MORPHOLOGIC PRECURSORS OF OVARIAN EPITHELIAL TUMORS

Objective: To correlate various types of hyperplastic lesions of the o varian surface epithelium with primary disease of the female genital t ract. Methods: Using whole-organ multiple sections of the ovary, we st udied 200 hysterectomy and bilateral salpingo-oophorectomy specimens d istributed into four groups: cases without hyperplastic or neoplastic disease in the tube, uterus, or vagina; those with contralateral epith elial ovarian tumors; those with endometrial adenocarcinomas; and thos e with polycystic ovary disease. Results: We found a high frequency of hyperplastic and metaplastic changes in the surface epithelium or in the inclusion cysts in ovaries with contralateral epithelial ovarian t umors (92%), endometrial adenocarcinomas (76%), and polycystic ovary d isease (68%) compared to ovaries without hyperplastic or neoplastic di sease (22%). These changes were frequently associated with intracystic papillae and psammoma bodies similar to those observed in epithelial tumors. The inclusion cysts were unrelated morphologically to signs of preceding ovulation, but were related to deep crypts of the ovarian e pithelium and to stromal hyperplasia. Conclusions: The hyperplastic an d metaplastic changes of the surface epithelium and related inclusion cysts can be considered morphologic precursors of common epithelial tu mors. Similar changes are found as a response to a hormonal ovarian or extraovarian stimulus, which may play an important role in ovarian ca rcinogenesis.