One of the most common pathways in the development of high-grade serous carcinoma of the ovary.

High-grade serous carcinoma arising from benign cysts in the ovary

As we explained in the book Fere Ex Nihilo (page 76), there are multiples pathways in the development of high-grade serous carcinoma. One of the most common and very easy to prove, is when HGSC arises in benign cysts, frequently with atrophic epithelium. Another issue, clearly appreciated in these images is the multicentricity of the neoplasm. Other pathways in the development of HGSC are: de novo in the stroma, through mesenchymal epithelial transition; or from endosalpingiosis, serous cystadenomas, serous borderline tumors, low-grade serous carcinomas, adenofibromas, or from the mesothelial surface. Multiple images, confirming the different origins of HGSC can be found in the Fere Ex Nihilo book, pages 95 to 109.