Ovary tumor
Other ovarian specific tumors
Adenomatoid tumor

Authors: Joseph Peevy, M.D. and Eman Abdulfatah, M.D. (see Authors page)
Editors: Rouba Ali-Fehmi, M.D., Sudeshna Bandyopadhyay, M.D. Luis Blanco, M.D. and Dong Ping Shi, M.D.

Revised: 10 January 2017, last major update February 2016

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Adenomatoid tumor [title] ovary
Cite this page: Adenomatoid tumor. PathologyOutlines.com website. http://pathologyoutlines.com/topic/ovarytumoradenomatoid.html. Accessed April 23rd, 2017.
Definition / General
  • Benign lesion, often incidental finding on oophorectomy specimen
  • More frequently these lesion are found in males (epididymis, spermatic cord, and testicular membrane); however, in females lesions are seen more commonly in fallopian tubes, broad ligament, and uterus
  • Thought to arise from mesothelial serosal cells.
  • First described by Golden and Ash in 1945 (Am J Pathol 1945;21:63)
Essential Features
  • Rarely found within ovary
  • Typically small with 0.5 - 3cm incidental lesions near hilum
Terminology
  • Previously known as benign mesothelioma of the genital tract
Epidemiology
Sites
  • Ovarian and juxtaovarian sites are rare
  • Occur predominantly at the ovarian hilum and may extend into and replace the ovarian parenchyma
  • Most frequently unilateral, found within fallopian tube, broad ligament, or on uterine serosal surface
Pathophysiology / Etiology
Clinical Features
  • Asymptomatic, discovered as an incidental finding
  • Usually 0.5 - 3.0 cm, rarely larger and symptomatic
Diagnosis
  • Histologic recognition, confirmed by immunophenotype
  • Often incidental
Laboratory
Radiology Description
  • Not routinely performed for primary diagnosis
  • Case reports describe incidental lesions on transvaginal ultrasound displaying multilocular cystic mass often with vascularized central / solid portion
  • Radiographic differential diagnosis, if provided, may include epithelial tumors, inclusion peritoneal cysts, and multiple large follicles
  • CT imaging seldom describes lesion (J Clin Ultrasound 2005;33:233)
Prognostic Factors
  • Benign behavior, no reports of recurrence or malignant transformation
Case Reports
Treatment
  • Excision results in complete cure
  • Recurrence after excision is rare
Gross Description
  • Small, round to oval, well circumscribed tumor
  • Cut surface may have small cystic spaces
Micro Description
  • Composed of clefts and spaces lined by cuboidal, low columnar, or flattened epithelial-like cells
  • Surrounded by connective tissue that varies from loose and edematous to dense and hyalinized
  • The epithelial-like cells may exhibit marked vacoulation, which in some cases may contain weakly basophilic material
  • A spotty lymphoid aggregate may be a low-power clue to the diagnosis
  • Distinctive thread-like bridging strands crossing the tubular spaces are useful diagnostic features
  • Morphologic patterns:
    • Adenoid
    • Angiomatoid
    • Cystic
    • Glandular
    • Solid
    • Tubular
    • Plexiform
    • Canalicular
  • Similar appearance to appearance found within other locations
  • Relatively well-demarcated, non-encapsulated solid aggregates of cells forming cleft-like spaces lined by low-columnar to cuboidal flattened epithelial-like cells
  • Cells often surrounded by stroma that ranges from dense / fibrotic to loose / edematous
  • Epithelial-like cells may display marked vacuolization, signet-ring like appearance, or oxyphilic cytoplasm
Micro Images

Images hosted on PathOut server:

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Scattered cysts



Images hosted on PathOut server contributed by Eman Abdulfatah, M.D.::

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Adenoid pattern, 40x

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Adenoid pattern, 100x


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Angiomatoid pattern, 40x

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Angiomatoid pattern, 100x

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Trabecular pattern, 40x

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Trabecular pattern, 100x

Cytology Description
  • Smears are moderately cellular with sheets of monotonous round to oval cells showing indistinct cell borders and moderate to abundant pale cytoplasm with vacuolations
  • Nuclei are eccentric in location, but regular with inconspicuous nucleoli
Positive Stains
Negative Stains
Electron Microscopy Description
  • No microvilli, no bundles of cytoplasmic filaments, no tight junctional complexes, no intercellular spaces
Molecular / Cytogenetics Description
  • No specific genetic abnormality has been identified
Differential Diagnosis