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Flashcards in Ovary Witrak Deck (35):
1

What causes Polycystic Ovarian Syndrome (PCOS)?

Don't know...it is thought to maybe be hypothalamic or pituitary malfunction

2

What are some characteristics of PCOS?

Menstrual irregularity
Hyperandrogenism

3

What are some of the potential downstream effects of the menstrual irregularity seen with PCOS?

Anovulation → chronic/sustained estrogen effect → increased risk of endometrial hyperplasia/carcinoma

4

What are some of the potential downstream effects of the hyperandrogenism seen with PCOS?

Hyperandrogenism → Hirsutism, acne, and male pattern balding

5

What are some associations of PCOS?

Enlarged ovaries with polycystic features
Obesity
Insulin resistance/Diabetes

6

A transvaginal ultrasound is performed on a patient, and polycystic ovaries are seen. Is this enough to diagnose this patient with PCOS?

NO...polycystic ovaries can be seen in normal women

7

What are the potential ovarian tumor origins?

Ovarian surface (Mullerian) epithelium
Sex cord/stromal cells
Germ Cells
Metastatic from somewhere else

8

What origin of ovarian tumors occurs most often?

Ovarian surface (Mullerian) epithelium

9

What are the two main types of Mullerian epithelium ovarian tumors?

Serous
Mucinous

10

Do serous tumors tend to be unilateral or bilateral?

Serous tend to be bilateral

11

Do mucinous tumors tend to be unilateral or bilateral?

Mucinous tend to be unilateral

12

What is the most common cause of GYN cancer death?

Epithelial ovarian carcinoma

13

What familial cancer syndromes are associated with epithelium ovarian carcinoma?

BRCA1 (35-46%)
BRCA2 (13-23%)
Lynch (3-14%)

14

What cancer marker is associated with epithelial ovarian carcinoma?

CA-125

15

How is CA-125 used?

Used to follow for tumor recurrence and to monitor treatment

16

Are sex cord/stromal cell ovarian tumors usually bad?

Not really...usually low grade/stage and are surgically curable

Rarely reoccur or metastasize

17

What are three types of sex cord/stromal cell ovarian tumors?

Fibroma/thecoma
Granulosa cell tumors
Sertoli/Leydig cell

18

What type of sex cord/stromal cell ovarian tumors is most common?

Fibroma/thecoma (70%)

19

What is often seen with fibroma?

Large tumors
Ascites and pleural effusion (Meig's syndrome)

20

What type of sex cord/stromal cell ovarian tumor most commonly causes neoplastic estrogen excess?

Granulosa cell tumor...makes sense...

21

Are sex cord/stromal cell tumors typically unilateral or bilateral?

Sex cord/stromal cell tumors are typically unilateral

22

What is the average age of diagnosis with a sex cord tumor?

50 (12% < 30)

23

What are the symptoms associated with sex cord tumors?

Adrenal mass/pelvic displacement
Precocious puberty
Abnormal uterine bleeding
Endometrial hyperplasia/CA
Hirsutism/overt virilization

24

What markers can by used for stromal cell tumors?

Estrogen
Androgen
Inhibin

25

What category of ovarian tumors makes up 70% of ovarian neoplasms in 10-30yo women?

Germ Cell Tumors (GCTs)

26

What is an example of a benign GCT?

Mature cystic teratoma (majority of germ cell tumors)

27

Are mature cystic teratomas typically unilateral or bilateral?

Mature cystic teratomas are bilateral 10-12% of the time

28

What is the female equivalent of testicular seminoma?

Dysgerminoma

29

Is dysgerminoma usually bad?

Make up 33% of all malignant GCTs
Rarely aggressive

30

What do dysgerminoma cells resemble? (Pathoma)

Oocytes...large cells with clear cytoplasm and central nuclei

31

Yolk sac (endodermal sinus) tumors are also malignant, but they tend to be more AGGRESSIVE. Who usually develops these tumors? what serum marker is elevated in these markers?

Yolk sac tumors are the most common germ cell tumor in kids

Serum α-fetoprotein is often elevated

32

Besides yolk sac tumors, what are some other aggressive malignant GCTs?

Immature teratomas
Mixed germ cell tumor

33

What are some rare forms of GCTs?

Pure embryonal carcinoma
Non-gestational choriocarcinoma
Pure polyembryoma

34

What are some general symptoms of GCTs?

Mass/torsion/rupture

35

What is a Kruckenburg carcinoma?

Bilateral mucinous carcinoma usually from the stomach

Signet cells are seen on histology