- Tumor histology and immunohistochemical studies:

- Histologic type: Serous borderline tumor Serous borderline tumor, micropapillary / cribriform variant Serous borderline tumor with microinvasion Microinvasive low-grade serous carcinomaa Low-grade Serous carcinoma High-grade Serous carcinoma Mucinous borderline tumor Mucinous borderline tumor with intraepithelial carcinoma Mucinous borderline tumor with microinvasion Mucinous adenocarcinoma Endometrioid borderline tumor Endometrioid carcinoma Endometrioid carcinoma, seromucinous type Seromucinous borderline tumor Clear cell borderline tumor Clear cell carcinoma Borderline Brenner tumor Malignant Brenner tumor, malignant Mesonephric-like adenocarcinoma Small cell carcinoma, hypercalcemic type Dedifferentiated carcinomae Undifferentiated carcinoma, NOS Carcinosarcoma (malignant mixed Mullerian tumor) Carcinoma, subtype cannot be determined Mixed epithelial borderline tumor (specify types and percentages): Mixed carcinoma (specify types and percentages): Endometrioid stromal sarcoma, low-grade Endometrioid stromal sarcoma, high-grade Adenosarcoma Leiomyosarcoma Fibrosarcoma Granulosa cell tumor, adult type Granulosa cell tumor, juvenile type Steroid cell tumor, NOS Steroid cell tumor, malignant Sertoli-Leydig cell tumor Other sex cord-stromal tumor (specify type): Immature teratoma Teratoma with malignant transformation (specify type): Malignant struma ovarii, specify type: Dysgerminoma Yolk sac tumor Embryonal carcinoma Gonadoblastoma Choriocarcinoma, non-gestational type Mixed malignant germ cell tumor (specify types and percentages): Gastrointestinal stromal tumor Solitary fibrous tumor, malignant Desmoplastic small round cell tumor Other (specify):

Endometrioid carcinomas are graded via a 3-tier FIGO system identical to their endometrial counterparts. Mucinous carcinomas are graded via Silverberg, FIGO or growth pattern-based systems. Immature teratomas can be graded using either a 2-tier or 3-tier system. Sertoli-Leydig cell tumors are graded via a 3-tier grading system based on the degree of tubular differentiation of the Sertoli component, the quantity of gonadal stroma, and the number of Leydig cells. For mixed tumors, report the highest grade tumor and comment on all others.

FIGO Grading System (recommended for endometrioid carcinomas and may also be used for mucinous carcinomas; when severe nuclear atypia is present in the majority of the tumor cells in grade 1 or 2 tumors (grade 3 nuclei), the FIGO grade is increased by one)

Silverberg Grading System (recommended for mucinous carcinomas and may also be used for endometrioid carcinomas)

Growth Pattern-based Grading (recommended for mucinous carcinomas only)

2-Tier Grading System (recommended for immature teratomas only)

3-Tier Grading System (recommended for immature teratomas only)

- Other tissue/ organ involvement: Not applicable Not identified Right ovary Left ovary Ovary (side not specified) Right fallopian tube Left fallopian tube Fallopian tube (side not specified) Vagina Right parametrium Left parametrium Parametrium (side not specified) Pelvic wall Bladder wall Bladder mucosa Rectal wall Bowel mucosa Omentum Other organs/tissue (specify): Cannot be determined (explain):

+ Ancillary studies include BRCA1 and BRCA2 mutation testing, POLE hot spot mutations and DNA mismatch repair status (+/- other IHC tests).

I: Tumor confined to ovaries or fallopian tube(s)
IA: Tumor limited to one ovary (capsule intact) or fallopian tube; no tumor on ovarian or fallopian tube surface; no malignant cells in ascites or peritoneal washings
IB: Tumor limited to both ovaries (capsules intact) or fallopian tubes; no tumor on ovarian or fallopian tube surface; no malignant cells in the ascites or peritoneal washings
IC: Tumor limited to one or both ovaries or fallopian tubes, with any of the following:
IC1: Surgical spill
IC2: Capsule ruptured before surgery or tumor on ovarian or fallopian tube surface
IC3: Malignant cells in the ascites or peritoneal washings
IC: Tumor limited to one or both ovaries or fallopian tubes, not otherwise specified

II: Tumor involves one or both ovaries or fallopian tubes with pelvic extension (below pelvic brim) or peritoneal cancer
IIA: Extension and / or implants on uterus and / or fallopian tubes and / or ovaries
IIB: Extension to other pelvic intraperitoneal tissues

III: Tumor involves one or both ovaries or fallopian tubes, or peritoneal cancer, with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and / or metastasis to the retroperitoneal lymph nodes
IIIA1: Positive retroperitoneal lymph nodes only (cytologically or histologically proven)
IIIA1(i): Metastasis up to 10 mm in greatest dimension
IIIA1(ii): Metastasis more than 10 mm in greatest dimension
IIIA2: Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes
IIIB: Macroscopic peritoneal metastases beyond the pelvis up to 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes
IIIC: Macroscopic peritoneal metastasis beyond the pelvis more than 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ)

IV: Distant metastasis excluding peritoneal metastases
IVA: Pleural effusion with positive cytology
IVB: Parenchymal metastases and metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity)

Serous tubal intraepithelial carcinoma (STIC) Endometriosis Endosalpingiosis

- Other (specify):