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Invasive breast carcinoma - IARC

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A<br />

Fig. 2.116 A Adenomatous hyperplasia of the rete ovarii.Note the branching network of spaces. B Cyst of rete ovarii. The cyst lining has shallow infoldings.<br />

B<br />

exceptional. A bilateral tumour with a retiform<br />

tubulopapillary histology admixed<br />

with transitional-like areas has been<br />

reported {2495}. The patient initially had<br />

stage II disease, and the tumour<br />

recurred with elevated serum levels of<br />

CA125.<br />

Adenoma<br />

Adenoma of the rete ovarii typically<br />

occurs as an incidental finding in middleaged<br />

or elderly women, is located in the<br />

hilus and is well circumscribed {2495}. It<br />

is composed of closely packed elongated<br />

tubules, some of which are dilated<br />

and contain simple papillae, and may<br />

show stromal luteinization or concomitant<br />

hilus cell hyperplasia. All re p o rted adenomas<br />

have behaved in a benign fashion.<br />

Cystadenoma and cystadenofibroma<br />

One cystadenofibroma and two cystadenomas<br />

of the rete ovarii, one of which<br />

was bilateral, have been reported {2040}.<br />

In both instances they originated from<br />

the rete, involved only the ovarian medulla<br />

and were tubulopapillary cystic proliferations<br />

of clear columnar cells. The stroma<br />

was densely populated by luteinized<br />

cells, which caused irregular bleeding in<br />

both postmenopausal patients. The bilateral<br />

case had on one side a non-invasive<br />

adenoma but with marked cellular atypia<br />

and pleomorphism.<br />

Adenomatous hyperplasia<br />

Among the proliferative lesions, adenomatous<br />

hyperplasia of the rete ovarii is<br />

similar to the same lesion in the testis<br />

{1169}. It is differentiated from adenoma<br />

only by its poorly defined margins.<br />

Cysts<br />

Most cysts are unilocular with an average<br />

diameter of 8.7cm {2495} and a smooth<br />

inner surface. Histologically, they show<br />

serrated contours with crevice formation.<br />

Their lining consists of a single layer of<br />

cuboidal to columnar non-ciliated cells.<br />

Their walls contain tracts of smooth muscle<br />

and foci of hilus cells, which are<br />

sometimes hyperplastic and may be<br />

responsible for some hormonal manifestations<br />

{2495}.<br />

Tumours and related lesions of the rete ovarii 181

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