Tumors of the Ovary, Maldeveloped Gonads, Fallopian Tube, and Broad Ligament

By Robert E. Scully, Robert H. Young, and Philip B. Clement (Atlas of Tumor Pathology, third series, fascicle 23), 527 pp, with illus, Washington, DC, Armed Forces Institute of Pathology, 1998.With the long-awaited third series of the Armed Forces Institute of Pathology's fascicle on gynecologic pathology, both the title and authorship have expanded to reflect the breadth of the field to date. The 527-page monograph includes 2 new chapters on tumors of the fallopian tube and tumors of the broad ligament and other uterine ligaments, and several others have been revised since the second series was published 20 years ago. Each chapter has been written using the updated World Health Organization nomenclature system for the histologic classification of ovarian tumors. Additionally, the authors include immunohistochemical and molecular pathologic techniques throughout the text.The 27 chapters are superbly written, and the line drawings and photomicrographs are of excellent quality. The increased use of color has enhanced many of the gross and microscopic photomicrographs, in particular the immunohistochemical stains. Comparison tables are used judiciously throughout the text, adding to the overall quality of the monograph. The references are current. The major strength of the monograph is the emphasis on clinicopathologic correlation, which is woven seamlessly throughout the text.The chapters on surface epithelial-stromal tumors provide a thorough description of serous borderline tumors, including the more unusual cribriform and micropapillary patterns. The histologic types of implants of serous borderline tumors are described in detail. The morphologic features of the endocervical and intestinal types of mucinous borderline tumors are described, and theories on the origin of pseudomyxoma peritonei are provided. Explanatory tables list the criteria for distinguishing the site of origin of endometrioid carcinomas that involve both the endometrium and the ovary, an issue that can provide confusion for the pathologist. A complete description of ovarian endometrial stromal sarcomas, adenosarcomas, and carcinosarcomas is presented.The chapters on sex cord–stromal tumors describe sclerosing peritonitis in association with luteinized thecoma, and the section on Sertoli-Leydig cell tumors has been expanded to include an in-depth discussion of those with heterologous elements. Several variants of the yolk sac tumor, within the germ cell group, are described and include the hepatoid, endometrioid, and intestinal types.The chapters on miscellaneous primary tumors and secondary tumors provide a complete review of lesions arising within and metastasizing to the ovary. The chapter on paraendocrine and paraneoplastic syndromes associated with ovarian tumors describes a wide variety of disorders, and various lesions that simulate ovarian neoplasms are described in the chapter on tumorlike lesions.A new addition to this monograph are the chapters on tumors of the fallopian tube, broad ligament, and uterine ligaments. They complete the discussion on lesions of the adnexae.The third series of Atlas of Tumor Pathology is a must read for all pathologists and pathology residents. Once again, Dr Scully, now in collaboration with Drs Young and Clement, has produced one of the best, well-written, and concise reviews of the topic to date. This reviewer only hopes that they don't keep their faithful audience waiting so long for the fourth series!