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DIT Reproductive > Repro 10 - Ovarian Tumor > Flashcards

Repro 10 - Ovarian Tumor Flashcards

1
Q

What substances are associated w/ functional ovarian cysts?

A

Smoking. Tamoxifen. Progestin-only contraceptives.

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2
Q

What are functional ovarian cysts?

A

Thin walled structures containing serous fluid. There are common and there are different types. Often found incidentally on imaging.

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3
Q

What is a Theca-Lutein cyst?

A

Caused by luteinization and hypertrophy of the theca interna layer of ovary. This is due to elevation of LH or Beta-hCG which can be see in: multiple gestation, choriocarcinoma, molar pregnancy, ovarian hyperstimulation syndrome.

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4
Q

What is an endometrioid cyst?

A

Caused by endometriosis within the ovary. After years, it collects congealed blood, hence why it’s called “Chocolate cyst”.

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5
Q

What is the normal size of an ovary?

A

It is 2 to 5 cm.

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6
Q

What is a good tumor marker for many ovarian cancers? What is it used for?

A

CA-125. Not used for screening; too nonspecific. Used to monitor disease.

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7
Q

What are risk cancers for ovarian cancers?

A

Family history: BRCA1, BRCA2, HNPCC (Lynch syndrome). Uninterrupted ovulatory cycles; nulliparity doubles risk. Early menarche, late menopause.

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8
Q

What are the 4 main categories of ovarian tumors?

A

Epithelial (60% of ovarian tumors, 90% of ovarian cancers). Germ cell. Stromal. Metastatic (GI, breast, endometrium).

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9
Q

Which type of ovarian tumor is the most common tumor and the most common of ovarian cancer?

A

65% of ovarian tumors. 90% of ovarian cancers.

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10
Q

What are the main types of epithelial cell ovarian tumors?

A

[SERious Menstrual ENemies CLEARly Bring Misery] In order of frequency: Serous, mucinous, endometrioid, clear cell, Brenner, mixed.

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11
Q

What are the main types of germ cell ovarian tumors?

A

Teratoma. Dysgerminoma. Endodermal sinus. Choriocarcinoma.

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12
Q

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

A

Granulosa-theca cells. Sertoli-Leydig cell. Fibroma.

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13
Q

What is a cystadenoma?

A

A benign (-adenoma) epithelial cell ovarian tumor. 20% bilateral. It is an uniocular cyst lined by fallopian tube epithelium (ciliated).

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14
Q

What is a Serous Cystadenocarcinoma?

A

An epithelial cell ovarian cancer, it makes up 50% of the ovarian tumors found. Often bilateral. May look like fallopian tube epithelium but may be anaplastic. May contain psamomma bodies (concentric rings of calcification).

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15
Q

What is a Mucinous cystadenoma?

A

An epithelial cell ovarian tumor. Benign. Unilateral. May be multilocular and large. Lined by columnar cells that contain mucin and look like intestinal cells.

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16
Q

What is mucinous cystadenocarcinoma?

A

An epithelial cell ovarian cancer. Malignant. Looks like adenocarcinoma of intestine. May contain Pseudomyxoma peritonei; intraperitoneal mucinous material which is often seen w/ appendiceal cancers.

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17
Q

What is an endometrioid tumor?

A

An epithelial cell ovarian Adenocarcinoma. Looks like endometrium. In 15-20% co-exist w/ endometrial adenocarcinoma.

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18
Q

What is a Clear cell tumor?

A

An epithelial cell ovarian tumor. Very rare. Cells contain abundant, clear cytoplasm.

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19
Q

What is a Brenner tumor

A

An epithelial cell ovarian tumor. Benign. Unilateral. Solid and encapsulated. Looks like transitional epithelium of bladder. “Coffee bean nuclei”; the nuclei appear like that.

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20
Q

What type of ovarian tumor make up 70% of the tumor found in women b/w 10 to 30 y.os?

A

Ovarian germ cell tumors.

21
Q

What is a teratoma?

A

An ovarian germ cell tumor, they make up 90% of the ovarian germ cell tumors. Contains elements from multiple embryonic layers.

22
Q

Which type of teratoma is the most common?

A

Mature teratomas make up 95% of cases; they are called dermoid cysts. Immature are the other type (5%) and contain immature neural elements. Most common in 1st and 2nd decade of life.

23
Q

What is a struma ovarii?

A

A type of teratoma, it contains metabolically active thyroid tissue that can lead to thyrotoxicosis.

24
Q

What is a Dysgerminoma?

A

Occur in young women (as early as 7 months of age). Malignant. It is the equivalent to seminoma in males. They are composed of undifferentiated germ cells, large vesicular cells with clear cytoplasm and centrally placed nuclei. “Sheets of uniform cells”. May produce LDH and/or hCG. May be associated w/ Turner syndrome.

25
Q

What is an Endodermal sinus tumor?

A

AKA “Yolk-sac” tumor. An ovarian germ cell. 1/3 of patients present this at premenarchal stage. They are malignant and derived from primitive yolk sac. Friable, solid yellow mass. “Schiller-Duval bodies”; glomerulus-like structures, they are blood vessels enveloped by germ cells. Causes elevation of AFP.

26
Q

What is an Ovarian choriocarcinoma?

A

An ovarian germ cell cancer. They are rare, highly malignant. Differentiates towards trophoblastic (placenta) structures. Can metastasize (esp. Lung). Produces hCG.

27
Q

What is the most common of the stroma/sex cord ovarian tumors?

A

Fibroma.

28
Q

What is a Fibroma?

A

The most common of the stroma/sex cord ovarian tumors. Benign. Tends to occur in postmenopausal women. Not hormonally active. Due to fibroblast proliferation. Associated with Meig’s syndrome.

29
Q

What is Meigs’ syndrome?

A

Triad: Fibroma, Ascites, Pleural effusion (hydrothorax).

30
Q

What is Granulosa-theca cell tumor?

A

A stroma/sex cord ovarian tumor. Malignant. May produce estrogen, inhibin, and/or progesterone. Can cause precocious puberty, endometrial hyperplasia. “Call-Exner bodies”; small eosinophilic fluid-filled spaces b/w granulosa cells in disarray that resemble primordial follicles.

31
Q

What are Sertoli-Leydig cell tumor?

A

A stroma/sex cord ovarian tumor. They are rare and can be benign or malignant. Can get large (average 15 cm) They contain testicular structures that produce androgens, leading to virilization. May also produce: inhibin or AFP.

32
Q

What is the name of the ovarian tumor if it comes from the GI tract?

A

Krukenberg tumor; mucin secreting, Signet ring cell adenocarcinoma.

33
Q

What ovarian tumor produces AFP?

A

Yolk-sac (endodermal sinus) tumor.

34
Q

What ovarian tumor is estrogen-secreting, leading to precocious puberty?

A

Granulosa-theca tumor.

35
Q

What ovarian tumor is testosterone-secreting, leading to virilization?

A

Sertoli-Leydig cell tumor.

36
Q

What ovarian tumor has Psammoma bodies?

A

Serous cystadenocarcinoma.

37
Q

What ovarian tumor has multiple different tissue types?

A

Teratoma.

38
Q

What ovarian tumor is lined w/ fallopian tube-like epithelium?

A

Serous cystadenoma.

39
Q

What ovarian tumor has ascites and hydrothorax?

A

Ovarian fibroma (Meigs’ syndrome).

40
Q

What ovarian tumor has Call-Exner bodies?

A

Granulosa-theca cells tumor.

41
Q

What ovarian tumor resembles bladder epithelium?

A

Brenner tumor.

42
Q

What ovarian tumor has elevated beta-hCG?

A

Choriocarcinoma. Dysgerminoma.

43
Q

What are three protective factors for ovarian cancer?

A

Pregnancy. Breastfeeding. OCPs.

44
Q

RFF: Most common benign ovarian tumor.

A

Serous cystadenoma.

45
Q

RFF: Most common malignant ovarian tumor.

A

Serous cystadenocarcinoma.

46
Q

RFF: Disarrayed granulosa cells in eosinophilic fluid.

A

Call-Exner bodies.

47
Q

What imaging modality is preferred to evaluate and follow ovarian masses?

A

Ultrasound.

48
Q

Which ovarian mass can be associated w/ Psammoma bodies?

A

Serous cystadenocarcinoma.

DIT Reproductive (18 decks)

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