On the site of origin of epithelial tumors of the ovary

Ovaries removed at 1,050 autopsies (accidental deaths) and from 300 patients with various benign gynaecological diseases were studied in search of the incipient benign epithelial tumors. One percent of the ovaries contained incipient mucinous tumors, 1.1%--Brenner tumors, 0.5%--endometrioid tumors. The exact percentage of the serous tumors was difficult to establish because of the absence of morphological criteria that distinguish these tumors from tumor-like conditions (inclusion cysts). The mucinous and Brenner tumors, as well as some serous tumors were located deep in the medullary or hilar regions of the ovary and were not connected to the covering of the ovary. The theory of incessant ovulation that links ovulatory damage of the ovarian surface with the initiation of neoplastic growth does not explain the genesis of all epithelial tumors. It is more likely that the latter two types arise in other parts of the female gonad. The process of morphogenesis of epithelial benign tumors is closely related to stromal alterations, specific for each histogenetic entity.

Ovarian tumors; Incipient ovarian tumors; Epithelial tumors of the ovary; Genesis of ovarian tumors

[1] Czernobilsky B.: "Primary epithelial tumors of the ovary". In: Kurman R. J. (ed) "Blaustein's Pathology of the Female Genital Tract". Fourth ed. Springer Verlag, Berlin, 1994, 511.

[2] Russel P.: "Surface epithelial-stromal tumors of the ovary". In: Kurman R. J. (ed) "Blaustein's Pathology of the Female Genital Tract". Fourth ed. Springer Verlag Berlin, 1994, 705.

[3] Scully R. E.: "Minimal cancer of ovary". Clinics Oncol., 1982, 12, 379.

[4] Scully R. E.: "Ovary". In: Henson D. E.,A lborez-Saavedra J. (eds) "The Pathology of Incipient Neoplasia". W. B. Saunders, Philadelphia, 1986, 279.

[5] Scully R. E.: "Pathology of ovarian cancer precursors". J. Cell. Biochem., (Suppl.), 1995, 23, 208.

[6] Blaustein A., Lee H.: "Surface cells of the ovary and pelvic peritoneum: A histochemical and ultrastructural comparison". Gynecol. Oncol., 1979, 8, 34.

[7] Blaustein A., Kaganowicz A., Wells J.: "Tumor markers in inclusion cysts of the ovary". Cancer, 1982, 49, 722.

[8] Deligdish L., Gil J.: "Characterization of ovarian dysplasia by interactive morphometry". Cancer,1989, 63, 743.

[9] Dietel J., Buchhols F., Stoll P.: "Das Ovarielle Deckepithel und Seine Histogenetische Beziehungen zum Ovarialkarzinom". Geburtshilfe Frauenheilkd, 1986, 46, 561.

[10] Hamilton T. C.: "Ovarian cancer. Part I: Biology". Curr. Probl. Cancer, 1992, Jan/Feb, 14-18.

[11] Langchlan S. C.: "Conceptual unity of the mullerian tumor group". Cancer, 1968, 22, 601.

[12] Mulligan R. M.: "A survey of epithelial inclusions in the ovarian cortex of 470 patients". J. Surg. Oncol., 1976, 8, 61.

[13] von Numers C.: "Observations on metaplastic changes in the germinal epithelium of the ovary and on the aetiology of ovarian endometriosis". Acta Obstet Gynecol. Scand., 1965, 44, 107.

[14] Radisavljevic S. V.: "The pathogenesis of ovarian inclusion cysts and cystomas". Obstet. Gynecol., 1977, 49,424.

[15] Shevchuk M. M., Fenoglio C. M., Richart R. M.: "Histogenesis of Brenner tumor". Cancer, 1980a, 46, 2607.

[16] Schevchuk M. M., Fenoglio C. M., Richart R. M.: "Histogenesis Brenner Tumor". Cancer, 1980b, 46, 2617.

[17] Fox H.: "The pathology of early malignant change". In: Sharp F., Mason W. P., Leake R. E. (eds) "Ovarian Cancer. Biological and Therapeutic Challenges". Chapman and Hall Medical, London 1990, 165.

[18] Fathalla M. F.: "Incessant ovulation - a factor in ovarian neoplasia?". Lancet, 1971, 2, 163.

[19] La Vecchia C., Franceschi S., Gallus G. et al.: "Incessant ovulation and ovarian cancer: a critical approach". In J. Epidemiol., 1983, 12, 161.

[20] Salazar H., Godwin A. K.. Daly M. B., Laub P. B., Hogan W. M., Rosenblum N.,B oenteM . P. et al.: "Microscopic benign and invasive malignant neoplasms and a cancer-prone phenotype in prophylactic oophorectomies". J. Natl. Cancer Inst., 1996, 88, 1810.

[21] Arey L.B.: "The origin and form of the Brenner tumor". Am. J. Obstet. Gynecol., 1961, 81, 743.

[22] Berge T.,B orglin N.E .: "Brenner Tumors". Cancer, 1967, 20, 308.

[23] Green R. R.: "The diverse origin of Brenner Tumors". Am. J. Obstet. Gynecol., 1952, 64, 878.

[24] Schiller H.: "Zur Histogenese der Brennerschen ovarial Tumoren". Arch. Gynakol., 1934, 157, 65.

[25] Stange H. H., Schaumkell K. W.: "Ein Beitrag zur formalen und kausalen Genese der Brenner Tumoren". Zentralb fur Gynakol., 1957, 9, 351.

[26] Stohr G.: "The relationship of the Brenner tumor to the rete ovarii". Am. J. Obstet. Gynecol., 1956, 72, 389.

[27] McCluskey L. L., Dubeau L.: "Biology of ovarian cancer" Current Opinion in Oncology, 1997, 9, 465.

[28] van Wagenen G., Simpson M. E.: "Embryology of the Ovary and Testis". Yale University Press, New Haven and London, 1965, 88.

[29] Haney A. F., Newbold R.R., Fetter B. F.,M cLachlan J. A: "Paraovarian cysts associated with prenatal diethylstilbestrol exposure". Am. J. Pathol., 1986, 124, 405.

[30] Dallenbach-Hellweg G.: "On the histogenesis and morphology of ovarian carcinomas". J. Cancer Res. Clin. Oneal., 1984, 107, 71.

[31] Beller U., Haimovitc R.. Ben-Sasson S.: "Periovulatory multifocal mesothelial proliferation as a possible association with malignant transformation". Int. J. Gynecol. Cancer, 1995, 5, 306.

[32] Rothacker D.: "Benigne und prakanzerose Veranderungen des ovariellen Oberflachenepithels". Pathologe, 1931, 12, 266.

[33] Papadaki L.,B eilby J. 0. W.: "Ovarian cystadenofibroma: A consideration of the role of estrogen in its pathogenesis". Am. J. Obstet. Gynecol., 1975, 121, 501.

[34] Resta L.,R usso S.,C alucci G.A .,P rat J.: "Morphologic precursors of ovarian epithelial tumors". Obstet. Gynecol., 1993, 82, 181.

[35] AdamsT .,A uersperg N.: "Autoradiographic investigation of estrogen binding in cultured rat ovarian surface epithelial cells". J. His toe hem. Cytochem., 1983, 31, 1321.

[36] Jabara A. G.: "Induction of canine ovarian tumors by diethylstilbestrol and progesterone". Aust. J. Exp. Biol., 1962, 40, 139.