Gynaeoncology

Question 1

Which ovarian tumour has transitional epithelium from Wolffian remnants?

Answer 1

Brenner tumour

Question 2

Which ovarian tumour has no stromal invasion?

Answer 2

Borderline serous

Question 3

Which ovarian tumour is Mullerian in origin with a poor prognosis?

Answer 3

Clear cell

Question 4

Which ovarian tumour is associated with Meig’s syndrome?

Answer 4

Fibroma, thecoma

Question 5

Which ovarian tumour is associated with schiller-duval bodies

Answer 5

Endodermal

Question 6

What ovarian tumour is associated with Inhibin B

Answer 6

Granulosa cell

Question 7

What are the side effects of

Cyclophosphamide

Answer 7

Alkylating agent

Haemorrhagic cystitis - as acrolein excreted in the urine
Alopecia

Question 8

What are the side effects of

Paclitaxel

Answer 8

binds to microtubules

neutropenia, arrhythmias, sensory peripheral neuropathy, alopecia, hypersensitivity

Question 9

What are the side effects of

Vincristine

Answer 9

binds to tubulin

neurotoxicity - parasthesia, motor weakness, CN palsy
myelosuppression

Question 10

What are the side effects of

Cisplatin

Answer 10

Nephrotoxic
Peripheral neuropathy
Middle ear hearing loss and tinnitis

Question 11

What are the side effects of

Methotrexate

Answer 11

mucositis
nausea, vomiting
photosensitivity
nephrotoxicity
hepatotoxicity

Question 12

Tell me about..

Mucinous tumours - cystadenoma

Answer 12

Cystadenoma - multilocular

Rupture may cause pseudomyxoma peritonei and SBO

Question 13

Tell me about..

Mucinous tumours - cystadenocarcinoma

Answer 13

Usually solid
Can be associated with appendicular cancer
Inc CEA and CA125

Question 14

Tell me about..

Clear cell carcinoma

Answer 14

Mullerian origin
Poor prognosis
10% are bilateral
15% primary in the uterus

Question 15

Tell me about..

Brenner tumours

Answer 15

Transitional epithelium from Wolffian remnants
Fibrous elements
Usually benign (99%)

Question 16

Tell me about..

Borderline tumours

Answer 16

Low malignant potential 
No stromal invasion
May have extra ovarian spread in 20%
serous - 50% bilateral 
mucinous - 5% bilateral

Question 17

Tell me about..

Endometrioid carcinoma

Answer 17

May be secondary from endometrial cancer

Can arise in endometriosis

Question 18

Tell me about..

Granulosa cell tumours

Answer 18

Solid
75% endocrine function
Usually over 60 years old, can be prepubescent
PMB/precocious puberty
Juvenile - 5% malignant and aggressive

Question 19

Tell me about..

Androblastoma

Answer 19

Sertoli - most common and usually benign

70% oestrogen, 20% androgen, 10% no hormones

Question 20

Tell me about..

Germ cell tumours

Answer 20

2-3% malignant

30% if woman aged less than 20

Question 21

Tell me about..

Dysgerminoma

Answer 21

10-15% bilateral
Not associated with hirsutism
Secretes: LDH, pALP, b-hCG(30%)
Histology: “lymphoid infiltration of the stroma”

Question 22

Tell me about..

Embryonic tumours

Answer 22

Dermoids - usually benign
1% change to malignant

If immature teratoma - often in first 2 decades of life and often malignant. unilateral. Thyroid hormones - struma ovarii or serotonin - carcinoid

Embryonal carcinoma - secretes b-hCG and AFP

Question 23

Tell me about..

Yolk sac/endodermal sinus tumour

Answer 23

secretes AFP
presents 14-20 years
unilateral

Question 24

Tell me about..

Malignant ovarian choriocarcinoma

Answer 24

secrete b-hCG
may present with precocious puberty
poor prognosis