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Papillary Serous Cystadenocarcinoma
Etiology

10% of patients have evidence of ovarian or ovarian-breast cancer syndrome (see pathogenesis)
remainder sporadic
Pathogenesis

may be associated with mutations in BRCA1,
Epidemiology

peri- or post-menopausal women of low parity
gonadal dysgenesis
ovarian epithelial cancer = 6% of female cancer; and 50% of female cancer deaths due to late detection and failure to determine high risk group
serous = 40% of ovarian cancers; 2/3 are bilateral
General Gross Description

capsule may be smooth or irregular or show papillary projections
partially cystic partially solid neoplasm
interior papillae are soft and tan over firm dense stroma
cyst fluid is clear, colorless and thin
•Examples:
Ovarian Carcinoma involving the omentum Papillary Serous Cystadenocarcinoma
General Microscopic Description

"finger like" papillae with fibrovascular core
covered by multilayered cuboidal or columnar epithelium
nuclei are hyperchromatic with prominent nucleoli
mitoses frequent
psammomma bodies (concentric lamellated calcifications)
invasion of stroma with fibrosis: "desmoplasia"
•Examples:
Papillary Serous Adenocarcinoma (4X) Papillary Serous Adenocarcinoma (20X) Papillary Serous Adenocarcinoma (40X) Papillary Serous Cystadenocarcinoma (10X) Papillary Serous Cystadenocarcinoma (20X) Papillary Serous Cystadenocarcinoma (40X)
Clinical Correlation

early symptoms vague, late abdominal distension with ascites and pain
rarely detected on routine examination
Stage I confined to ovary(ies), II confined to pelvis, III with extension to abdominal cavity, IV distant metasases
most women Stage III or IV at presentation
spread across serosal surfaces and to lymph nodes
removal of bulk of tumor and chemotherapy are major therapy
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1065-1068

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Papillary Serous Cystadenocarcinoma
Synopsis by: Melinda Sanders M.D. (T87000M84413)[38]
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