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|Micrograph of serous carcinoma, a type of serous tumour.|
|Classification and external resources|
Serous tumours are part of the surface epithelial-stromal tumour group of ovarian neoplasms, which derive from Mullerian epithelium. They are common neoplasms with a strong tendency to bilaterality, and they account for 50% of all ovarian tumours. Sixty percent are benign (cystadenoma), 10% are borderline and 30% are malignant (cystadenocarcinoma).
Benign serous tumours are unilocular (have one lobe); however if very large may be multilocular, contain clear fluid and have a smooth lining composed of columnar epithelial cells with cilia. On gross examination, the serous tumor may present as either a cystic lesion in which the papillary epithelium is contained within a few fibrous walled cysts, or the papillary projections may be away from the surface epithelium. Surgery is curative.
In borderline lesions, the cyst or surface is lined by papillary structures, which are often very complex. Surgery is usually curative. Microscopically, stromal papillae are covered by atypical epithelial cells, but stromal invasion is absent, nuclear stratification is present.
Malignant serous tumours are solid, may be cystic and often show haemorrhage and necrosis. They are lined by a complex papillary pattern with presence of nuclear anaplasia. Serous carcinomas often have bulky peritoneal and omental metastases, and spread to the lymph nodes is frequent.
Unsurprisingly, 5-year survival decreases as the stage increases. There is a 25% survival rate with a stage III serous carcinoma. Staging:
- Stage I - Tumour growth limited to ovaries.
- Stage II - Growth involving one or both ovaries with pelvic extension.
- Stage III - Tumour involving one or both ovaries with implants outside pelvis.
- Stage IV- Tumour involving one or both ovaries with presence of distant metastasis.