This type of benign ovarian neoplasm occurs more frequently than the pseudomucinous ,variety. Because it, is primarily a papillary growth, the tumor is far more dangerous, for its malignant potentiality is greater. It is the factor, plus the facts that these tumors are more heavily concentrated in the reproductive years, and tend to occur bilaterally more often than the pseudomucinous cyst,that: makes serous.cystadenomas such a problem in therapy.
Benign serous cystadenoma contains two types of papillomata:
1) Simply a connective tissue core covered by a single layer of columnar cells resembling fallopian tubal epithelium.
2) Proliferative; activity of the cyst. is more pronounced, the same central core and the epithelial covering is often several layers thick and is composed of low columnar and, occasionally large rounded vesicular cells, some desquamating. With the serous papillo-matous cystade noma the problem is a more difficult one, particuarly because the histological differentiation between the benign and malignant is such more difficult, and because even cysts which liistologically are benign not infrequently, exhibit essentially malignant characteristics such as implantation infilfrotion of surrounding organs recurrence´ and ultimately the death of the patient
At any rate, the incidence of malignant change in serous papillary- cyst is much high than in the pseudomucinous variety benign commonly ´put at no less than 25 per cent Abel notes :the ratio.. of serous to, pseudomucinous malignancies as 4 : 1, Munnell et al believe it is 7 : 1.
Malignant changes, appear when;
A. The epithelial covering of the papillae piles up into several palisaded layers;
B. greater variation is noted in. the size of the cells;
c. The :growth pattern in the epithelial cells may have become totally irregular;
d. The cells are more hyperchromatic and the nuclei´reveal mitoses;
e. The connective tissue cores and the cyst wall become invased, and large, solid epithelialiuvasive masses are formed.
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