A serous tumour is a

neoplasm A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

that typically has papillary to solid formations of tumor cells with crowded nuclei, and which typically arises on the modified Mullerian-derived

serous membrane The serous membrane (or serosa) is a smooth tissue membrane of mesothelium lining the contents and inner walls of body cavities, which secrete serous fluid to allow lubricated sliding movements between opposing surfaces. The serous membrane ...

s that surround the

ovaries The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. T ...

in females. Such ovarian tumors are part of the surface epithelial-stromal tumour group of

ovarian tumor Ovarian tumors, or ovarian neoplasms, are tumors arising from the ovary. They can be benign or malignant (ovarian cancer). They consist of mainly solid tissue, while ovarian cysts contain fluid. Histopathologic classification Ovarian tumors are ...

s. They are common neoplasms with a strong tendency to occur bilaterally, and they account for approximately a quarter of all ovarian tumors. Rarely, serous tumors arise from within the uterus, notably uterine serous carcinoma, which typically arises in postmenopausal women. Rarely, serous tumors arise from other parts of the

peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mes ...

, including serous

primary peritoneal carcinoma Primary peritoneal cancer or carcinoma is also known as serous surface papillary carcinoma, primary peritoneal carcinoma, extra-ovarian serous carcinoma, primary serous papillary carcinoma, and psammomacarcinoma. It was historically classified und ...

s. Even more rarely they arise in other body locations, such as the

lungs The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either si ...

Ovarian serous tumours

Low grade

Histopathology of ovarian serous borderline tumor

The "low grade" classification of serous tumors includes benign and borderline tumors, as well as low grade malignant tumors. Benign serous tumors are distinguished from borderline tumors by the absence of cellular stratification. Stromal invasion distinguishes borderline tumors from low grade malignant tumors. Surgery is curative for benign tumors, and likely curative for other low grade tumors. Benign serous tumors include serous cystadenomas, cystadenofibromas, and adenofibromas. Benign and borderline serous tumours are commonly

unilocular A locule (plural locules) or loculus (plural loculi) (meaning "little place" in Latin) is a small cavity or compartment within an organ or part of an organism (animal, plant, or fungus). In angiosperms (flowering plants), the term ''locule'' usu ...

. Benign tumors contain clear fluid and have a smooth lining composed of columnar epithelial cells with

cilia The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike proje ...

. 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. In borderline lesions, the cyst or surface is lined by papillary structures, which are often very complex.

Microscopically Microscopy is the technical field of using microscopes to view objects and areas of objects that cannot be seen with the naked eye (objects that are not within the resolution range of the normal eye). There are three well-known branches of micr ...

, stromal papillae are covered by atypical

epithelial cell Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...

s, but stromal invasion is absent, and nuclear stratification is present. Approximately 15% of serous tumors are borderline. In borderline tumors and low grade carcinomas, psammoma bodies are often found. Serous psammocarcinoma is a low grade variant in which massive psammoma bodies are present.

High grade

High grade serous tumors often involve both ovaries. The tumors are solid and cystic with

haemorrhage Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, v ...

and

necrosis Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated diges ...

. They are morphologically heterogenous. Serous carcinomas often have bulky

peritoneal The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mes ...

and omental

metastases Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, the ...

, and spread to the

lymph node A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that includ ...

s is frequent. Unsurprisingly, 5-year survival decreases as the stage increases. There is a 25%

survival rate Survival rate is a part of survival analysis. It is the proportion of people in a study or treatment group still alive at a given period of time after diagnosis. It is a method of describing prognosis in certain disease conditions, and can be use ...

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.

Epidemiology

25% of ovarian tumors and 40% of

ovarian cancer Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different ...

s are serous tumors. Family history and nulliparity have been identified as risk factors for the disease.

Uterine serous carcinoma

''Uterine serous carcinoma'' is an uncommon form of

endometrial cancer Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most ...

that typically arises in postmenopausal women. It is typically diagnosed on

endometrial biopsy The endometrial biopsy is a medical procedure that involves taking a tissue sample of the lining of the uterus. The tissue subsequently undergoes a histologic evaluation which aids the physician in forming a diagnosis. Medical uses There are a ...

, prompted by

post-menopausal bleeding Vaginal bleeding is any expulsion of blood from the vagina. This bleeding may originate from the uterus, vaginal wall, or cervix. Generally, it is either part of a normal menstrual cycle or is caused by hormonal or other problems of the reproductiv ...

. Unlike the more common low-grade endometrioid endometrial adenocarcinoma, uterine serous carcinoma does not develop from

endometrial hyperplasia Endometrial hyperplasia is a condition of excessive proliferation of the cells of the endometrium, or inner lining of the uterus. Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient levels of t ...

and is not hormone-sensitive. It arises in the setting of endometrial

atrophy Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations (which can destroy the gene to build up the organ), poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply t ...

and is classified as a

type II endometrial cancer Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most o ...

References

External links

{{Medical resources , DiseasesDB = , ICD10 = , ICD9 = , ICDO = , OMIM = , MedlinePlus = , eMedicineSubj = , eMedicineTopic = , eMedicine_mult = , MeshID = Gynaecological cancer