Bilateral mass lesions of the ovaries

A 50-year-old woman has noted increasing abdominal enlargement for the past year. On physical examination, there is a fluid wave, but no tenderness. Bowel sounds are present. She has no vaginal bleeding. An abdominal ultrasound reveals bilateral 10 and 7 cm adnexal masses. At surgery there are bilateral mass lesions of the ovaries. A total abdominal hysterectomy is performed. Pathologic examination of the ovarian masses reveals that they are unilocular, filled with watery fluid, and covered with papillary excrescences on all surfaces. Which of the following neoplasms is this woman most likely to have?

A Granulosa-theca cell tumors
B Mature cystic teratomas
C Fibrosarcoma with metastases
D Serous cystadenocarcinomas
E Clear cell carcinomas

Ans: D.

CORRECT. This is a classic appearance. However, a borderline serous tumor must be distinguished microscopically.


Option A Incorrect. Granulosa-theca cell tumors or fibrothecomas are solid tumors.
Option B Incorrect. Such 'dermoid cysts' are often filled with sebaceous material and lots of hair.
Option C Incorrect. This is rare. Sarcomas are typically large, solid masses.
Option E Incorrect. Clear cell carcinomas of the ovary are usually solid tumors.