Ovarian & Fallopian tube tumors Flashcards
(46 cards)
what are the diff places in the ovary that a tumor can arise from?
epith
stroma
germ cells
rarely, a met from other primary cancers
what is the most common origin of an ovarian cancer?
epithelium
what is a Krukenberg tumor?
a met to the ovary (primary is usually GI, breast, or endometrium)
how is ovarian c. spread?
direct exfoliation of cells through peritoneal fluid, lymph spread. Hematogenous is more rare.
CP of advanced ov ca?
vague ab'l pain early satiety pelvic P urinary freq, dysuria ascites (2/2 intraperitoneal tumors) ventral hernia ileus (2/2 bowel being encased with tumor) => malnutrition, cachexia
how does ovarian epith cancer arise?
prolonged periods of uninterrupted ovulation (nulliparity, delayed childbearing, late menopause) => disruption of epith => need to activate cellular repair mechs => more opportunities for mutations to arise
familiar ov cancer syndromes:
Lynch II (HNPCC + ov + breast + endometrial) BRCA2 >> BRCA1
what is the risk of dvp’ing ov ca in an ave-risk pt? (1 in what)
1 in 60
median age of dx of ov ca?
61
what should you think of in a pt under age 20 with an ovarian tumor?
germ cell tumors (not epith)
what can protect against ov ca?
OCPs (less ovulatory events)
multiparity
breastfeeding
chronic anovulation
what is a Sister Mary Joseph nodule
ov ca mets to umbilicus
w/u of adnexal mass:
pelvic u/s
dtm if benign or malignant
may need CT or MRI
DO NOT do paracentesis or cyst aspiration! Can spread dis!
if malignant, need to decide if its ov primary or met from somewhere else.
u/s findings of a benign adnexal mass:
< 8cm cystic not loculated unilateral calcifications, teeth, hair present
u/s findings of a malignant adnexal mass:
> 8 cm solid or cystic + solid multilocular bilateral ascites
how is ov ca staged?
surgically - do TAHBSO, omentectomy, peritoneal washes, cytology, pap smear of diaphragm, sample pelvic & para-aortic LNs
char’ics of each stage:
stage I = growth is limited to ovaries stage II = dis extends from ovary to pelvis stage III = dis extends into ab'l cavity stage IV = distant mets (most are at stage III or IV)
what are the 6 types of ovarian epithelial tumors?
serous mucinous endometrioid clear cell Brenner undiff'd
what is the most common malig ov epith cell tumor?
serous cystadenocarcinomas
where do ovarian epith tumors tend to extend?
peritoneum, not underlying ovary
what is CA-125 used for?
tracking effect of tx & recurrence
tx of ov ca?
TAHBSO, omentectomy, bilat pelvic & para-aortic LN sampling. Then chemo, then “second-look” laparoscopy.
5-yr survival rate for epith cell ov ca?
20%
what do germ cell tumors arise from?
totipotent germ cells (ccan diff’ate into yolk salk, placenta, fetus)
