Ovarian serous cystadenoma

Case contribution: Dr Radhiana Hassan


  • A 43 years old
  • Presented with irregular menstrual bleeding
  • Ultrasound shows ovarian cyst
Contrast-enhanced CT scan abdomen and pelvis in axial plane, soft tissue window

CT scan findings:

  • There is a large well-encapsulated cystic mass in the pelvis measuring 16x13x11 cm.
  • No solid component or septation seen.
  • No calcification or fat component.
  • The uterus is normal. No ascites.

Intra-operative findings:

  • Large left ovarian cyst measuring 20×15 cm. Removed intact. Opened up after surgery, benign-looking, clear cyst.
  • Uterus is normal in size.
  • Right ovary and both fallopian tubes are normal.
  • No ascites. No endometriotic spot.

HPE findings:

  • Macroscopy: specimen labelled as TAHBSO and left ovarian cyst consist of a uterus, cervix, both ovaries and fallopian tubes with attached ovarian cyst. The left ruptured unilocular cystic lesion located between the left ovary and left fallopian tube. This lesion measures 100×75 mm with the cyst wall 2-4 mm in thickness. No solid area seen.
  • Microscopy: Sections of the left ovarian cyst is lined by cuboidal epithelium to tubal type epithelium. The ecto and endocervix are unremarkable. The endometrium is non-secretory. The right ovary shows cystic follicles and corpora albicans. No malignancy.
  • Interpretation: left ovarian cyst: serous cystadenoma.

Diagnosis: Ovarian serous cystadenoma.


  • Ovarian serous cystadenomas are benign epithelial tumours and comprise about 20% of all benign ovarian tumours.
  • It is usually seen in women between 20 – 60 years
  • Present clinically as cystic adnexal masses
  • 15% are bilateral
  • Imaging findings:  average size of 5-10 cm but frequently grow larger, cysts that may have thin septations and occasionally papillary projections, tend to be unilocular, but may also be multilocular.
  • Histologically lined by a single layer of non-ciliated cuboidal to tall columnar epithelium.
Author: radhianahassan