Ovarian tumours: classification
- Topic
Ovarian tumours are named after the cell they come from. Knowing the four families, the age of the patient and the marker usually narrows the list.
What it is
The ovary contains three kinds of cell that give rise to tumours: the surface (Müllerian-type) epithelium, the germ cells and the sex cord–stromal cells; it also receives metastases. Epithelial tumours are the commonest and include nearly all ovarian cancers in adults, divided into benign, borderline and malignant. Germ cell tumours are typical of young women and girls and are mostly benign mature teratomas, while sex cord–stromal tumours often make hormones. Serum markers point to particular tumours and are used to follow treatment.
Key facts
- Benign epithelial tumours peak in young to middle adult life; malignant ones in middle and older age.
- Bilateral tumours are more often serous carcinomas or metastases.
- Risk of epithelial cancer rises with nulliparity, family history, BRCA1 and BRCA2, Lynch syndrome and endometriosis; oral contraceptives, pregnancy, breastfeeding and tubal ligation or salpingectomy lower it.
- Mature cystic teratoma is the commonest ovarian tumour in young women.
The four families of ovarian tumours
| Family | Main types | Typical patient | Clues |
|---|---|---|---|
| Surface epithelial | Serous, mucinous, endometrioid, clear cell, Brenner | Adults; cancers mostly after 40 | Often cystic; CA-125; BRCA and Lynch in hereditary cases |
| Germ cell | Teratoma, dysgerminoma, yolk sac tumour, choriocarcinoma | Girls and young women | Rapid growth; AFP, hCG, LDH |
| Sex cord–stromal | Granulosa, thecoma, fibroma, Sertoli–Leydig | Any age; granulosa adult form near menopause | Hormone effects: bleeding, precocious puberty, virilisation; inhibin |
| Metastatic | Krukenberg (signet ring), colorectal, appendiceal, breast | Older adults with a known or hidden primary | Bilateral, surface nodules, gastrointestinal markers |
Markers
- CA-125
- AFP
- hCG
- LDH
- Inhibin
- Estradiol and testosterone
Clinical notes
- Most present with an adnexal mass, pain, bloating or symptoms of hormone excess; malignant epithelial tumours usually present late with ascites.
- Torsion is more common with benign, mobile, moderately sized tumours such as teratomas.
Test yourself
Think of the answer, then tap the question to see it.
What are the four families of ovarian tumours?
Surface epithelial, germ cell, sex cord–stromal, and metastatic tumours.
Which serum marker points to a yolk sac tumour, and which to a granulosa cell tumour?
AFP for yolk sac tumour; inhibin for granulosa cell tumour.
What defines a borderline ovarian epithelial tumour?
Epithelial proliferation with atypia but no destructive stromal invasion; it has an excellent prognosis.
Elsewhere in DurgiPedia
- CA-125
- Alpha-fetoprotein (AFP)
- Tumour markers: principles of use
- Lactate dehydrogenase (LDH) as a lab marker
- Ovary: follicles, ovulation and corpus luteum
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Epithelial Ovarian Cancer (StatPearls (NCBI Bookshelf), 2026); Ovarian Germ Cell Tumors Treatment (PDQ®)–Health Professional Version (National Cancer Institute, 2026).
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Representative model, for educational purposes only.