Flashcards in Ovarian Neoplasms Deck (18)
How does an ovarian neoplasm present?
adnexal mass, abdominal distension, bowel obstruction, pleural effusion. DX: surgically. Monitor progression by measuring CA-125 levels.
What are the Benign ovarian neoplasms?
Serous cystadenoma, mucinous cystadenoma, endometrioma, mature cystic teratoma (dermoid cyst), Brenner tumor, Fibromas, Thecoma
Most common ovarian neoplasm. Thin walled, uni or multilocular. Lined with fallopian-like epithelium. Often bilateral
Multiloculated, large. Lined by mucus secreting epithelium.
Mass arising from growth of ectopic endometrial tissue. Complex mass on ultrasound. Presents with pelvic pain, dysmenorrhea, dysparenuia
Mature Cystic Teratoma (dermoid cyst)
Germ cell tumor, most common ovarian tumor in women (20-30 years old). Can contain elements from all 3 germ layers; teeth, hair, sebum are common components. Can present with pain secondary to ovarian enlargement or torsion. Can also contain functional thyroid tissue and present as hyperthyroidism (struma ovarii)
looks like bladder. solid tumor that is pale yellow-tan in color and apears encapsulated. "coffee bean" nuclei on H&E
Bundles of spindle shaped fibroblasts. Meigs syndome - triad of ovarian fibroma, ascites, and hydrothorax. Pulling sensation in groin
Like granulosa cell tumors, may produce estrogen. Usually present as abnormal uterine bleeding in a postmenopausal woman.
What are the malignant ovarian neoplasms?
Immature teratoma, granulosa cell tumor, serous cystadenocarcinoma, mucinous cystadenocarcinoma, dysgerminoma, choriocarcinoma, yolk sac (endodermal sinus) tumor, krukenberg tumor
Aggressive, contains fetal tissue, neuroectoderm. Immature teratoma is most typically represented by immature/embryonic like neural tissue. Mature teratoma are more likely to contain thyroid tissue.
Granulosa cell tumor
Most common sex cord stromal tumor. Predomionanty women in their 50s. Often produce estrogen and/or progesterone and present with abnormal uterine bleeding, sexual precocity (in pre-adolescents), breast tenderness. Histology shows Call-Exner Bodies (resemble primordial follicles).
Most common ovarian neoplasm, frequently bilateral. Psammoma bodeis
Pseudomyxoma Peritonei-intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor.
Most common in adolescents. Equivalent to male seminoma but more rare. 1% of all ovarian tumors; 30% of germ cell tumors. Sheets of uniform 'fried egg' cells. hCG, LDH = tumor markers.
Rare; can develop during or after pregnancy in mother or baby. malignancy of trophoblastic tissue (cytotrophoblasts, syncytiotrophoblasts); NO chorionic villi present. Increase frequency of theca-lutein cysts. Presents with abnormal B-hCG, shortness of breath, hemoptysis. Hematogenous spread to lungs. Very responsive to chemotherapy.
Yolk Sac (endodermal Sinus) tumor
Aggressive, in ovaries or testes (boys) and sacrococcygeal area in young children. Most common tumor in male infants. Yellow, friable (hemorrhagic), solid mass. 50% have Schiller-Duval bodies (resemble glomeruli). AFP tumor marker