Ovarian serous cystadenoma 2


  • A 49 years old lady
  • Incidental finding of cystic lesion in the pelvis during ultrasound done for routine medical check up.
  • No abdominal pain. Menses are normal
CT scan of the pelvis in axial plane soft tissue window post contrast

CT scan findings:

  • A cystic lesion on the left side of pelvis, measuring about 7x7x6 cm (yellow arrows)
  • The lesion has thin wall, no septa, no calcification within it, no fat component and no enhancement seen post contrast
  • Fluid level is seen within the mass
  • A tubular cystic structure seen adjacent to it may represent dilated fallopian tube (red arrows)
  • No local infiltration, no distant metastasis, no ascites

Intraoperative findings:

  • Left ovarian tumour mainly cystic, 8x10x6 cm. Adhered to lateral pelvic side wall, bladder peritoneum anteriorly and medially to descending colon
  • Left fallopian tube dilated, Right fallopian tube normal
  • No ascites
  • Omentum, bowel, liver and spleen undersurface normal

HPE findings:

  • Macroscopy: specimen labelled as left ovarian cyst consists of a cystic mass weighing 150 gms. The mass measures 95x70x65 mm. Cut section shows a uniloculated cyst filled with fluid. The cyst wall ranging from 1 mm to 6 mm in thickness. There are 2 solid areas noted measuring 22x15x15 mm and 40x25x9 mm.
  • Microscopy: Left ovarian cyst show a benign cyst lined by a single layer or ciliated cuboidal to flattened epithelium. No nuclear atypia. The solid areas show ruptured corpus luteum and area of hemorrhage surrounded by hemosiderin-laden macrophages. No lining epithelium seen. No evidence of malignancy.
  • Interpretation: left ovary: serous cystadenoma

Diagnosis: Ovarian serous cystadenoma


  • Ovarian serous cystadenomas are benign ovarian epithelial tumours.
  • It is the commonest type of ovarian epithelial neoplasm and accounts for 60% of ovarian serous tumours.
  • The peak incidence is at the 4th to 5th decades of life.
  • Usually asymptomatic,  if symptoms are present, they are usually related to mass effect with displacement of adjacent structures.
  • It can be bilateral in 15% of cases.
  • On imaging, it is often seen as a unilocular cystic mass with homogeneous CT attenuation, with a thin regular wall or septum, and usually no endocystic or exocystic vegetation
Author: radhianahassan