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Flashcards in Ovarian Cancer Deck (40)
1

What are the 4 types of ovarian cancers

epithelial (90%)
germ cell
sex cord stromal
metastatic

2

Smx of ovarian CA

asmx in early stages
vague and pain, bloating, distension, early satiey in later stages

3

what is the etiology of ovarian CA

chronic, uninterrupted ovulation --> inc cellualr repair --> inc opportunities for gene deletion/mutation

4

what is the ovarian tumor marker used for testing tx response and recurrance but not for screening or dx

CA-125

5

risk factors for ovarian cancer

family history (#1)

familial ovarian cancer syndrome (BRCA, HNPCC/Lynch II)

uninterrupted ovulation (nulliparity, infertility, early menarch, late menopause)

6

protective factors against ovarian cancers

OCPs
multiparity
breastfeeding
chroninc anovulation

7

suspect ovarian cancer, next steps?

pelvic US --> staging

8

differentiate between stages:

Ia
Ib
Ic
IIa
IIb
IIc
IIIa
IIIb
IIIc
IV

Ia : one ovary
Ib : 2 ovaries
Ic : + ovarian surface tumor, ruptures capsule, malignant ascities, peritoneal cytology +

IIa : invades FT or uterus
IIb : invaides other pelvic tissue
IIc : + ovarian surface tumor, ruptures capsule, malignant ascities, peritoneal cytology +

IIIa : abd peritoneal met+, < 2cm
IIIb : abd peritoneal met+, > 2cm
IIIc : pelvic/paraaortic/inguinal LN+

IV : distal mets

9

Treatemt specific for
- epithelial ovarian cancer
- germ cell
- sex cord stromal

- epithelial ovarian cancer: surgery (TAHBSO, omentectomy, pelvic/paraaortic LNectomy, carboplatin/pacltaxel)

- germ cell : USO + BEP (bleomycin, etopside, cisplatin)

- sex cord stromal : USO only

10

what is carcinomatous ileus

*complication of ovarian cancer

intraperitoneal tumor spread --> ascities and bowel encasement --> intermittent bowel obstruction

11

what is a sister-mary-joseph nodeule

ovarian cancer met to umbillicus

12

what is pseudomyxoma peritonei

*complication of ovarian cancer

"jelly belly" assc with appendiceal carcinoma and mucinous cystadenocarcinoma

caused by cancerous cells (mucinous adenocarcinoma) that produce abundant mucin or gelatinous ascites.[1] The tumors cause fibrosis of tissues and impede digestion or organ function, and if left untreated, the tumors and mucin they produce will fill the abdominal cavity. This will result in compression of organs and will destroy the function of colon, small intestine, stomach, or other organs. Prognosis with treatment in many cases optimistic,[2] but the disease is lethal if untreated, with death by cachexia, bowel obstruction, or other types of complications.

13

What is Meigs syndrome?

*complication of ovarian cancer

triad of ascites, pleural effusion and benign ovarian tumor (fibroma, Brenner tumour and occasionally granulosa cell tumour). It resolves after the resection of the tumor.

14

What is latzko triad?

pain, profuse watery d/c, pelvic mass, assc with fallopian tube adenocarconoma

15

What type of ovarian tumor can cause precocious puberty

granulosa cell tumor

16

at what stage is epithelial ovarian cancer found?

III+ (bc is it asmx)

17

MC type of epithelial cancer

serous cystadenocarcinoma

18

bilateral ovarian tumor lined with fallopian tube like epithelium

serous cystadenoma

(type of epithelial tumor)

19

bilateral ovarian tumor with psamomma bodies on histologyuy

serous (papillary) cystadenocarcinoma

(type of epithelial tumor)

20

multilocular cyst lined w/ mucous secreting epithelium

mucinous cystadenoma

(type of epithelial tumor)

21

pseudomyxoma peritonei is assc with what type of ovarian tumor

mucinous adenocarcinoma

(type of epithelial tumor)

22

type of ovarian tumor that resembles endometrial cancer and had good px

endometrioid carcinoma

(type of epithelial tumor)

23

ovarian tumor with masses of glycogen-filled clear cells

clear cell carcinoma
**good prognosis

24

benign, ovarian tumor that resembles bladder (transitional epithelium)

Brenner tumor

(type of epithelial tumor)

25

type of ovarian tumor that grows rapidly in women < 20 yo (found at earlier stages)

germ cell tumor

26

WHat is the MC type of germ cell tumor

mature teratoma (aka dermoid cyst) = MC benign

dysgerminomas = MC malignant

27

what is a teratoma?

tumor of totipotent fetal tissue

28

how is a mature and immature teratoma distinguised

mature = benign and contains hair/teeth/calcification

immature = aggresively malignat, contains neural tissue

29

WHat is stuma ovarii?

monodermal, contains thyroid tissue

(type of germ cell ovarian tumor)

30

ovarian tumor assc with elevated LDH, assc w/ tumor syndrome (45, XO), good prognosis due to radiosensitivity

dysgerminoma

(type of germ cell ovarian tumor)

31

ovarian tumor assc with elevated AFP, biopsy shows schiller-duval bodies that resemble primitive glomeruli

endodermal sinus (yolk sac) tumor

(type of germ cell ovarian tumor)

32

ovarian tumor assc with elevated b-hCG, is also a malignant type of GTD

choriocarcinoma

(type of germ cell ovarian tumor)

33

slow growing steroid-secreting tumors

sex-cord stromal tumors

34

MC type of sex-cord stromal tumors

granulosa cell tumors

35

ovarian tumor that secretes estrogen --> inc risk of endometrial hyperplasia, histo shows call-exner bodies

granulosa cell tumor

(type of germ cell ovarian tumor)

36

ovarian tumor that presents with pulling sensation in groin and shows histology with bundles od spindle shaped fibroblasts

Fibroma

(type of germ cell ovarian tumor)

37

ovarian tumor with andoblastoma, secretes testosterone and causes virilization

Sertoli-Leydig cell tumor

(type of germ cell ovarian tumor)

38

Metastatic stomach cancer, Dx mucin containing signet ring cells

Krukenberg tumor

39

very rare cancer (0.5%), 15% present with Latxio's triad (pain, profuse watery d/c (hydrops tubae profluens), pelvic mass)

falopian tube cancer

40

management for fallopian tube cancer

pelvic US, same as epithelial ovarian cancers