Proliferating Ovarian “Epithelial” Tumours: A Clinico‐Pathological Analysis of 144 Cases

Abstract

In a 25-year period, 144 patients with proliferating epithelial ovarian tumours were treated at the King George V Memorial Hospital. These tumours were classified according to the World Health Organisation (WHO) Histological Classification of Ovarian Tumours and subsequently divided into 4 grades of proliferation, again on histological criteria. The tumours were staged at laparotomy in accord with the recommendations of the International Federation of Gynecology and Obstetrics (FIGO). Follow-up data, analysed by a life-table method, were correlated against histological type of tumour, histological grade of proliferation, clinical/laparotomy stage, and mode of surgical therapy. Stage 1 proliferating tumours may be treated by surgery alone, including unilateral salpingo-oophorectomy in selected cases. Stage 2 and Stage 3 tumours should be treated similarly to invasive ovarian carcinomas of the same stage, despite their overall favourable prognosis.

Serous borderline (low malignant potential, atypical proliferative) ovarian tumors: Workshop perspectives

“…4,36,37 The variable histological appearance of peritoneal implants and their possible prognostic significance was examined in several studies between 1979 and 1986; these studies failed to document a clear difference in survival between patients with different implant types. 11,38,[39][40][41] During this period, infiltration of underlying normal tissue was documented as a strong adverse prognostic factor by McCaughey et al 42 and Bell and Scully, 43 who carefully distinguished between noninvasive implants with an abundant but superficial stromal reaction and invasive implants with definitive invasion of underlying tissue. Subsequently, Gershenson and Silva 44,45 and later K. Bell and Kurman, 22 although accepting tissue invasion as a poor prognostic feature, suggested additional histological findings in peritoneal lesions without obvious invasion of underlying tissue that might also indicate an adverse prognosis.…”

Borderline epithelial tumors of the ovary

“…Unfortunately, the literature contains numerous reports of Stage III borderlinelike ovarian mucinous tumors associated with pseudomyxoma peritonei. 20,21,67,93 This has led to a falsely high prevalence of advanced-stage disease and an overestimation of the metastatic potential of borderline mucinous tumors. In the absence of pseudomyxoma peritonei, the vast majority of high-stage primary ovarian mucinous tumors contain overtly invasive carcinoma with an infiltrative pattern and almost all are fatal.…”

“…27,29 Fortunately, the approach advocated by some of not diagnosing noninvasive carcinoma within a mucinous borderline tumor has largely been abandoned. 21,23 When noninvasive carcinoma is focal or confined to a few widely spaced and clearly noninfiltrative glands or cysts, diagnosis is not a problem ( Figure 34). More problematic are those tumors in which multiple closely approximated glands lined by histologically malignant epithelium are separated by only thin strands of unaltered ovarian stroma ( Figure 35).…”

“…The vanguard of proponents was led by pathologists and gynecologists in Scandinavia, 8,10,11,14 and a few in the United States 9,[15][16][17][18][19] and Australia. 20,21 Some pathologists in leading academic medical centers refused to incorporate borderline tumor into their diagnostic nomenclature, routinely diagnosing most serous and mucinous borderline tumors as welldifferentiated cystadenocarcinoma until quite late in the 20th century. For instance, a recent review of early-stage ovarian carcinomas from 1980 through 2000 at a leading cancer center resulted in reclassification of 29% of the cases as borderline tumors.…”

A Cell Line, ROSE 199, Derived from Normal Rat Ovarian Surface Epithelium

“…The histology of the pa pillary layer resembles that seen in human ovarian serous papillary cystadenomas of borderline malignancy ( fig. le) [11,13]. Sec tions of a ROSE 199 culture in the process of lifting off the growth surface ( fig.…”