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Human Ovarian Tissue Cortex Surrounding Benign and Malignant Lesions

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Abstract

Objective

To quantify the number of follicles in patients with ovarian pathologies, benign and malignant, in pregnant and nonpregnant states and to determine how the presence of ovarian masses and BRCA status affects follicular counts.

Materials and Methods

Slides from 134 reproductive-aged women undergoing oophorectomy were examined using light microscopy by 3 independent counters blinded to the diagnosis. In all, 20 patients had cancer, 69 had benign conditions, and 35 patients were BRCA+ or had a strong family history of breast and/or ovarian cancer. In all, 10 women were either pregnant or immediately postpartum.

Results

Patients undergoing risk-reducing surgery had significantly decreased follicle count compared to physiologic control. Patients with cancer had significantly decreased counts compared to all other groups. There were no differences within the benign cohort.

Conclusions

When compared to benign masses, the cortex surrounding an ovarian malignancy has decreased follicle density. The stretch impact may minimize any impact on total follicle numbers. Furthermore, there may be a proliferation of ovarian stroma, with the same number of follicles spread over a larger surface area. This information is important when counseling women with ovarian masses regarding the use of ovarian tissue cryopreservation.

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Authors and Affiliations

  1. Division of Reproductive Biology, Department of Obstetrics and Gynecology, Northwestern University, IL, Chicago, USA

    Mary Ellen Pavone MD, MSCI

  2. Division of Reproductive Endocrinology and Infertility, Feinberg School of Medicine at Northwestern University, IL, 60611, Chicago, USA

    Mary Ellen Pavone MD, MSCI

  3. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois at Chicago, IL, Chicago, USA

    Jennifer Hirshfeld-Cytron MD, MSCI

  4. Office of Research on Women’s Health, National Institutes of Health, MD, Bethesda, USA

    Candace Tingen PhD

  5. Feinberg School of Medicine at Northwestern University, IL, Chicago, USA

    Cristina Thomas BA & Jessina Thomas BA

  6. Gynecologic Oncology, Advocate Health Care, IL, Chicago, USA

    M. Patrick Lowe MD

  7. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Feinberg School of Medicine at Northwestern University, IL, Chicago, USA

    Julian C. Schink MD

  8. Division of Fertility Preservation, Department of Obstetrics and Gynecology, Feinberg School of Medicine at Northwestern University, IL, Chicago, USA

    Teresa K. Woodruff PhD

Authors
  1. Mary Ellen Pavone MD, MSCI
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  2. Jennifer Hirshfeld-Cytron MD, MSCI
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  3. Candace Tingen PhD
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Correspondence to Mary Ellen Pavone MD, MSCI.

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Pavone, M.E., Hirshfeld-Cytron, J., Tingen, C. et al. Human Ovarian Tissue Cortex Surrounding Benign and Malignant Lesions. Reprod. Sci. 21, 582–589 (2014). https://doi.org/10.1177/1933719113506498

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