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Sem 4 Mini 3 > Ovarian Cysts and Tumors of Epithelial Origin > Flashcards

Ovarian Cysts and Tumors of Epithelial Origin Flashcards

1
Q

Example of Non-neoplastic Ovarian Disease?

A

Polycystic Ovarian Disease (stein leventhal syndrome)

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2
Q

Types of Non Neoplastic Cysts?

A

Follicle Cysts

Corpus Luteum Cysts

Theca Lutein Cysts

Surface Epithelium Inclusion Cysts

Chocolate Cysts

Polycystic Ovaries

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3
Q

What is the Classic triad in PCOS?

A

Amenorrhea

Hirsutism

Obesity

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4
Q

Cause of development of Polycystic Ovaries?

A

polycystic ovaries d/2 persisten anovulation

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5
Q

Diagnostic Criterion for PCOS?

A

At least 2 of the following 3 features:

  • Oligo-ovulation or anovulation (manifested as oligio- or a- menorrhea)
  • Hyperandrogenism (clinical or biochemical)
  • Polycystic Ovaries (defined on ultrasonography)
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6
Q

What are the predisposing factors of PCOS?

A
  • Mostly unk. Etiology
  • Functional deficit in P450c17 (17 hydroxylase)
  • Familal disorder
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7
Q

Key features of PCOS?

A
  • Insulin resistance
  • Androgen Excess
  • Abnormal Gonadotropin dynamics
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8
Q

Pathogenesis of PCOS?

A

A proposed mechanism for anovulation and elevated androgen levels suggests that, under the increased stimulatory effect of luteinizing hormone (LH) secreted by the anterior pituitary, stimulation of the ovarian theca cells is increased. Hyperinsulinemia also can lead to theca cell hyperplasia with the same results. These cells, in turn, increase the production of androgens (eg, testosterone, androstenedione). Because of a decreased level of follicle-stimulating hormone (FSH) relative to LH, the ovarian granulosa cells cannot aromatize the androgens to estrogens, which leads to decreased estrogen levels and consequent anovulation. Growth hormone (GH) and insulin-like growth factor–1 (IGF-1) may also augment the effect on ovarian function

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9
Q

what are the morphologic signs of anovulation?

A

Multiple, small, and subcapsular follicular cysts (unruptured follicles)

thick and smooth ovarian surfaces (no ovulation–no rupture–no scar)

no corpora lutea and corpora albicanata

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10
Q

Other morphological signs of PCOS?

A

Hyperplastic and fibrotic stroma

Hyperplastic theca interna

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11
Q

PCOS Complications?

A
  • Infertility
  • Increased risk of DM
  • Increased risk of CVD (cardio or cerebro)
  • Increased risk of developing endometrial hyperplasia–>endometrial carcinoma
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12
Q

Common age for developing Ovarian tumors?

A

any age, mainly reproductive.

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13
Q

Prognosis of Ovarian tumors?

A

poor

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14
Q

Are ovarian tumors unilateral or bilateral?

A

unilateral>bilateral

(except serous cystadenoCA)

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15
Q

How to screen for ovarian tumors?

A

pelvic sonography/CT/MRI/PET

BRCA screening

Osteopontin, serum CA-125 glycoprotein

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16
Q

Risk factors for Ovarian Cancers?

A

Family history

Age

Obesity

17
Q

Risk REDUCERS for ovarian cancer

A
  • pregnancy and lactation
  • “the pill”- oral contraceptives
  • tubal ligation
  • ovariectomy in high risk
  • low fat diet
18
Q

Origin of Ovarian Tumors?

A

Mullerian ducts are formed from coelomic epithelium and evolve into serous (tubal), endometrial and mucinous (Cervix) epithelium.

19
Q

What are the symptoms of ovarian neoplasia?

A

bloating or pressure in the belly

pain in the abdomen or pelvis

felling full too quickly during meals

urinating more frequently

20
Q

Simplified clinical staging of Ovarian Cancer?

A
21
Q

Methods of Tx for Ovarian Cancer?

A

Chemotherapy

Surgery

Anti-angiogenesis therapy

22
Q

What are the most common ovarian tumors?

A

Surface epithelial (mullerian) tumors

23
Q

What are examples of surface epithelial tumors?

A

Benign: Minimal Epithelial proliferation
Borderline: Moderate to high epithelial proliferation
Malignant: Epithelial proliferation with stromal invasion

24
Q

Oncogenesis of Serous and Mucinous Ovarian CA

A
25
Q

Serous Cystadenoma gross morphology?

A

uni-/paucilocular cyst, smooth lining, with occasional epithelial folds

26
Q

Serous cystadenoma histology?

A

one layer of columnar cells

27
Q

Serous CystadenoCA Gross morphology?

A

Bilateral solid or cystic uni-/paucilocular

Papillae on external and internal surfaces

28
Q

Diagnostic feature of serous cystadenoCA?

A

Psammoma Bodies

29
Q

Mucinous Cystadenoma

A
30
Q

Mucinous CystadenoCA

A
31
Q

Mucinous CystadenoCA histology

A
32
Q

Jelly Belly Syndrome?

A

Pseudomyxoma Peritonei

33
Q

How does jelly belly syndrome present?

A
  • Jelly like mucus within peritoneal cavity
  • Cystic implants on peritoneal leaflets
34
Q

Origin of Jelly Belly Syndrome?

A

mucinous tumors either from appendix or ovary

35
Q

Oncogenesis of Clear Cell and Endometrioid Ovarian CA

A
36
Q

Endrometrioid CA

A

Concomitatnt endometrial carcinoma may be seen in 15-30% of women.

37
Q

Clear Cell CA

A
38
Q

Brenner Tumor

A
39
Q

REVIEW OF LECTURE

A

Sem 4 Mini 3 (7 decks)

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