Precancerous Lesions of the Ovary

The late diagnosis in the vast majority of ovarian carcinomas and the high lethality is often attributed to lack of symptoms and absence of any screening system. Ovarian tumors can become available for study in their early invasive or preinvasive stages. The identification of the actual tissue changes that characterize any early neoplastic process is crucial for any screening program. The progress to invasive cancer is however not predictable, and depends on non-morphological factors related to host defense mechanisms, heredity, and oncogenic activity. The vast majority of ovarian malignant neoplasms arise from the surface epithelium or germinal epithelium covering the ovarian surface as an extension of the peritoneal mesothelium, which is a cuboidal flat layer of cells, resting on a basement membrane and often displaying tall columnar cells or papillary infoldings due to inflammatory processes, such as ovulation, endometriosis, and periovarian adhesions due to a variety of causes. The histological identification of the precursors of epithelial cancer is very crucial and contributes to significant decrease in other gynecologic cancers, such as cervical carcinoma and endometrial carcinoma.