertoli cells, leydig cells, and fibroblasts of stromal origin, singly or in various combinations.

Examples of sex cord stromal tumors include: 

  • Fibromas
  • Fibrothecomas
  • Granulosa cell tumors
  • Sertoli-leydig cell tumors
  • Thecomas
  • Hilus cell tumors aka pure leydig cell tumors
  • Gonadoblastoma
  • Pregnancy luteoma

What are Fibromas?

Fibromas are benign tumors that are composed of fibrous or connective tissue. They can grow in any organ. 

What is the Pathology of Fibromas?

The pathology of fibromas is:

-Etiology: The cause of fibromas is unknown.

-Genes involved: TP53, ESR1 gene/

-Pathogenesis: The sequence of events that lead to fibromas are: due to hereditary or sporadic genetic abnormalities, the ovarian stromal cells are transformed into neoplasms.  

-Morphology: The morphology associated with fibromas shows Well circumscribed mass with smooth, lobulated surface.

-Histology: The histology associated with fibromas shows nonencapsulated, Variably cellular fascicular or less frequently, storiform growth of tumor cells.

How does Fibromas Present?

Patients with fibromas typically are females Mean age 48 years, uncommon before 30. The symptoms, features, and clinical findings associated with fibromas include: ovarian mass, such as abdominal pain, pelvic pain, abnormal bleeding, prolonged periods or distension and increased urinary frequency.

How is Fibromas Diagnosed?

Fibromas is diagnosed by blood tests for CA125 levels, pelvic examination, ultrasonography, CT scan, MRI. 

How is Fibromas Treated?

Fibromas is treated by surgical excision salpingo-oophorectomy, oophorectomy or ovarian sparing procedure, hysterectomy, myomectomy.

What is the Prognosis of Fibromas?

The prognosis of fibromas is excellent. Cellular fibromas may recur, often after a long interval, warranting long term follow up. 

What are Fibrothecomas?

Fibrothecomas are a spectrum of benign sex cord–stromal tumors composed of fibroblastic stromal cells and/or luteinized theca-like cells. When both cell types are present in a tumor, it is typically classified as fibrothecoma.

What is the Pathology of Fibrothecomas?

The pathology of fibrothecomas is:

-Etiology: The cause of fibrothecomas is mass effect causing compression on different organs.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to fibrothecomas.

-Morphology: The morphology associated with fibrothecomas shows heterogeneous solid mass.

-Histology: The histology associated with fibrothecomas shows fibrous tissue.

How does Fibrothecomas Present?

Patients with fibrothecomas typically females at any age, but most commonly arise in middle-aged to postmenopausal women. The symptoms, features, and clinical findings associated with fibrothecomas include: menorrhagia, abdominal pain, pleural effusion, abdominal distention. 

How is Fibrothecomas Diagnosed?

Fibrothecomas is diagnosed by ultrasound, CT scan, histological studies, and laparotomy.

How is Fibrothecomas Treated?

Fibrothecomas are treated by resection.

What is the Prognosis of Disease With First Letters Capitalized?

The prognosis of fibrothecomas is unknown.

What are Granulosa Cell Tumors?

Granulosa cell tumors are that which arise from granulosa cells. They are estrogen secreting tumors and present as large, complex, ovarian masses.

What is the Pathology of Granulosa Cell Tumors?

The pathology of granulosa cell tumors is:

-Etiology: The cause of granulosa cell tumors is unknown.

-Genes involved: GSP oncogene, AKT gene, FOXL2, C134W.

-Pathogenesis: The sequence of events that lead to granulosa cell tumors.

-Morphology: The morphology associated with granulosa cell tumors shows unilateral, Encapsulated with smooth lobulated surface.

-Histology: The histology associated with granulosa cell tumors shows trabecular and corded, insular, microfollicular patterns.

How does Granulosa Cell Tumors Present?

Patients with granulosa cell tumors typically females of wide age range, most common in postmenopausal women with peak age 50 – 55 years. The symptoms, features, and clinical findings associated with granulosa cell tumors include abdominal pain and abnormal vaginal bleeding, menorrhagia, irregular menstruation, or amenorrhea. 

How is Granulosa Cell Tumors Diagnosed?

Granulosa cell tumors is diagnosed by pelvic examination, ultrasonography, CT scanning, and biopsy.

How is Granulosa Cell Tumors Treated?

Granulosa cell tumors is treated by surgical excision, hormone modulation therapy, chemotherapy, and radiation therapy.

What is the Prognosis of Granulosa Cell Tumors?

The prognosis of granulosa cell tumors is good. But homozygous FOXL2 mutation and chromosomal imbalance are associated with early relapse and worse outcome.

What are Sertoli-Leydig Cell Tumors?

Sertoli-leydig cell tumors are a rare cancer of the ovaries which produce and release a male sex hormone called testosterone.

What is the Pathology of Sertoli-Leydig Cell Tumors?

The pathology of sertoli-leydig cell tumors is:

-Etiology: The cause of sertoli-leydig cell tumors is unknown but genetic mutations might be the cause.

-Genes involved: DICER1 gene.

-Pathogenesis: The sequence of events that lead to sertoli-leydig cell tumors are germline mutations in DICER1, a gene encoding the RNase III enzyme in the microRNA maturation pathway.

-Morphology: The morphology associated with sertoli-leydig cell tumors shows unilateral, solid cut surface, with cystic components.

-Histology: The histology associated with sertoli-leydig cell tumors shows Cystic component, Open or compressed Sertoli cell tubules, admixed with clusters of Leydig cells in the intervening stroma.

How does Sertoli-Leydig Cell Tumors Present?

Patients with sertoli-leydig cell tumors typically in females with a mean age of 25 years. The symptoms, features, and clinical findings associated with sertoli-leydig cell tumors include pelvic pain or a pelvic mass, hirsutism, clitoromegaly, breast atrophy and menstrual irregularity or amenorrhea.

How is Sertoli-Leydig Cell Tumors Diagnosed?

Sertoli-leydig cell tumors is diagnosed by: blood tests for testosterone levels, CT scan, MRI, ultrasound.

How is Sertoli-Leydig Cell Tumors Treated?

Sertoli-leydig cell tumors is treated by conservative fertility sparing surgery, lymphadenectomy, bilateral salpingo-oophorectomy, platinum based adjuvant chemotherapy. 

What is the Prognosis of Sertoli-Leydig Cell Tumors?

The prognosis of sertoli-leydig cell tumors is good overall. Patients with germline DICER1 mutations have a favorable prognosis compared with those with somatic DICER1 mutations only.

What are Thecomas?

Thecomas are benign ovarian neoplasms composed only of theca cells and produce estrogen.

What is the Pathology of Thecomas?

The pathology of thecomas is:

-Etiology: The cause of thecomas is unknown.

-Genes involved: PTCH gene.

-Pathogenesis: The sequence of events that lead to thecomas.

-Morphology: The morphology associated with thecomas shows unilateral, solid, lobulated mass with cystic change and hemorrhage.

-Histology: The histology associated with thecomas shows ovoid to round nuclei, Indistinct cell membranes impart a syncytial appearance.

How does Thecomas Present?

Patients with thecomas typically in females with age ranges from 16 to 81 years. The symptoms, features, and clinical findings associated with thecomas include postmenopausal bleeding, pelvic pain and pressure, abdominal bloating, non-specific abdominal discomfort and abdominal pain.

How is Thecomas Diagnosed?

Thecomas is diagnosed by biopsy, histologic examination, serum levels of inhibin A and inhibin B, sonography, MRI, CT scan, PET scan. 

How is Thecomas Treated?

Thecomas is treated by oophorectomy for fertility sparing, total hysterectomy with bilateral salpingo-oophorectomy in post-menopausal women.

What is the Prognosis of Thecomas?

The prognosis of thecomas is good but the prognosis of malignant thecomas is poor, postoperative systemic chemotherapy or radiotherapy to the patients with malignant thecomas can improve their survival. 

What are Hilus Cell Tumors aka pure Leydig Cell Tumors?

Hilus cell tumors aka pure leydig cell tumors are uncommon branch of androgen producing neoplasms which are mostly benign and have characteristic gross and microscopic features.

What is the Pathology of Hilus Cell Tumors?

The pathology of hilus cell tumors is:

-Etiology: The cause of hilus cell tumors is unknown.

-Genes involved: DICER1 gene.

-Pathogenesis: The sequence of events that lead to hilus cell tumors are unknown. 

-Morphology: The morphology associated with hilus cell tumors shows unilateral lesions.

-Histology: The histology associated with hilus cell tumors shows large lipid laden cells with distinct borders. Reinke crystals are common.

How does Hilus Cell Tumors Present?

Patients with hilus cell tumors typically in females 32 to 82 years of age range. The symptoms, features, and clinical findings associated with hilus cell tumors include intestinal obstruction, virilization, hirsutism, baldness, deeping of voice, clitoromegaly, and amenorrhea.

How is Hilus Cell Tumors Diagnosed?

Hilus cell tumors is diagnosed by: microscopic examination, blood test for testosterone levels, ultrasound, CT scan.

How is Hilus Cell Tumors Treated?

Hilus cell tumors is treated by: laparotomy, Total hysterectomy and bilateral salpingoophorectomy. 

What is the Prognosis of Hilus Cell Tumors?

The prognosis of hilus cell tumors is good after excision. 

What is a Gonadoblastoma?

Gonadoblastoma is a rare ovarian lesion that consists of germ cells that resemble those of dysgerminoma and gonadal stroma cells and are benign but sometimes may become malignant. 

What is the Pathology of Gonadoblastoma?

The pathology of gonadoblastoma is:

-Etiology: The cause of gonadoblastoma is abnormal chromosomal karyotype, gonadal dysgenesis

-Genes involved: 46,XY; 45,X/46,XY; or 45,XO karyotypes

-Pathogenesis: The sequence of events that lead to gonadoblastoma are: Gonadal differentiation starts after 5 weeks of gestation and depends on sex chromosome of fetus, errors in this complex multistep process of sexual differentiation may cause dysgenetic gonads.

-Morphology: The morphology associated with gonadoblastoma shows bilateral, tumors usually small and may be microscopic

-Histology: The histology associated with gonadoblastoma shows Nests of dysgerminoma-like germ cells, Hyalinization and calcification

How does Gonadoblastoma Present?

Patients with gonadoblastoma typically in females at age younger than 30 years. The symptoms, features, and clinical findings associated with gonadoblastoma include: distension of abdomen, excessive hair growth over the body and hoarseness of voice, hirsutism, intraabdominal mass, abnormal menstruation.  

How is Gonadoblastoma Diagnosed?

Gonadoblastoma is diagnosed by: ultrasound, CT scan, blood tests for tumor markers, beta hCG and testosterone levels, laparotomy, bilateral oophorectomy and hysterectomy 

How is Gonadoblastoma Treated?

Gonadoblastoma is treated by: local excision, adjuvant chemotherapy  

What is the Prognosis of Disease With First Letters Capitalized?

The prognosis of gonadoblastoma is excellent if no malignancy. Successful pregnancy has been achieved in patients with gonadal dysgenesis following stimulation of uterine growth with cyclical hormone replacement.

What are Pregnancy Luteomas?

Pregnancy luteoma are rare, nonneoplastic lesions of the ovary thought to be caused by the hormonal effects of pregnancy.

What is the Pathology of Pregnancy Luteomas?

The pathology of pregnancy luteomas is:

-Etiology: The cause of pregnancy luteomas is hormonal effects of pregnancy.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to pregnancy luteomas are: when ovarian parenchyma is replaced by proliferation of luteinized stromal cells that may become hormonally active with production of androgens which occur mostly in female fetus and male fetuses are unaffected. 

-Morphology: The morphology associated with pregnancy luteomas shows solid, soft, tan, or flesh colored, with hemorrhagic foci.

-Histology: The histology associated with pregnancy luteomas shows abundant eosinophilic and finely granular cytoplasm.

How does Pregnancy Luteomas Present?

Patients with pregnancy luteomas typically in females with advanced maternal age i.e., more than 35 years old. The symptoms, features, and clinical findings associated with pregnancy luteomas include: asymptomatic however, virilization to mother and female baby.

How is Pregnancy Luteomas Diagnosed?

Pregnancy luteomas is diagnosed during surgery or imaging like ultrasound, MRI, and CT scan.  

How is Pregnancy Luteomas Treated?

Pregnancy luteomas is treated by surgery. 

What is the Prognosis of Pregnancy Luteomas?

The prognosis of pregnancy luteomas is good. They resolve by 3 months postpartum; androgens levels reduce in the first 2-3 weeks and clinical virilisation symptoms generally disappear in 2–6 months after delivery.

What are Metastatic Tumors to the Ovaries?

Metastatic tumors to the ovaries are an advanced stage malignancy that has spread from the cells in the ovaries to distant areas of the body. Most metastatic tumors to the ovary are from the female genital tract. A particularly interesting tumor that metastasized to the ovaries is the Krukenberg tumor.

What is a Krukenberg tumor?

Krukenberg tumor is a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast.

What is the Pathology of Krukenberg Tumor?

The pathology of krukenberg tumor is:

-Etiology: The cause of Krukenberg tumor is metastases from gastric cancer.

-Genes involved: KRT7 gene.

-Pathogenesis: The sequence of events that lead to Krukenberg tumor are: signet-ring carcinoma of the stomach, which spread within the bloodstream or lymphatic system or within the peritoneal cavity causing enlargement of the ovaries from metastases. 

-Morphology: The morphology associated with krukenberg tumor shows large, bilateral, solid ovarian masses, with clear well-defined margins and ascites.

-Histology: The histology associated with Krukenberg tumor shows malignant cells.

How does Krukenberg Tumor Present?

Patients with Krukenberg tumor typically in females during reproductive years. The symptoms, features, and clinical findings associated with Krukenberg tumor include abdominal or pelvic pain, abdominal bloating, pain during intercourse, and irregular bleeding. 

How is Krukenberg Tumor Diagnosed?

Krukenberg tumor is diagnosed by pelvic ultrasound, CT scan, MRI, and biopsy.

How is Krukenberg Tumor Treated?

Krukenberg tumor is treated by palliative surgeries including unilateral or bilateral salpingo-oophorectomy alone, or a total hysterectomy combined with bilateral salpingo-oophorectomy.

What is the Prognosis of Krukenberg Tumor?

The prognosis of Krukenberg tumor is poor.