Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GYN > Ovarian cancer > Flashcards

Ovarian cancer Flashcards

1
Q

How often are they benign?

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How common? Deaths?

A

2 (after endometrial cancer?)

But #1 KILLER (wrt gynecologic cancer). Accounts for 50% of deaths from female genital tract cancer. This is cuz there aren’t screening tools.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

5 year survival

A

25-45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How often are they epithelial tumors?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which is caused from GI mets?

A

Krukenberg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Spread?

A

Direct exfoliation

Lymphatic
Hematogneous (brain/lung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of advanced disease?

A

Ascites, bowel encaseemnt causing intermittent bowel obstruction aka “carcinomatous ileus”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cause?

A

Unclear but believed to be after chronic uninterrupted ovulation (this disrupts the epithelium and activates cell repair mechs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Genetic risk?

A

BRCA1 85% breast cancer risk, 30-50% ovarian cancer risk

HNPCC

Cancer tends to occur 10 years earlier than these people (so like 50s or even 40s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Average age of diagnosis?

A

61 (same as endometrial) with 2/3 being over age 55.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk factors

A 
Familial ovarian cancer syndrome hx > familial hx of it
Breast cancer
Uninterrupted ovulation
Increasing age
Talcum powder
Obesity BMI >30
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Protective factors

A

OCPs, breastfeeding, multiparity, chronic anovulation, infertility, early menarche, nulliparity, late menopause

TUBAL LIGATION AND HYSTERECTOMY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Physical exam

A

Possibly solid, fixed, irregular pelvic mass

Mets to umbilicus aka Sister Mary Joseph nodule

Ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnosis

A

Pelvic ultrasound

Barium enema and IVP help r/o GI and genitourinary causes of sx.

Need to look for mets as soon as you make diagnosis

MONITORING WITH CA-125, AFP, LDH, hCG

Remember that CA-125 is actually very nonspecific and can be seen in lots of cancers or benign conditions, like pancreatitis, cirrhosis, endometriosis, fibroids, normal/ectopic pregnancy, PID, peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Staging

A

SURGICAL

TAHBSO, omentectomy, peritoneal washings, pap smear of diaphragm, pelvic and paraaortic LN sampling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for malignant epithelial tumors?

A

Surgery + chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What chemo agents for epithelial?

A

Carboplatin and paclitaxel

Patients with optimal debunking given intraperitoneal cisplatin and paclitaxel chemo along with IV chemo

18
Q

For evaluating success of treatment of epithelial?

A

CA-125 and CAT scan imaging

19
Q

How often do epithelial recur?

A

Frequently. Give chemo.

20
Q

5 year survival

A

20% for epithelial (80-95% for stage 1, 40-70% for stage II, 30% for stage III…)

21
Q

What are the epithelial cancers?

A 
#1 is serous cystadenocarcinoma
Mucinous
Endometrioid
Clear cell
Brenner
Undifferentiated

CAUCASIAN

22
Q

Describe serous tumors

A

large, cystic, bilateral 65% of the time

23
Q

Germ cell tumors? Age group?

A

0-25 yo. (younger more likely to be malignant)

Also more common in blacks and Asians.

Benign cystic mature teratoma aka dermoid cyst is MC. 95% are benign

Malignant:

  • Dysgerminomas 50%
  • Immature teratomas 20%
  • Endodermal sinus (yolk sac) 20%
  • Uncommon: Embroynal carcinoma, nongestational choriocarcinoma (composed of placenta tissue), mixed germ cell
24
Q

In contrast to epithelial tumors, germ cell tumors:

A

Grow rapidly, are limited to one ovary, and are stage I at diagnosis, considered quite curable

25
Q

Marker for dysgerminoma

A

LDH

26
Q

Marker for endodermal sinus

A

AFP

27
Q

Marker for embroynal

A

AFP and hCG

28
Q

Marker for choriocarcinoma

A

HCG

29
Q

Clinical manifestations of germ cell tumors

A

Most women have abdominal pain.

Grow rapidly so tend to hemorrhage and necrosis, so acute pelvic pain

30
Q

Treatment for germ cell tumors

A

Unilateral salpingo-oophorectomy (if fertility is desired)
Otherwise, TAHBSO with surgical staging.

Everything but stage Ia dysgerminomas and immature teratomas req multi agent chemo: BEP- bleomycin, etoposide, cisplatin.

Very curable

31
Q

Sex cord stromal tumors

A

Low grade and can occur at any age. Unilateral, rarely recur. Ages 40-70. Since some are functional and produce estrogen, may have concomitant endometrial hyperplasia (25-50%) or carcinoma (5%).

Granulosa-theca (70%)
Sertoli-Leydig
Ovarian fibroma

32
Q

Granulosa-theca characteristics

A 
Resemble fetal ovaries
Produce lots of estrogen
Coffee-bean nuclei 
"Call-exner bodies"
Produce estradiol and inhibinA/B (get an endometrial sampling!)
33
Q

Sertoli-Leydig characteristics

A

Resemble fetal testes

Produce testosterone, androgens (virilization)

34
Q

Fibroma characteristics

A

Mature fibroblasts, NOT FUNCTIONING (unlike the others)

Ascities, right hydrothorax, mass = Meigs syndrome

35
Q

Treatment of sex cord stromal tumors?

A

Unilateral salpingoophorectomy.

Chemo and radiation have no regular role!

36
Q

Fallopian tube cancer

A

Can occur at any age.
Progression similar to ovarian cancer w/ peritoneal spread and ascites.

Most are adenocarcinomas

10% bilateral (often the result of mets)

Very very rare

37
Q

Epidemiology of fallopian tube cancer

A

Caucasian, 55-60 yo.

BRCA1 and 2, nulliparity, infertility

38
Q

Clinical manifestations of fallopian tube cancer

A

Asymptomatic usually

Latzko’s triad: profuse watery discharge, pelvic pain, pelvic mass

Hydrops tubae profluens (intermittent hydrosalpinx)

39
Q

Diagnosis of fallopian tube cancer, staging, treatment

A

Often incidental finding during surgery. CA-125 may be elevated.
Surgical staging.
Same treatment as ovarian
Chemo w/ carboplatin and paclitaxel.
Prognosis slightly better than epithelial ovarian cancer.

40
Q

What is a dermoid cyst?

A

Benign cystic teratoma

41
Q

How often are dermoid cysts bilateral?

A

10%

GYN (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions