Human Ovarian Tissue Cortex Surrounding Benign and Malignant Lesions

Abstract

Objective: To quantify the number of follicles in patients with ovarian pathologies, benign and malignant, in pregnant and nonpregnant states and to determine how the presence of ovarian masses and BRCA status affects follicular counts. Materials and Methods: Slides from 134 reproductive-aged women undergoing oophorectomy were examined using light microscopy by 3 independent counters blinded to the diagnosis. In all, 20 patients had cancer, 69 had benign conditions, and 35 patients were BRCAþ or had a strong family history of breast and/or ovarian cancer. In all, 10 women were either pregnant or immediately postpartum. Results: Patients undergoing risk-reducing surgery had significantly decreased follicle count compared to physiologic control. Patients with cancer had significantly decreased counts compared to all other groups. There were no differences within the benign cohort. Conclusions: When compared to benign masses, the cortex surrounding an ovarian malignancy has decreased follicle density. The stretch impact may minimize any impact on total follicle numbers. Furthermore, there may be a proliferation of ovarian stroma, with the same number of follicles spread over a larger surface area. This information is important when counseling women with ovarian masses regarding the use of ovarian tissue cryopreservation.

Ovarian tissue cryopreservation in female-to-male transgender people: insights into ovarian histology and physiology after prolonged androgen treatment

“…In case of benign ovarian lesions, ovarian stroma may proliferate, resulting in the same number of follicles but spread over a larger surface area (Pavone et al, 2014). Also, preventive oophorectomy in patients carrying a BRCA mutation did not seem an appropriate control group as the mutation might be associated with reduced follicular pools (Pavone et al, 2014). To put our results in perspective, we compared our findings to ovarian histology of age-matched normal fertile women in other published studies.…”

“…In the described age group (24.3 ± 6.15 years), oophorectomy in healthy normal fertile women rarely occurs, in some exceptions for a benign or malignant ovarian mass. On the basis of the study by Pavone et al (2014), it is shown that this is not an appropriate control group as follicle density in the cortex surrounding an ovarian malignancy is decreased. In case of benign ovarian lesions, ovarian stroma may proliferate, resulting in the same number of follicles but spread over a larger surface area (Pavone et al, 2014).…”

“…On the basis of the study by Pavone et al (2014), it is shown that this is not an appropriate control group as follicle density in the cortex surrounding an ovarian malignancy is decreased. In case of benign ovarian lesions, ovarian stroma may proliferate, resulting in the same number of follicles but spread over a larger surface area (Pavone et al, 2014). Also, preventive oophorectomy in patients carrying a BRCA mutation did not seem an appropriate control group as the mutation might be associated with reduced follicular pools (Pavone et al, 2014).…”

Antimüllerian hormone levels are lower in BRCA2 mutation carriers

“…(18) Histopathology examination of human ovaries suggests that BRCA mutation carriers undergoing risk-reducing oophorectomy have fewer follicles than women undergoing oophorectomy for other reasons. (19)…”

Alginate encapsulation supports the growth and differentiation of human primordial follicles within ovarian cortical tissue

“…Fixed tissue was processed using an automated [50]. Only follicles with a visible oocyte nucleus within the section were counted.…”