How do ovarian malignant tumors spread?
What is the most common germ cell tumor of the ovary?
Most common = benign cystic teratoma
lined with hairy skin, dermoid cysts
Compare benign and malignant ovarian germ cell tumors.
When teratomas are left in place, the skin and other tissues of its wall may gradually undergo malignant transformation.
List the most common sex cord stromal tumors of the ovary.
Compare granulosa cell tumors with thecomas and Sertoli-Leydig cell tumors.
Granulosa: solid tumor, hormonally inactive or produce estrogen, small (benign) or large (malignant), slow growth
Thecoma: always benign, solid tumors, secrete estrogens
SL: solid tumors, secrete androgens and cause virilization, benign or malignant
What is Krukenberg tumor?
Metastasis from carcioma of the stomach that produces bilateral enlargement of the ovaries
Explain the various forms of infertility.
Ovum-related: immature, inferior quality
Sperm-related: varying quality, no living sperm, or not enough, not mobile
Genital organ-related: PID
Systemic factors: antibodies to sperm or ova, etc
What are the most common sites of implantation in ectopic pregnancy?
Fallopian tube is the most common site, but can occur ont he ovary or the peritoneal surface.
Compare placenta accreta and placenta previa.
Accreta >> deep penetration of the placental villi into the wall of the uterus
Previa >> implantation of the zygote in the lower segment of the uterus
What is the difference between complete and incomplete abortion?
complete = fetus and placenta are expulsed
incomplete = expulsion of some fetal parts and placenta, while retaining others
Describe the pathologic features of gestation trophoblastic disease.
An abnormality of placentation, leading to tumor-like changes.
The trophoblast (epithelial lining) consists of two cell types: cytotrophoblastic and syncytiotrophoblastic
Benign = hydatidiform mole
Malignant = choriocarcinoma
Compare complete and incomplete hydatiform mole.
Incomplete: two sperms fertilize oocyte
What is choriocarcinoma, and which hormone does it secrete?
In 50% of cases arises from preexisting complete mole
Highly invasive and secrete HCG
*if invades the veins, mets to lung, liver, and brain
RESPONDS to methotrexate
Discuss the pathogenesis and list clinical features of toxemia of pregnancy