ovarian cancer Flashcards
what is the typical exam stem for someone with ovarian cancer?
> 50 presenting with IBS symptoms for the first time
what is the most common main type of ovarian tumour?
surface epithelium
what are the 3 main types of ovarian tumour?
- surface epithelium
- germ cell
- sex cord
what are the different types of surface epithelium tumours?
- serous
- mucinous
both form cystic masses and are referred to as cyst adenomas or cystacrinomas if they are malignant
what are the different types of germ cell tumours?
teratoma- tends to be benign, and made of hair and teeth
Dysgerminoma- malignant with elevated LDH
Endodermal sinus (yolk sac) tumour- malignant and presents in children- have raised AFP
choriocarcinoma- malignant and had high BHCG
what are the three different types of sex cord stroll tumours?
- Granulosa theca cells- malignant and secrete oestrogen, present in post menopausal women experiencing vaginal bleeding due to endometrial hyperplasia
- sertoli-ledig- benign and secrete androgens causing hirsutism and virilization
- fibroma- benign and can cause meg’s syndrome-> fibroma, cites and pleural effusion
what do you call an ovarian tumour that has metastasised from a site like a gastroadenocarcinoma?
Krukenberg tumour - have signet ring cells on cytology
what are the risk factors for ovarian cancer?
- BRACA1 and BRACA2
- lynch syndrome→ HNPCC
- Any factor that increases thenumber of ovulations:
- Nulliparity
- Early menarche
- Late menopause
- Smoking
- Hormone replacement therapy (HRT)
what things are protective against ovarian cancer?
- COCP
- pregnancy
- breastfeeding
which conditions apart from ovarian cancer increase CA125?
menstruation, endometriosis, benign ovarian cysts, pelvic inflammatory disease
when would you do an ultrasound investigation for ovarian cancer?
if CA125 >35
what is the risk management index based on?
CA125 , menopausal status, US findings
what risk management index indicates assessment by specialist?
> 250
which additional investigations should be considered for ovarian cancer?
- CT pelvis and abdomen:if the investigations above are suggestive of ovarian cancer, CT is used for staging to assess disease spread
- Alpha-foetoprotein (AFP) and hCG:women under 40 years should have AFP and hCG checked to screen for germ cell tumours
what is the management for everyone with ovarian cancer?
staging laparotomy
chemotherapy is recommended for everyone except low grade and stage
