Non-neoplastic Lesions, Pathology of the Ovary

Naveena Singh
In: Encyclopedia of Pathology · 2022 · pp. 1–5 · doi:10.1007/978-3-319-28845-1_5650-1 · W4382120692
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This paper describes non-neoplastic, tumor-like ovarian lesions including follicle cysts, which are solitary physiological cysts over 3 cm that can cause pelvic pain or hormonal manifestations.

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This encyclopedia entry reviews non-neoplastic, tumor-like ovarian lesions listed in the WHO 5th edition of Female Genital Tumours, describing lesions such as follicle cysts and their clinical presentations, age distribution, and presumed hormonal etiologies. It highlights that follicle cysts are physiological, often asymptomatic, but can cause pelvic pain from rupture or torsion and may present hormonal manifestations, with the caveat that the etiologic discussion is framed as believed mechanisms rather than evidence from a single study. Endometriosis is briefly considered within the broader ovarian pathology context, but most of the text is a categorical overview rather than original data. Relevance to endometriosis: endometriosis-associated ovarian neoplasia and endometriosis origin/pathogenesis are cited in the entry’s reference list and the paper notes endometriosis in its brief consideration, though the main focus is non-neoplastic ovarian lesions and their WHO classification.

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Introduction

A variety of non-neoplastic, tumor-like lesions occur in the ovary, some of which are listed in the World Health Organisation Classification of Female Genital Tumours, 5th edition (WHO 2020). The WHO-listed lesions are described briefly below, followed by a brief consideration of endometriosis. Follicle Cyst These are solitary physiological cysts, lined by granulosa cells, which measure >3 cm. These are usually asymptomatic, but may present with pelvic pain due to rupture or torsion, hormonal manifestations such as isosexual pseudoprecocity, or a mass lesion. These are most common in women of reproductive age, but may occur at any age, including in neonates and children (Brandt and Helmrath 2005), as well as after the menopause. In children these may be a component of McCune–Albright syndrome (Rodriguez-Macias et al. 1999). The underlying etiology is believed to be a disturbance in pituitary hormone production with failure in ovulation causing fluid to accumulate in the...

References

and Further Reading Brandt, M. L., & Helmrath, M. A. (2005). Ovarian cysts in infants and children. Seminars in Pediatric Surgery, 14(2), 78–85. https://doi.org/10.1053/j.sempedsurg.2005.01.002. PMID: 15846563. Burandt, E., & Young, R. H. (2014). Pregnancy luteoma: A study of 20 cases on the occasion of the 50th anniversary of its description by Dr. William H. Sternberg, with an emphasis on the common presence of follicle-like spaces and their diagnostic implications. The American Journal of Surgical Pathology, 38(2), 239–244. https://doi.org/10.1097/PAS.0000000000000100. PMID: 24335664. Carrasco-Juan, J. L., Álvarez-Argüelles Cabrera, H., Martín Corriente, M. C., González-Gómez, M., Valladares Parrilla, R., Gutiérrez García, R., & Díaz-Flores, L. (2017). Ovarian Leydig cells (OLC): A histomorphological and immunohistochemical study. Histology and Histopathology, 32(10), 1089–1097. https://doi.org/10.14670/HH-11-876. Epub 2017 Jan 27. PMID: 28127725. Carvalho, L., Podgaec, S., Bellodi-Privato, M., Falcone, T., & Abrão, M. S. (2011). Role of eutopic endometrium in pelvic endometriosis. Journal of Minimally Invasive Gynecology, 18(4), 419–427. https://doi.org/10.1016/j.jmig.2011.03.009. Epub 2011 May 26. PMID: 21620779. Christensen, J. T., Boldsen, J. L., & Westergaard, J. G. (2002). Functional ovarian cysts in premenopausal and gynecologically healthy women. Contraception, 66(3), 153–157. https://doi.org/10.1016/s0010-7824(02)00353-0. PMID: 12384202. Clement, P. B., & Scully, R. E. (1980). Large solitary luteinized follicle cyst of pregnancy and puerperium: A clinicopathological analysis of eight cases. The American Journal of Surgical Pathology, 4(5), 431–438. https://doi.org/10.1097/00000478-198010000-00003. PMID: 7435772. Dunaif, A., Hoffman, A. R., Scully, R. E., Flier, J. S., Longcope, C., Levy, L. J., & Crowley, W. F., Jr. (1985). Clinical, biochemical, and ovarian morphologic features in women with acanthosis nigricans and masculinization. Obstetrics and Gynecology, 66(4), 545–552. PMID: 3900841. Hallatt, J. G., Steele, C. H., Jr., & Snyder, M. (1984). Ruptured corpus luteum with hemoperitoneum: A study of 173 surgical cases. American Journal of Obstetrics and Gynecology, 149(1), 5–9. https://doi.org/10.1016/0002-9378(84)90282-5. PMID: 6720774. Irving, J. A., & McCluggage, W. G. (2007). Ovarian spindle cell lesions: A review with emphasis on recent developments and differential diagnosis. Advances in Anatomic Pathology, 14(5), 305–319. https://doi.org/10.1097/PAP.0b013e3180ca8a5b. PMID: 17717430. Lomme, M., Kostadinov, S., & Zhang, C. (2011). Large solitary luteinized follicle cyst of pregnancy and puerperium: Report of two cases. Diagnostic Pathology, 10(6), 3. https://doi.org/10.1186/1746-1596-6-3. PMID: 21219622; PMCID: PMC3022785. Lynn, K. N., Steinkeler, J. A., Wilkins-Haug, L. E., & Benson, C. B. (2013). 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E., Kay, V. R., Marks, R. M., Liblik, K., Koti, M., & Tayade, C. (2018). The Immunopathophysiology of endometriosis. Trends in Molecular Medicine, 24(9), 748–762. https://doi.org/10.1016/j.molmed.2018.07.004. Epub 2018 Jul 24. PMID: 30054239. Tannus, J. F., Hertzberg, B. S., Haystead, C. M., & Paulson, E. K. (2009). Unilateral luteoma of pregnancy mimicking a malignant ovarian mass on magnetic resonance and ultrasound. Journal of Magnetic Resonance Imaging, 29(3), 713–717. https://doi.org/10.1002/jmri.21530. PMID: 19243065. Wang, Y., Nicholes, K., & Shih, I. M. (2020). The origin and pathogenesis of endometriosis. Annual Review of Pathology, 15, 71–95. https://doi.org/10.1146/annurev-pathmechdis-012419-032654. Epub 2019 Sep 3. PMID: 31479615; PMCID: PMC7980953. WHO Classification of tumours: Female genital tumours (Vol. 4, 5th ed.). 2020. International Agency for Research on Cancer (IARC). ISBN: 978-92-832-4504-9. Yance, V. R. V., Marcondes, J. A. M., Rocha, M. P., Barcellos, C. R. G., Dantas, W. S., Avila, A. F. A., Baroni, R. H., Carvalho, F. M., Hayashida, S. A. Y., Mendonca, B. B., & Domenice, S. (2017). Discriminating between virilizing ovary tumors and ovary hyperthecosis in postmenopausal women: Clinical data, hormonal profiles and image studies. European Journal of Endocrinology, 177(1), 93–102. https://doi.org/10.1530/EJE-17-0111. Epub 2017 Apr 21. PMID: 28432270. Young, R. H., & Scully, R. E. (1984). Fibromatosis and massive edema of the ovary, possibly related entities: A report of 14 cases of fibromatosis and 11 cases of massive edema. International Journal of Gynecological Pathology, 3(2), 153–178. https://doi.org/10.1097/00004347-198402000-00005. PMID: 6490313. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2022 Springer Nature Switzerland AG About this entry Cite this entry Singh, N. (2022). Non-neoplastic Lesions, Pathology of the Ovary. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5650-1 Download citation DOI: https://doi.org/10.1007/978-3-319-28845-1_5650-1 Received: Accepted: Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-28845-1 Online ISBN: 978-3-319-28845-1 eBook Packages: Living Reference MedicineReference Module Medicine

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