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OB/GYN Boards by Subject > Ovarian cancer > Flashcards

Ovarian cancer Flashcards

(55 cards)

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1
Q

Proportion of GYN cancer that is ovarian and proportion of GYN cancer deaths that are ovarian.

A

25% / 50%

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2
Q

Lifetime risk of ovarian cancer for average woman

A

1:70

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3
Q

Percent of ovarian cancers of each type

A

Epithelial 85%
Germ cell 10%
Sex cord stromal 5%

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4
Q

Risk factors for ovarian cancer (5)

A
  1. Early menarche
  2. Late menopause
  3. Ovulation induction agents
  4. Environmental factors? (talc, asbestos)
  5. Genetics
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5
Q

Protective factors against ovarian cancer (5)

A
  1. OCPs
  2. Pregnancy
  3. Breastfeeding
  4. Tubal ligation
  5. Hysterectomy
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6
Q

Genetic syndromes related to ovarian cancer (3)

A

BRCA1, BRCA2, Lynch II

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7
Q

Chromosomes of BRCA mutations

A 
BRCA1 = chromosome 17
BRCA2 = chromosome 13
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8
Q

Risk of ovarian cancer with each BRCA mutation

A

BRCA1 50%

BRCA2 25%

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9
Q

Risk of breast cancer with each BRCA mutation

A

BRCA1 60-90%

BRCA2 60-90%, also male breast cancer increased

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10
Q

Mutations of Lynch (HNPCC)

A

MSH2 or MLH1

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11
Q

Cancers caused by Lynch (HNPCC)

A

Colon (most common, proximal colon)
Endometrial
Stomach, small intestine, ovary, urinary tract, bile duct, etc.

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12
Q

Only way to make definitive diagnosis of ovarian cancer

A

Surgical USO

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13
Q

Size concerning for ovarian malignancy pre- and post-menopausal

A

> 8 cm premenopausal

>5 cm postmenopausal

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14
Q

CA125 concerning in premenopausal woman

A

> 200

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15
Q

Most common histology of epithelial ovarian cancer

A

Serous (50-60%)
Endometrioid (20%)
Mucinous (15%)
Clear cell (5%)

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16
Q

FIGO staging of ovarian cancer by location

A

Stage I - ovary
Stage II - pelvis
Stage III - abdomen and retroperitoneum
Stage IV - distant

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17
Q

Stage I

A 
IA - unilateral
IB - bilateral
IC1 - surgical spillage
IC2 - capsule rupture prior to surgery
IC3 - positive washings
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18
Q

Stage II

A

IIA - tube or uterus

IIB - other pelvic or peritoneal extension

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19
Q

Stage III

A

IIIA1 - retroperitoneal LNs
IIIA2 - microscopic extrapelvic spread
IIIB - visible but <2 cm
IIIC - >2 cm

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20
Q

Stage IV

A

IVA - pleural effusion with cytology pos

IVB - parenchymal mets to liver, spleen, or extra-abdominal organs (including inguinal LNs)

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21
Q

Percent of ovarian cancer found stage III-IV

A

70-80%

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22
Q

Treatment stage IA to IB

A

Fertility preservation at staging acceptable, no further treatment

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23
Q

Treatment stage IC

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A

Adjuvant chemo (carbo/taxol)

24
Q

Treatment stage II-III

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A

Cytoreductive surgery, adjuvant chemo (carbo/taxol, taxol/platinum)

25
Treatment stage IV
Neoadjuvant chemo (carbo/taxol), then cytoreductive surgery
26
"Optimal cytoreduction"
<1 cm residual nodule
27
Recurrence treatment
Secondary cytoreductive surgery if >6 mos since treatment | Otherwise, second-line chemotherapy (can also do for later recurrence)
28
Most common tumor type on first two decades of life
Germ cell tumor (70%)
29
Follow-up after remission
Physical exam q3 mos x 5 yrs CA125 q3mos CT q6mos
30
Categories of germ cell tumors
1. Benign (mature teratoma) 2. Malignant arising from constituents of dermoids (squamous, struma ovarii) 3. Primitive malignant GCTs (dysgerminoma, yolk sac, immature teratoma, choriocarcinoma, embryonal carcinoma, polyembriomas, mixed)
31
Proportion of dermoids that are bilateral
12%
32
1% of all dermoids for patients >40 y/o contain this type of malignancy
Squamous cell carcinoma
33
LDH
Dysgerminoma
34
Alpha-fetoprotein
Endodermal sinus (yolk sac) tumor
35
Beta hcg
Choriocarcinoma
36
GCT likely to be caught during pregnancy
Dysgerminoma (15%)
37
Malignancy likely to occur in dysgenetic ovary (46XY or mosaic)
Dysgerminoma -> gonadoblastoma
38
Schiller-Duvall bodies
Endodermal sinus (yolk sac) tumor - cross-section of single papilla with a central vessel surrounded by tumor cells
39
Grading of immature teratoma based on...
Amount of neural element
40
Most common mixed GCT
Dysgerminoma
41
Treatment for germ cell tumors
USO, chemo (bleomycin, etoposide, cisplatin = BEP)
42
Only germ cell tumor that is radiation sensitive
Dysgerminoma
43
Sex cord cells
Granulosa, Sertoli
44
Mesenchymal (stromal) cells
Theca, Leydig, fibroblasts
45
Proportion of malignant ovarian tumors that are sex cord stromal
5%
46
Age distribution for sex cord stromal
Many <40 y/o but does continue to increase over age
47
Meig's syndrome
Fibroma + pleural effusion
48
Call-Exner bodies
Granuloma cell tumor - cavities filled with fluid or basement membrane material
49
Coffee bean nuclei
Granulosa cell tumor - oval, grooved
50
Most common sex cord stromal tumor
Granulosa cell tumor
51
2 types of granulosa cell tumor
Adult or juvenile (adult = 95%)
52
Prognosis of granulosa cell tumor
90% are found stage I 10 yr survival 90% Indolent growth, so late recurrence
53
Juvenile granulosa cell tumor prognosis if caught late
Poor, aggressiveif found advanced
54
Syndromes associated with juvenile granulosa cell tumor
Ollier's disease - enchondromatiosis | Maffucci's syndrome - ^ + hemangiomas
55
Sex cord stromal with annular tubules
Association with Peutz-Jegher (36%) - occurs in 4th decade of life and tend to be benign Without PJS - occurs in 3rd decade of life, large and palpable, 20% malignant

OB/GYN Boards by Subject (22 decks)

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