Ovary, Benign

Auto text: “Insert Ovary and Tube Tumor” or “Insert Ovaries and Tubes Prophylactic”

Triage

  1. Weigh and measure.
  2. Document if ovary was received intact vs. disrupted/previously opened.
  3. Measure length and diameter of fallopian tube (if attached)
  4. Ink the outer surface of the ovary (cauterized areas may help to identify external surface).
  5. Open cystic structures over sink and note whether cyst is unilocular or multilocular. Describe contents (serous/mucoid, clear, blood, hair, and the amount of fluid).
  6. Describe internal lining surface (smooth, plaque-like thickenings, papillary excrescences, etc.).
  7. Note average thickness of cyst wall or variations of thickness.

Gross

  1. If for prophylactic salpingo-oophorectomy, submit the ENTIRE specimen per SEE-FIM protocol as follows:
    • Ovary serially sectioned.
    • Body of tube transversely sectioned.
    • Fimbriated end of tube radially sectioned (Place NO MORE than 2-3 sections in a cassette to ensure proper orientation).
    • All of associated soft tissue.
    • If a prophylactic uterus was resected with adnexa, please refer to Uterus, BRCA or Uterus, Lynch guidelines.
  1. Simple serous/physiological cyst: If ovarian parenchyma is recognized in the wall, two sections will confirm the diagnosis (i.e. one of cyst wall and one of wall with ovarian stroma).
  2. Dermoid cyst (teratoma): Areas of thickening in the wall may contain tissues of various germ-cell layers and immature elements.  Submit 1 section per cm including sampling the thickened / solid areas thoroughly. The calcified areas do not need to be submitted unless grossly are abnormal.
  3. Endometriotic cyst: Submit 2-3 sections of cyst wall, as well as 1 of normal ovary (if present). Submit all solid areas since tumors may arise in endometriotic cysts.
  4. Mucinous tumors: Even if grossly benign, submit 1 section per cm (2-3 per cassette).
    • For all cysts with thin-walled areas, submit thin walls as a “membrane-roll” rather than strips on edge, which are difficult to embed on edge.

Updated 6-22-2020 SRR

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