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How is teratoma classified?
(1) mature (benign), (2) immature (malignant), and (3) monodermal or highly specialized.
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What is the morphology of mature (Benign) Teratomas?
- 1. unilocular cysts containing hair and cheesy sebaceous material as well as teeth
- 2. the cyst wall is composed of stratified squamous epithelium with skin adnexal structures
- 3.About 1% of the dermoids undergo malignant transformation (mc scc)
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What is the origin of mature cystic teratoma?
from an ovum after the first meiotic division
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What are the mc monodermal or Specialized Teratomas?
carcinoid and struma ovary
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What are the characteristics of The specialized teratomas?
- Always unilateral (difference from metastasis)
- Struma ovarii is composed entirely of mature thyroid tissue which may hyperfunction.
- The ovarian carcinoid arises from intestinal epithelium in a teratoma, may also be functional, if particularly large (>7 cm).
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What are the features of Immature Malignant Teratomas?
- Component tissues resemble embryonal and immature fetal tissue
- The higher the neuroepithelium, the higher the grade, the higher the risk of extraovarian extension
- Seen in prepubertal females (mature seen in reproductive ages)
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What is the ovarian counterpart of seminoma?
Dysgerminoma
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What are the molecular markers of dysgerminoma?
- Oct3, Oct4, and Nanog (maintain pleuripotency)
- c-KIT (receptor tk)
- HCG (if syncytiotrophoblastic tissue present)
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What is the morphology of dysgerminoma?
- 1. large vesicular cells having a clear cytoplasm, well-defined cell boundaries, and centrally placed regular nuclei
- 2. sheets or cords separated by scant fibrous stroma
- 3. As in the seminoma, the fibrous stroma is infiltrated with mature lymphocytes and occasional granulomas
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What is the paraneoplastic syndrome seen in mature cystic benign teratoma?
Limbic encephalitis
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What are the features of Endodermal Sinus (Yolk Sac) Tumor?
- Similar to the normal yolk sac, the tumor is rich in α-fetoprotein and α1-antitrypsin
- Its characteristic histologic feature is a glomerulus-like structure composed of a central blood vessel enveloped by germ cells within a space lined by germ cells (Schiller-Duval body)
- Conspicuous intracellular and extracellular hyaline droplets are present in all tumors, and some of these stain for α-fetoprotein by immunoperoxidase techniques.
- aggressive
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What are features of ovarian choriocarcinoma?
- Very aggressive
- Unlike placental counterpart do not respond to chemo
- Always mixed with other types
- High HCG levels
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Where are the SEX CORD–STROMAL TUMORS derived from?
ovarian stroma, which in turn is derived from the sex cords (undifferentiated gonadal mesenchyme) of the embryonic gonad
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What are the morphological features of Granulosa–Theca Cell Tumors?
- 1.Tumors that are hormonally active have a yellow coloration to their cut surfaces, due to intracellular lipids. The pure thecomas are solid, firm tumors.
- 2. small, distinctive, gland-like structures filled with an acidophilic material recall immature follicles (Call-Exner bodies)
- Positive for inhibin (granulosa component)
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What are the clinical features of Granulosa–Theca Cell Tumors?
- 2/3 in postmenopausal women
- Granulosa cell tumors have clinical importance for two reasons: (1) their potential to elaborate large amounts of estrogen and (2) the small but distinct hazard of malignancy in the granulosa cell forms
- precocious puberty, endometrial hyperplasia, cystic disease of the breast, and endometrial carcinoma
- some may be masculinizing
- Use inhibin as a marker
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