This article reports a case of an ovarian collision tumour consisting of an ovarian fibroma and a serous cystadenoma. A 60-year-old woman exhibited symptoms of post-menopausal bleeding and abdominal pain persisting for three months. Computerized tomography identified a solid mass with a cystic component in the right adnexa, and the patient underwent staging laparotomy. Gross examination of the right ovary revealed a cystic tumour with adjacent solid mass. The histopathological analysis identified a cystic mass that matched the characteristics of a serous cystadenoma, with an adjacent solid mass that matched the characteristics of a sex-cord stromal tumour, both located in the right ovary. Additionally, a small cyst that matched the characteristics of a serous cystadenoma was found in the left ovary. There have been only seven previously reported examples of this specific mix of ovarian tumours. Mostly affecting patients above 60 years of age, although tumour markers levels are normal, such cases may present with a complex clinical scenario, as in this case, and demand a comprehensive diagnostic and therapeutic approach.

Ovarian lesions represent a diagnostic challenge for the radiologist and should be approached according to the patient\'s age, menstrual cycle, and imaging characteristics. These lesions can be cystic, mixed, or solid-predominant structures. Generally, the occurrence of benign lesions surpasses that of malignant ones at a ratio of 3:1. However, within infantile and juvenile age groups, this becomes an infrequent occurrence, making up only about 5% of ovarian tumor cases. This case report sheds light on a unique scenario involving a pediatric patient who harbored 2 benign tumors simultaneously: a mature cystic teratoma and a serous cystadenoma.

Tumors of the ovarian epithelial type of testis are an infrequent entity. We report a case of borderline serous tumor in an 18-year-old male who presented with a right testicular mass, clinically suspicious of carcinoma. After right inguinal exploration, two pedunculated para-testicular masses were identified in the appendix of the right testis and epididymis. The histological features were as complex papillary structures lined by columnar cells with mild to moderate pleomorphism. Microscopically, features of borderline serous testicular tumors are identical to the morphology of the same tumors encountered in the ovarian counterparts. These tumors usually reveal papillae with fibrovascular cores lined by stratified cuboidal to columnar epithelium. This case highlights a need for clinicians and pathologists to be aware of this infrequent entity and improve the best patient management attitude. Serous epithelial tumors are common ovary tumors but are very rare entities in the testis. These tumors originate from the remnant of Mullerian ducts or Mullerian metaplasia of tunica vaginalis and are nonaggressive, even associated with extra ovarian spread, and have outstanding prognosis. A review of the literature has shown nearly fifty reported cases worldwide, and most of the cases occur in young to middle-aged adults.

Serous tubal intraepithelial carcinoma is a precursor lesion for high-grade pelvic serous carcinoma. The incidence is 0.6%-6% in tubectomy specimens of women who are BRCA-1,2 positive or have a strong family history of breast or ovarian cancer. STIC in women who do not have BRCA-1,2 mutations or concomitant high-grade serous carcinoma is exceedingly rare. Ectopic tubal gestation coexisting with serous tubal intraepithelial carcinoma is very rarely reported. These lesions pose considerable difficulty in the diagnosis. A combination of histology and immunohistochemical expression p53 and ki67 substantially improves the reproducibility of the diagnosis. Diagnosing these lesions will help identify potential at risk patients and their families for carcinoma. Adequate prolonged follow-up for incidental serous tubal intraepithelial carcinoma is the mainstay. We report one such case of a 31-year-old female who was operated for the right tubal gestation and found to have serous tubal intraepithelial carcinoma.

Serous endometrial intraepithelial carcinoma is the precursor of invasive uterine serous carcinoma. Here, we present two cases of serous endometrial intraepithelial carcinoma with omental micrometastasis and discuss their clinical significance. Two menopausal patients with abnormal endometrial biopsy findings underwent hysterectomy and comprehensive surgical staging (bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymphadenectomy). Although gross examination failed to detect tumors, the pathological diagnosis was serous endometrial intraepithelial carcinoma. Both patients had omental micrometastasis; they were diagnosed with International Federation of Gynecology and Obstetrics stage IVB disease and received postoperative chemotherapy. One patient died of the carcinoma 9 months after the hysterectomy, and the other had a recurrence of carcinoma 17 months after the end of the initial therapy. The present cases and literature review highlight the importance of meticulous inspection for micrometastasis in the abdominal cavity, including the omentum and peritoneum, for predicting prognosis.

The diagnosis and management of borderline ovarian tumors during pregnancy are still not standardized, because these tumors are rarely encountered. We report the case of a 27-year-old pregnant woman who presented with an ovarian mass in her first trimester. Magnetic resonance imaging revealed a multilocular cystic component with papillary lesions in the background of endometriosis, suggesting a seromucinous borderline tumor or ovarian cancer. A right salpingo-oophorectomy and partial omentectomy were performed at 7 weeks of gestation. Pathological examination demonstrated a serous borderline tumor. The subsequent pregnancy course was uneventful, and she gave birth to a healthy baby at 39 weeks of gestation. She wanted to retain fertility, and close follow-up was performed. Four years later, she became pregnant, and a lesion suggesting recurrence in the left ovary was detected. An abdominal left ovarian cystectomy was performed at 13 weeks of gestation, which demonstrated recurrence of the serous borderline tumor. She gave birth to a healthy baby at 39 weeks of gestation. Two months after delivery, she underwent total abdominal hysterectomy with left salpingo-oophorectomy, which revealed no malignant findings. We also reviewed 10 reports that included 58 cases of borderline ovarian tumors diagnosed during pregnancy. The borderline ovarian tumors diagnosed during pregnancy exhibited different characteristics according to each subtype, suggesting the importance of diagnosing borderline ovarian tumor subtypes preoperatively.

Uterine serous carcinoma is a rare, high-risk histological subtype of endometrial cancer, and use of adjuvant treatment in early stage IA disease is inconsistent, especially when the tumor is confined entirely within an endometrial polyp. We herein present a case of extrauterine recurrence in a 67-year-old female with polyp-confined, stage IA uterine serous endometrial cancer. She underwent comprehensive surgical staging with the pathology returning a 5 cm uterine serous carcinoma confined completely to a 7 cm polyp with negative margins, negative myometrial and lymphovascular space invasion, and twenty-nine negative para-aortic and pelvic lymph nodes. She went on to complete six cycles of adjuvant carboplatin and paclitaxel. She presented with a new pleural effusion approximately 20 months after receiving definitive treatment, and a diagnosis of recurrent, metastatic uterine serous carcinoma was confirmed through cytology. A review of the literature suggests practice patterns involving adjuvant treatment for polyp-confined stage IA uterine serous carcinoma are highly variable. Prospective studies clarifying the utility of adjuvant treatment for polyp-confined disease in comprehensively staged patients, especially pertaining to the impact this pathology has on recurrence risk, are needed for these patients.

Although obesity has been associated with endometrioid (type I) and, to a lesser extent, with serous (type II) endometrial cancer (EC), the association with the same histotypes of ovarian cancer (OC) remains unclear. Therefore, we intended to compare the role of BMI in carcinogenesis of endometrioid and the serous malignancies, at both ovarian and endometrial level.
A retrospective case-to-case study was performed in the University Hospital of Bologna (Italy), through the review of primary EC matched with the corresponding OC cases in the same period (1988-2017).
We included 1052 women diagnosed with EC (n = 897 endometrioid, n = 52 serous) and 955 women affected by OC (n = 132 endometrioid, n = 627 serous). EC patients had higher median BMI than women diagnosed with OC (27.3 [23.4-31.9] vs 24.9 [21.7-27.5], p < 0.01). After controlling for confounding, 1 unit increase in BMI was associated with a 5% higher odds of endometrial as opposed to ovarian cancer (OR for ovarian as opposed to endometrial cancer 0.95; 95% CI 0.91-0.98, p = 0.004).
Increasing BMI is associated with endometrial rather than ovarian cancer, among both serous and endometrioid histotypes.

Primary retroperitoneal serous cystadenomas (PRSCs) are rare cystic lesions whose pathogenesis is currently not well understood. Although the vast majority of tumors are benign, early recognition and resection is necessary to avoid malignant transformation, rupture, and secondary infection. Here we present the case of a 79-year-old woman who presented with confusion, visual hallucinations, and a history of fall. As part of the work-up for abdominal distension, computed tomography scan of the abdomen and pelvis was performed, which revealed a right-sided retroperitoneal cystic lesion measuring 26.6 × 16.7 cm in size. The lesion was resected laparoscopically, and the surgical specimen measured 28 × 17 cm. Histology revealed a serous cystadenoma. The postsurgical course was uneventful, and no radiological recurrence was noted on 3 months follow-up. Very few primary retroperitoneal cystic lesions have been reported in the literature. Most lesions are benign and predominantly occur in females. They may remain asymptomatic for long periods of time and are usually discovered when they reach very large in size. In rare cases, these lesions may have malignant potential. Diagnosis of PRSC should be considered in the differential diagnosis of all retroperitoneal cysts.