Chapter 14: Malignant Diseases of the Ovary

Question 1

used as a tumor marker for carcinomas of embryonic origin

Answer 1

Alpha-fetoprotein (AFP)

Question 2

inherited gene mutation associated with a significant increase in breast and ovarian cancer risk

Answer 2

BRCA 1/BRCA 2

Question 3

protein found in tumor cells that results in an elevation of blood levels

Answer 3

CA 125

Question 4

tumor marker for colon, stomach, breast, lung, some thyroid, and ovarian cancers

Answer 4

carcinoembryonic antigen (CEA)

Question 5

Malignant tumor of the ovary arising from undifferentiated germ cells of the embryonic gonad; histologically identical to seminoma found in the testicle

Answer 5

dysgerminoma

Question 6

tumor of the ovary containing epithelial or stromal elements resembling endometrial tissue; typically arises from endometriosis; a large percentage are malignant

Answer 6

endometriod tumor

Question 7

neoplasm involving the surface epithelium of the ovary

Answer 7

epithelial ovarian cancer

Question 8

gene that produces a protein that regulates normal cell growth found in breast and ovarian cancer cells; identification of this protein enables determination of treatment options

Answer 8

HER2/neu

Question 9

Carcinoma of the ovary, usually mestastic from gastrointestinal cancer, marked by areas of mucoid degeneration and by the presence of signet-ring cells

Answer 9

Krukenberg tumor

Question 10

enzyme involved in the production of energy of the cells; elevated levels in the blood indicate tissue damage, cancers, or other diseases

Answer 10

Lactate dehydrogenase (LDH)

Question 11

surgical incision into the abdomen usually performed to evaluate the organs

Answer 11

laparotomy

Question 12

finding of pleural effusion, ascites, and an ovarian mass

Answer 12

meigs syndrome

Question 13

large cystic ovarian mass with thick-walled septations; may have internal debris-layering components

Answer 13

Mucinous cystadenocarcinoma

Question 14

accumulation of mucinous materian in the peritoneal cavity, either because of rupture of a benign or malignant cystic neoplasm of the ovary or mucocele rupture of the appendix

Answer 14

pseudomyxoma peritonei

Question 15

surgical removal of the ovary and fallopian tube

Answer 15

salpingo-oophorectomy

Question 16

type of epithelial ovarian cancer, which presents as partially cystic mass with solid components

Answer 16

serous carcinoma

Question 17

large multilocular ovarian neoplasm with papilly projections

Answer 17

serous cystadenocarcinoma

Question 18

related to the sex-cord (cord like masses of gonadal epithelial tissue) stromal tumors seen in ovaries, mostly in young adults

Answer 18

Sertoli-Leydig cell tumors/ androblastoma/arrhenoblastoma

Question 19

solid ovarian mass originating from the embryonic gonadal ridges and Sertoli cells

Answer 19

Sex-cord stromal tumors

Question 20

extremely rare neoplasm of the ovary containing thyroid tissue

Answer 20

stuma ovarii

Question 21

rare malignant form of a common germ cell tumor found in young adults; contains fat, bone, hair, skin, and/or teeth

Answer 21

teratoma/teratocarcinoma

Question 22

neoplasm originating in the germ cells (ovun)

Answer 22

yolk cell tumor/ endodermal sinus tumor

Question 23

Select the false statement.
a. Ovarian cancer has a strong family history, making genetic screening important.
b. Studies show that women who used oral contraceptives are at the greatest risk for developing epithelial ovarian cancer.
c. Ovarian malignancy is a disease of low prevalence, accounting for only 5% of all female cancers.
d. Approximately 50% of ovarian cancers occur in women in the sixth generation of life.

Answer 23

b

Question 24

Which technique is not directed at improving the detection and outcome of ovarian cancer?

Answer 24

pineal studies

Question 25

Choose the most unlikely risk factor for developing ovarian cancer. a. living in a developed country b. late menopause c. nulliparity d. menses with early onset

Answer 25

a

Question 26

Extended ovulatory activity, over 40 years, places women is what risk category for developing ovarian cancer?

Answer 26

high risk

Question 27

The gene that is related to errors in the replication process resulting in overexpression is:

Answer 27

HER2/neu

Question 28

A characteristic of most epithelial cancers is the tendency to:

Answer 28

form cystic masses with multiple septa

Question 29

The major pattern of metastatic spread of ovarian malignancy is direct extension involving the neighboring organs in the pelvis, peritoneal seeding, and ____ spead.

Answer 29

lymphatic

Question 30

Frequently, the only symptom of ovarian cancer is:

Answer 30

abdominal bloating and pain

Question 31

To increase specificity in diagnosing ovarian malignancy, laboratory values such as ______ are tested.

Answer 31

CA 125 AFP hCG CEA

Question 32

What imaging method provides the best diagnostic value by presenting calcifications, sometimes in a curvilinear fashion, soft tissue masses, and patterns suggesting abdominal distention?

Answer 32

Plain film radiography

Question 33

The imaging modality providing the most accurate tissue characterization regarding adnexal masses is:

Answer 33

MRI

Question 34

Menopausal females utilizing HRT (hormone replacement therapy) will demonstate:

Answer 34

normal sized ovaries

Question 35

Ovarian malignancy screening utilizing ultrasound should consider all except: a. ovarian position b. ovarian size c. ovarian texture d. bilateral ovarian comparison

Answer 35

a

Question 36

Metastasis to the ovary: a. is rare b. is common c. occurs most commonly from primary brain carcinoma d. causes bladder frequency

Answer 36

b

Question 37

Compressibility of a mass while scanning can assist in differentiating bowel from malignancy and is performed by:

Answer 37

"hands-on" manuever

Question 38

Nonneoplastic cystic foci of the ovary are commonly seen in ____ females and are difficult to differentiate from malignant lesions, so should be considered when determining the diagnosis.

Answer 38

menstruating

Question 39

Epithelial ovarian cancers typically form cystic masses and:

Answer 39

solid papillary growths

Question 40

Pseudomyxoma peritonei is defined as:

Answer 40

the accumulation of gelatinous material in the peritoneal cavity

Question 41

Ovarian malignancy is often associated with ascites that first accumulates in the:

Answer 41

dependent portion of the peritoneal cavity

Question 42

Color Doppler of malignant lesions frequently demonstrates:

Answer 42

prominent flow in the septations

Question 43

Ovarian masses, whether malignant or benign can result in _____ of the ovary.

Answer 43

torsion

Question 44

A large number of patients with ovarian malignancy present with or develop ______ bleeding.

Answer 44

uterine

Question 45

Two inherited gene mutations related to an increase of breast and ovarian cancer are _____ and _____.

Answer 45

BRCA 1/ BRCA 2 HER2/neu

Question 46

A Krukenberg tumor is a cancerous tumor of the _____ and usually metastasizes from _____ cancer.

Answer 46

ovary breast

Question 47

The effect of ovulation is known to cause increased inflammation and wound healing owing to repeated trauma to the ovarian ______.

Answer 47

epithelium

Question 48

Ascites associated with ovarian malignancy collects in the _____ and ______, mostly on the _____ side.

Answer 48

cul-de-sac paracolic gutters right

Question 49

Ovarian cancer is mostly a disease of ____ menopausal and ____ menopausal women.

Answer 49

peri post

Question 50

Ovarian cancer is the most common tumor responsible for _____ malignancy in women.

Answer 50

peritoneal

Question 51

Symptoms of abnormal _____ activity are sometimes a clue to the presence of an ovarian malignancy that is hormonally active.

Answer 51

endocrine

Question 52

Benign processes, such as ______, ______, and even pancreatitis result in an increased CA 125, as does ovarian cancer.

Answer 52

endometriosis fibroids

Question 53

AFP is alpha-protein; LDH is ______; CEA is _______; and hCG is _______

Answer 53

lactate dehydrogenase carcinoembryonic antigen human chorionic gonadotropin

Question 54

A CT examination can demonstrate pelvic sidewall masses, lymph node enlargement in the retroperitoneum, liver metastasis, and calcifications, especially when _____ and ____ contrast is given.

Answer 54

intravenous oral

Question 55

Although it cannot always distinguish a malignant process from benign, ____ remains the diagnostic method of choice as a screening technique for adenexal processes.

Answer 55

MRI

Question 56

The effective method to investigate for ovarian cancer includes ______ ultrasound, ______ examination, and the tumor marker _____.

Answer 56

transvaginal physical CA 125

Question 57

To determine pelvic mass from possible bowel, _____ must be identified.

Answer 57

peristalsis

Question 58

PET should only be used in a select group of patients in whom both ______ and ____ have failed to yield unequivocal results.

Answer 58

ultrasound MRI

Question 59

Fallopian tube neoplasms are rare and malignant. These lesions are mistaken for _____ malignancies.

Answer 59

ovarian

Question 60

Ovarian cancer is one of the most lethal forms of cancer owing to:

Answer 60

late stage diagnosis and low cure rate

Question 61

Exploratory _______ remains the gold standard in the visualization of adnexal malignancy. _____ imaging is most helpful in staging ovarian cancer.

Answer 61

laparotomy CT

Question 62

Eighty percent of ovarian malignancies originate from the _____ covering the ovaries

Answer 62

epithelium