Mucinous cystadenoma - Ovary -

This article will help you read and understand your pathology report for mucinous cystadenoma of the ovary.

by Emily Goebel, MD FRCPC, updated on November 7, 2018

Quick facts:
  • Mucinous cystadenoma is a non-cancerous ovarian tumour.
  • These tumours can grow to be very large which can cause significant symptoms for some patients.
The anatomy of the ovary

The ovaries are part of the female reproductive tract. They are small organs that are attached to the uterus by the fallopian tubes. The outer surface of the ovaries are lined by a thin layer of specialized tissue called an epithelium that forms a barrier around the outside of the ovary.

The organs inside the abdomen are lined by a thin layer of tissue called the peritoneum that is made up of similar cells. The ovaries also contain large cells called eggs. The tissue below the epithelium is called stroma.

 

Gynecological tract

What is mucinous cystadenoma?

A mucinous cystadenoma is a non-cancerous ovarian tumour.  While these tumours are non-cancerous, they can grow to be very large in size and can cause significant symptoms for many patients.

How do pathologists make this diagnosis?

Most tumours are similar in look and feel to a balloon filled with fluid. The inside of the tumour may be one large space or many small spaces spaces filled with fluid. Pathologists call these spaces cysts.

When the tumour is examined under the microscope, the tissue on the inside of the cysts is made up of an abnormal type of epithelium that produces a thick, gelatinous fluid called mucin. The mucin fills the inside of the tumour.

Some tumours will have thicker walls or solid areas in the center of the tumour. These tumours contain more cells and less fluid and are called mucinous cystadenofibromas. However, they are still non-cancerous.

For most women, the diagnosis of mucinous cystadenoma is only made when the entire tumour has been surgically removed and sent to a pathologist for examination. The fallopian tube and uterus may be removed at the same time.

In some situations, the surgeon will request an intraoperative or frozen section consultation from your pathologist. The diagnosis made by your pathologist during the intraoperative consultation can change the type of surgery performed or the treatment offered after the surgery is completed.​

Histologic type

There are two types of mucinous cystadenoma. Your pathologist will determine the type of tumour by examining the mucin producing cells in the epithelium under the microscope.

  1. Endocervical – In this type of tumour, the cells in the epithelium look similar to the cells that line the endocervical canal (the canal that leads from the cervix into the uterus).
  2. Intestinal – In this type of tumour the cells in the epithelium look similar to the cells that line the digestive (intestinal) tract.  The intestinal type is more common than the endocervical type.

Both types of tumours are non-cancerous. There is no difference in prognosis between these two types.

Atypia

Atypia is a word pathologists use to describe cells that look different from cells normally found in that location. Most mucinous cystadenomas do not contain any atypical cells. If they do contain atypia, they may be called mucinous tumor with focal atypia.

Examination of the tumour surface

Most mucinous cystadenomas have a smooth outer surface. Any solid areas on the surface will be examined closely under the microscope to make sure they do not contain any abnormal cells.

Epithelial proliferation

The inner surface of most mucinous cystadenomas are lined by a flat single layer of cells. Some tumours, however, have small growths or proliferations of the mucinous epithelium that make them look more complex when examined under the microscope.  If the tumour has areas with these features, it may be called mucinous tumor with focal epithelial proliferation.

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