Morphology: Putting it all Together

Ovarian Masses - Part 6 - 2
Morphology: Putting it all Together

How does morphology Perform in calling something benign?

If you think something is benign using our rules, you will be right almost every time!

How does morphology perform when calling something malignant?

This is where morphology struggles a bit
In Granberg's study, ultrasound tended to overcall things malignant when they were really benign

do postmenopausal women get more ovarian neoplasms?

NO! Actually, 75% of neoplasms occur in pre-menopausal women!
However, if you find a neoplsm in a post-menopausal woman it is more likely to be malignant

HOW GOOD IS MORPHOLOGY AT ACCURATELY DETERMINING the pathologic diagnosis OF A LESION?

Firstly, a minority of histologic types comprise the vast majority of masses
Benign Neoplasms
- Serous/Mucinous cystadenomas and Cystic Teratomas make up approximately 95% of all the lesions we see
- Over half are cystic teratomas and we can confidently diagnose those 75% of the time (link)
- 25% are serous cystadenomas which are either unilocular or oligoseptate, so we will confidently diagnose these as benign
Malignant Neoplasms
- These have many types of appearances which we have already discussed, but the point is that they are NOT going to look like either a cystic teratoma or a serous cystadenoma
Mucinous Cystadenoma (benign)
- This is the "problem child"
- These can look a lot like serous or mucinous cystadenocarcinomas
So, again, our problem isn't calling:
- benign lesions benign or
- malignant lesions benign....
- It's calling a benign lesion malignant

So, doppler must be the answer, right?