ovarian tumours

Question 1

Name the germ cell ovarian tumours

Answer 1

yolk sac tumours
dysgerminoma
teratoma
choriocarcinoma

Question 1

mnemonic for yolk sac tumours
AKA ‘endodermal sinus tumours’

Answer 1

SAC:
S chiller-Duval bodies - kind of look like a yolk sitting in egg whites!
A FP raised
C hildren (girls and boys)

Question 2

Mnemonic for dysgerminoma

Answer 2

dysGERMANoma
think of the German flag - 3 colours - 3-letter acronyms

LDH is raised
HCG is raised

Question 3

Name the sex cord stromal tumours

Answer 3

fibroma
sertoli-leydig tumour
granulosa-theca cell tumour

Question 4

sertoli-leydig tumour has what histopathology

Answer 4

Reinke crystals

Question 5

mnemonic to remember sertoli-leydig tumour

Answer 5

sertoli-leyDIG tumour

DIG for crystals
which crystals? Reinke crystals

Also, obviously, they secrete androgens, but you can tell that from the name

Question 6

mnemonic to remember Granulosa cell tumour

Answer 6

GRANulosa cell tumour
CALL your GRAN:
CALL-EXNER BODIES
But also remember that it secretes oestrogen

Question 7

mnemonic for Brenner tumour

Answer 7

Brenner = Bladder-like & Benign

Bladder-like = transitional epithelial (urothelial) cells

Question 8

ovarian cancer is the ___th most common cancer in females

Answer 8

7th most common malignancy in females

Question 9

serous epithelial cancers are what percentage of epithelial ovarian cancers

Answer 9

60 - 80%

Question 10

endometrioid epithelial cancers are what percentage of epithelial ovarian cancers

Answer 10

15 - 20%

Question 11

what type of epithelial ovarian cancer tends to be resistant to chemo?

Answer 11

clear cell carcinoma

Question 12

mnemonic for epithelial ovarian cancers (think of the possible symptoms!)

Answer 12

Early Satiety, Bloating, Constipation, Urinary: Malignancy

Endometroid
Serous
Brenner
Clear cell
(Undifferentiated)
Mucinous

Question 13

germ cell tumours are what percentage of ovarian cancer

Answer 13

5%

Question 14

sex cord stromal tumours are what percentage of ovarian cancer

Answer 14

5%

Question 15

which tumours secrete hormones? germ cell tumours or sex cord stromal tumours

Answer 15

trick questions: it’s some of both.

secretory Germ cell includes:
dysgerminoma - LDH & HCG
yolk sac: AFP
choriocarcinoma: HCG

secretory sex cord stromal tumours include:
sertoli-leydig - androgens
granulosa - oestrogen

Question 16

stage IIIc 5 year survival

Answer 16

20 - 50% (depending on subtype)

Question 17

most ovarian cancers are diagnosed at late stage. What percentage and what stage?

Answer 17

70% and IIIc
(where there are peritoneal deposits >2cm)

Question 18

what is a granulosa cell AKA

Answer 18

follicular cell
i.e. the ones that respond to FSH and make aromatase

It’s more helpful to remember that granulosa cell tumours are granulosa-theca cell tumours - then you can remember that these cells work together to make oestrogen happen

Question 19

endometriosis-linked ovarian cancer

Answer 19

clear cell
endometroid

Question 20

percentage of Brenner tumours that are malignant

Answer 20

5%

Question 21

describe Brenner tumour

Answer 21

aka (ovarian) transitional cell tumour due to histological appearance
on surface of ovary
rare (3% of ovarian cancers)
usually small <2cm
usually not malignant (only 5% malignant)
age 40-70s most common
fibrous so hypointense (dark) on T2 MRI
calcifications in 85% on CT

Question 22

what is a Krukenberg tumour

Answer 22

signet ring subtupe of metastatic tumour to the ovary
usually from stomach cancer
but can also be from colon/breast/lung/contralateral ovary

Question 23

most common fallopian tube malignancy

Answer 23

serous