L8: Ovarian Swellings - Pt 1 Flashcards
(101 cards)
1
Q
WHO Classification of Ovarian Tumors
A
2
Q
WHO Classification of Ovarian Tumors
- Non-Neoplastic
A
3
Q
WHO Classification of Ovarian Tumors
- Neoplastic
A
- Surface epithelial tumors.
- Sex cord stromal tumors.
- Germ cell tumors.
- Mixed tumors e.g., Gonadoblastoma
- Unclassified tumors
- Metastatic (2ry) tumors.
4
Q
Characters of Functional Cysts
A
5
Q
Examples of Non-Neoplastic Pathological Cystic Tumors
A
- Polycystic ovary syndrome
- Endometriotic cyst
- Tubo-ovarian cyst OR abscess
6
Q
Examples of Non-neoplastic Pathological Solid Tumors
A
- Hilar cell hyperplasia.
- Edema of the ovary.
- Pregnancy luteoma
7
Q
Types of Neoplastic Swellings
A
- Surface epithelial tumors
- Sex cord stromal tumors
- Germ cell tumors
8
Q
Types of Neoplastic Swellings
- Surface Epithelial Tumors
A
9
Q
Surface Epithelial Tumors
- Benign
A
10
Q
Surface Epithelial Tumors
- Borderline
A
Characters:
- At younger age.
- Bilateral with local metastasis.
11
Q
Surface Epithelial Tumors
- Malignant
A
1) Serous cystadenocarcinoma
2) Mucinous cystadenocarcinoma
12
Q
Sex cord stromal tumors
A
13
Q
Sex cord stromal tumors
- Feminizing Group
A
1) Ganulosa
2) Theca cell tumors
3) fibroma
14
Q
Sex cord stromal tumors
- Virlizing Group
A
1) Androblastoma
2) Sertoli cell
3) Leydig cell tumors
15
Q
Sex cord stromal tumors
- Combined
A
Gyn-andro-blastoma
16
Q
Sex cord stromal tumors
- Stromal Tumors
A
Connective tissue tumors
1) Fibroma
3) Sarcoma
2) Lymphoma
4) Lipoid cell tumors
17
Q
Germ Cell Tumors
A
18
Q
Germ Cell Tumors
- undifferentiated germ cells
A
Dysgerminoma.
19
Q
Germ Cell Tumors
- embryonic origin
A
20
Q
Germ Cell Tumors
- Mixed Tumors
A
Gonadoblastoma
21
Q
Germ Cell Tumors
- Metastasis (2ry) to the ovary
A
1) Typical → resemble the original tumor
2) Atypical - not resembling the original tumor =Kruckenberg’s tumor
22
Q
Incidence of Surface Epithelial Tumors
A
The commonest ovarian tumors “ 80% of ovarian tumors”.
23
Q
Age of Surface Epithelial Tumors
A
- At old age ≥ 60 years
- There is genetic & familial tendency “Lynch syndrome II” and usually occurring 10 years earlier than non-hereditary type
24
Q
Predisposing Factors for Surface Epithelial Tumors
A
- Ovulation trauma “Commonest predisposing factor”
- Other factors e.g. exposure to radiation, mump oophoritis.
25
Spread of ****Surface Epithelial Tumors****
* The main route of spread in malignant type is trans-celomic spread
26
What is The Commonest **Surface Epithelial Tumors**?
Serous Cystadenoma
27
NE of **Serous Cystadenoma**
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Types of **Serous Cystadenoma**
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ME of **Serous Cystadenoma**
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NE of **Serous Cystadenocarcinoma**
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ME of **Serous Cystadenocarcinoma**
* Layers of tubal like epithelium with malignant criteria
* Psammoma bodies also may present.
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**Mucinous Cystadenoma**
- Origin
Cervical like epithelium "mucin secreting".
33
**Mucinous Cystadenoma**
- NE
34
NE of **Mucinous Cystadenoma**
- Content
- mucin content which is usually thick, clear, bluish or colorless fluid.
35
NE of **Mucinous Cystadenoma**
- CS
- Usually multi-locular (Honeycomb) with thin wall.
- It may perforate or rupture ---> pseudomyxoma peritonei.
36
ME of **Mucinous Cystadenoma**
37
NE of **Mucinous Cystadenocarcinoma**
38
ME of **Mucinous Cystadenocarcinoma**
Adenocarcinoma like that of the cervix with malignant criteria.
39
Origin of **Endometriod Cystadenoma**
Endometrial like epithelium
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NE of **Endometriod Cystadenoma**
* Benign → small, single & unilateral tumor.
* Malignant → has the same criteria mentioned before.
41
Nature of **Brenner Tumor**
Usually Benign & Bladder like epithelium
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NE of **Brenner Tumor**
Usually benign: single, unilateral BUT solid.
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ME of **Brenner Tumor**
44
Secretions of **Brenner Tumor**
Rarely produce estrogen → postmenopausal bleeding
45
Nature of **Clear Cell Tumor (Mesonephroid)**
Mesonephric like epithelium
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NE of ****Clear Cell Tumor (Mesonephroid)****
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ME of **Clear Cell Tumor (Mesonephroid)**
48
Secretions of **Clear Cell Tumor (Mesonephroid)**
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Age of **Sex-Cord Stromal Tumors**
In middle age group but very rarely in premenarchal age
50
Nature of **Sex-Cord Stromal Tumors**
Usually, tumors are functioning as they secret hormones.
51
Color of **Sex-Cord Stromal Tumors**
Usually have commonly yellow color due to hormonal content.
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Types of **Sex-Cord Stromal Tumors**
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Types of **Sex-Cord Stromal Tumors**
- Feminizing Group
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Types of **Sex-Cord Stromal Tumors**
- Virilizing Group
55
NE of **Granulosa Cell Tumor**
- If Benign → its criteria
- If malignant → criteria of malignancy.
56
ME of **Granulosa Cell Tumor**
56
NE of **Theca Cell Tumor**
* As granulosa cell tumor
57
NE of **Fibroma**
58
ME of **Fibroma**
- It is formed of fusiform fibroblast, with fibrous matrix, commonly benign BUT solid tumor.
59
Complications of **Fibroma**
* All types of degeneration in uterine fibroid can occur
**EXCEPT red degeneration**
60
Meig's Syndrome Involve .......
- Ovarian fibroma
- Right hydrothorax
- Ascites.
61
Cause of **Meig's Syndrome**
Cause:
- Unclear but may be due to lymphatic irritation by the tumor
- Hydrothorax results from rich lymphatic connections across the diaphragm.
62
Fate of **Meig's Syndrome**
Spontaneously disappears after removal of the ovarian fibroma
63
**Pseudo Meig's Syndrome**
- With tumors other than fibroma (ovarian or uterine) e.g. Brenner tumor or Krukenberg 2ry or uterine fibroma, with ascites & right hydrothorax.
64
Predisposing factors for **Germ Cell Tumors**
65
Age in **Germ Cell Tumors**
Young age < 20 years EXCEPT dermoid cyst occurs at 20-30 years.
66
Spread of **Germ Cell Tumors**
Lymphatic spread
67
Nature of **Germ Cell Tumors**
Usually, tumors are functioning as they secrets hormones
68
**Dysgerminoma**
"undifferentiated germ cell tumor"
69
Incidence of **Dysgerminoma**
The commonest germ cell tumor
70
Age in **Dysgerminoma**
About 80% of germ cell tumor before 20 years
71
Nature of **Dysgerminoma**
Usually locally malignant tumor
72
NE of **Dysgerminoma**
73
ME of **Dysgerminoma**
74
Secretions of **Dysgerminoma**
1) a-feto protein
2) Placental ALP
3) LDH
4) a-1 antitrypsin.
75
Incidence of **Dermoid Cyst**
It is the commonest tumor that complicates pregnancy
76
Age in **Dermoid Cyst**
* At 20-30 years
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Nature of **Dermoid Cyst**
* It is usually benign tumor
78
NE of **Dermoid Cyst**
79
NE of **Dermoid Cyst**
- CS
80
NE of **Dermoid Cyst**
- Pedicle
81
ME of **Dermoid Cyst**
82
Incidence of **Immature Teratomas**
The 2nd most common germ-cell malignancy
83
Age in **Immature Teratomas**
occurs before 20 years of age.
84
ME in **Immature Teratomas**
Immature teratomas are classified according to a grading system (grades 1-3) that is based on the degree of differentiation & quantity of immature neural tissue
85
**Endodermal Sinus Tumor**
yolk sac carcinoma
86
NE of **Endodermal Sinus Tumor**
87
ME of **Endodermal Sinus Tumor**
88
Secretions of **Endodermal Sinus Tumor**
* a-1-antitrypsin
* a -fetoprotein
89
Incidence of **Embryoma & Polyembryoma**
* Extremely rare ovarian tumor
90
Nature of **Embryoma & Polyembryoma**
* Composed of embryoid bodies
* This tumor structures of early embryonic differentiation (i.e. endoderm, mesoderm and ectoderm).
91
Secretions of **Embryoma & Polyembryoma**
- a-fetoprotein
- HCG titers
92
NE & ME OF **Embryonal Carcinoma**
Shows criteria of malignancy
93
Secreations of **Embryonal Carcinoma**
- Estrogens & the patient exhibits symptoms & signs of precocious Pseudo-puberty or irregular bleeding.
- a -fetoprotein
- HCG.
94
ME of **Ovarian Choriocarcinoma**
- Show criteria of malignancy as malignant sheets of Trophoblastic tissues "the same appearance as gestational choriocarcinoma metastatic to the ovaries".
95
Secretions of **Ovarian Choriocarcinoma**
Much HCG that ++ the ovaries ----> precocious puberty in about 50% of patients
96
Incidence of **Mets to The Ovary**
97
Mode of Spread of **Mets to The Ovary**
- Direct extension
- Hematogenous spread.
- Lymphatic spread.
- Trans-celomic dissemination.
- Surface implantation.
98
**Mets to The Ovary**
- Site of Primary Tumors
99
NE of **Mets to The Ovary**
Usually, bilateral
100
ME of **Mets to The Ovary**
