Lymph Nodes

Site/number/size/number involved/extracapsular spread. Regional nodes: obturator (hypogastric), common iliac, external iliac, lateral sacral, para-aortic, inguinal. A regional lymphadenectomy will ordinarily include a minimum of 10 lymph nodes.

pN0 no regional lymph node metastasis pN1 metastasis in regional lymph node(s).

— beware of overcalling intranodal endosalpingiosis or Mul-lerian inclusions, which can be associated with borderline changes and difficult to distinguish from microscopic metastases. Comparison with the index ovarian lesion and disease elsewhere, e.g. peritoneum, is important in designation.

*Rupture of the capsule can be spontaneous or surgical.

Peritoneal metastasis outside the pelvis includes involvement of the omentum.

pTIa = confined to one ovary

pT2a = one or both ovaries with extension onto or into uterusand/ortube

Figure 23.1. Ovarian carcinoma. |JI]A|]|

pfl b = confined to both ovaries pTIc = confined to one or both ovaries with capsule rupture/serosal disease/malignant ascites or peritoneal washings*

3C/IIIC: Peritoneal metastasis > 2 cm

Figure 23.2. Ovarian carcinoma.

3a/iHA: Microscopic only

3b/uiB: Macroscopic peritoneal metastasis < 2 cm

Figure 23.2. Ovarian carcinoma.

TNM-.T3

FIGO: III

Liver capsule

Parenchymal

Liver capsule

Figure 23.3. Ovarian carcinoma. |W 7. OMENTUM/PERITONEUM

Forty percent of serous borderline tumours, especially exophytic lesions, are associated with foci of peritoneal serous epithelial proliferation, particularly in the omental and pelvic peritoneum.

Parenchymal

Figure 23.3. Ovarian carcinoma. |W 7. OMENTUM/PERITONEUM

Forty percent of serous borderline tumours, especially exophytic lesions, are associated with foci of peritoneal serous epithelial proliferation, particularly in the omental and pelvic peritoneum.

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