Ovarian Cysts/tumors Flashcards Preview

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Flashcards in Ovarian Cysts/tumors Deck (41)
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1

When should ovaries NOT be palpable?

Pre-menarchal
Post-menopausal: non-palpable w/in 3 years

2

What % of reproductive women are the ovaries palpable?

50%

3

What are the size of simple cysts in premenopausal? postmenopausal?

Premonopausal= <3 cm
Postmenopausal= <1 cm

4

What is this describing?
Hyper echoic nodule with distal acoustic shadowing

Benign Teratoma

5

What is this describing?
Network of linear curvilinear pattern

Hemorrhagic Cyst

6

What is this describing?
Homogenous echos

Endometrioma

7

Describe the appearance of a malignant adnexal mass/cyst

1. Solid
2. Nodular/papillary
3. Blood flow
4. Thick septations= >2 mm

8

List the Functional Ovarian Cysts

1. Follicular Cyst=MC*
2. Corpus Luteum Cysts
3. Theca Lutein Cysts

9

What is the MC type of functional ovarian cyst?

Follicular cyst

10

What do follicular cyst result from?

1. Failure of mature follicle to rupture
2. Failure of non-dominant follicles to undergo atresia

11

What do Corpus Luteum Cysts result from? Si/sx?

Failure of corps luteum resorption following ovulation= Continues to produce Progesterone=Missed/Delayed period

12

What is the fluid appearance of Theca Lutein Cysts?

Clear, Straw colored
B/L

13

What do Theca Lutein Cysts result from?

Increased chorionic gonadotropin levels:
1. Hydatidorm mole
2. Choriocarcinoma

14

List the Nonfunctional Epithelial Cell Ovarian Tumors

1. Serous
2. Mucionus
3. Endometriod

15

What is the MC Epithelial Cell Tumor? Presenting age?

Serous Cystadenoma
30-50 y.o.

16

Serous Cystadenoma treatment

Surgical: Cystectomy vs. Oophorectomy

17

Mucinous cyst adenoma (epithelial tumor) US findings

Multiocular septations
Large

18

Mucinous cyst adenoma (epithelial tumor) treatment

Surgical

19

What is the presenting age in germ cell tumors, teratoma?

Reproductive age=30

20

Teratoma clinical presentation

1. Asx: Incidental findings
2. Pelvic Pain: occurs secondary to torsion/rupture (rare)
3. Urinary urgency/frequency
4. Back pain

21

What would you order if you suspect a teratoma?

1. Transvaginal US: Unilateral, complex cyst
2. CEA, CA-125, AFG, BHCG= Normal

22

Teratoma treatment

Surgical

23

List the Stromal Cell tumors. What is unique about these tumors?

1. Granulosa Theca Cell Tumors
2. Sertoli-Leydig Cell tumors

*Malignant Potential

24

What do Granulosa Theca Cell Tumors produce? Along which cell type line?

Produce Estrogen
Develop Along Female Cell Type

25

What do Sertoli-Leydig Cell tumors produce? Along which cell type?

Produce Androgen
Male gonadal tissue type

26

What is the 2nd MC gynecologic CA?

Ovarian CA

27

Ovarian CA RF's

1. FHx: Ovarian, breast or colorectal CA (BRCA, Lynch Syndrome)
2. Personal Hx of Breast CA
3. Increased # of ovulatory cycles
4. Obesity
5. Endometriosis

28

What reduces your risk of ovarian cancer?

1. Long term OCP's
2. Multiparity, breastfeeding
3. Low fat diet
4. B/L Salpingectomy

29

List the 4 types of ovarian cancer

1. Epithelial
2. Germ Cell
3. Sex Cord and Stromal
4. Neoplasma Metastatic to ovary

30

What tumor suppressor gene mutation is associated with epithelial ovarian CA? At what part of the Fallopian tube does the mutation occur?

P53
DISTAL Fallopian tube

31

What is the MC epithelial ovarian CA? Where does it arise from?

High Grade Serous Carcinoma
Arises from Fallopian tubes

32

Are germ cell ovarian cancers normally unilateral or bilateral?

UNILATERAL

33

What is the MC germ cell ovarian cancer?

Dysgerminoma

34

Which germ cell ovarian cancer is the ONLY one that is NOT unilateral

Endodermal Sinus Tumor=Bilateral

35

Which germ cell ovarian cancer is the ONLY one that does NOT produce AFP tumor marker? What tumor marker does it produce?

Dysgerminoma= LDH, +/- hCG

36

What is the MC sex cord and stromal cancer? What age does it present? What does it produce?

Granulosa Cell
50's
Hyperestrogenism: precocious puberty, postmenopausal bleeding

37

Ovarian CA clinical presentation

1. Abd bloating/distention
2. Abd/pelvic pain
3. Early satiety
4. Lethargy
5. Urinary Urgency

38

Ovarian CA physical exam findings

1. Ascites
2. Pelvic mass

39

What kind of ovarian cancer would show an increase in CA-125

Epithelial

40

What kind of ovarian would have increased hCG, AFP, LDH?

Germ Cell

41

Ovarian CA treatment

1. Consult Gynecologist Oncologist
2. Surgical
3. Chemotherapy: advanced dz