Tumors / Cysts

Question 1

• rare, attributable to fact that epithelium of fallopian tubes does not shed cyclically (like endometrium)
• muscularis is thin and composed of cells that don’t respond to estrogenic stimulation

Answer 1

Tumors of Fallopian Tubes

Question 2

_____ are the most common lesions & these tumors account for 1% of all GYN malignancies

Answer 2

Adenocarcinomas

Question 3

• Common
• Follicles enlarge during proliferative phase
• If follicle does not rupture, remains filled w/ fluid and enlarge
• Remain small / have little clinical significance

Answer 3

Ovarian Cysts

Question 4

Where are ovarian cysts usually found?

Answer 4

Cortex of ovary

Question 5

broken grocery bag

Answer 5

Ruptured Follicular Cyst

Question 6

• If ovulated follicle transforms into corpus luteum & transforms into fibrotic corpus albicans, so a cavity could fill w/ fluid, leading to formation of _____.

Answer 6

Corpus Luteal Cyst

Question 7

• Ovaries are bilaterally enlarged & studded w/ follicular cysts
• Cause functional disturbance
• Amenorrhea, obesity, hirsutism, infertility
• Young women (2nd / 3rd decades)
• Ovaries: multicystic w/ thick, tough, pearly white capsule

Answer 7

Polycystic Ovarian Syndrome

Question 8

Another name for PCOS (Polycystic Ovarian Syndrome)

Answer 8

Stein–Leventhal syndrome

Question 9

Answer 9

Polycystic Ovarian Syndrome

Question 10

Pathology of which condition?

• Continuous/abnormal stimulation of ovary by FSH & LH
• (NOT periodic or sequential such as in follicular cysts & luteinized cysts which produce Androgens / male virulism)

Answer 10

PCOS

Question 11

How are Ovarian Neoplasms divided into subtypes?

Answer 11

Based on their cells of origin

Question 12

What are the 4 subtypes of Ovarian Neoplasms

Answer 12

• Tumors of surface/germinal epithelium
• Tumors of germ cells
• Tumors of sex cord stromal cells
• Metastases involving ovaries

Question 13

• On day ___ of menstrual cycles, the egg is discharged through single layer of cuboidal that lines surface of ovary.
• Trauma to surface of ovary monthly can be source of this tumor

Answer 13

Day 14

Tumor of surface/germinal epithelium

(Ovarian Neoplasm)

Question 14

Which neoplasm?

• Women w/ tumor secreting way too much estrogen
• This same tumor can produce androgens –> bearded lady

Answer 14

Tumor of sex cord stromal cells

(Ovarian Neoplasm)

Question 15

Ovarian Neoplams

• Are tumors usually benign or malignant?

Answer 15

Benign tumors are more common

Question 16

Which neoplasm?

• 2nd most common GYN cancer
• Ranks 1st for deaths of GYN cancers (most deadly)
• Causes more deaths than all other tumors of reproductive tract

Answer 16

Ovarian Neoplasms

Question 17

Which ovarian neoplasm is most common?

Answer 17

Tumors of surface/germinal epithelium

• Rupture at ovulation
• Each time the ruptured site heals each month, the proliferation of cells are at increased risk of transforming into tumors

Question 18

What would decrease a woman’s risk of Ovarian Neoplams caused by tumors of surface/germinal epithelium?

Answer 18

Birth Control Pills (suppress ovulation)

Question 19

• What are the 3 categories of Tumors of Surface Epithelium (Ovarian Neoplasms)?
• Which ones are cystic?
• Which ones are solid?

Answer 19

• Serous (cystic)
• Mucinous (cystic)
• Endometroid (solid)

Question 20

All tumors of surface epithelium (ovarian neoplasms) are either _______ or ________.

Answer 20

• Adenomas
• Adenocarcinomas

Question 21

Serous and Mucinous tumors of surface epithelium (ovarian neoplasms) are classified as ____, _____, or _____.

Answer 21

• Benign
• Borderline
• Malignant

Question 22

• Which surface tumor (ovarian neoplasm) is most common?
  
  • Several cysts lumped together within common outer capsule
  • Most are benign
  • If malignant are usually bilateral
  • These tumors mimic fallopian tube epithelium
  • Uncommon before puberty

Answer 22

Serous Tumors

Question 23

“jelly fish w/ a cyst”

Answer 23

Serous Cystadenoma

(Ovarian Neoplasm - Tumor of Surface Epithelium - Serous Tumor)

• Usually benign
• Mimics fallopian tube epithelium

Question 24

“Fat Starfish”

Answer 24

Serous Tumor of Borderline Malignancy

(Ovarian Neoplasms - Tumor of Surface Epithelium)

Question 25

Nemo eggs

Answer 25

Serous Cystadenocarcinoma

Question 26

Guts covered in blood

Answer 26

Serous Cystadenocarcinoma

Question 27

**Which neoplasm?** * Usually benign (7:1) * Usually unilateral * Cavity filled w/ thick yellow/clear jelly * If ruptured or if malignant tumor invades peritoneum --\> entire body filled w/ mucus * Mimics endocervical epithelium

Answer 27

**Mucinous Tumor** | (Ovarian neoplasm - Surface Tumor)

Question 28

Mucinous Tumor ruptures or malignant tumor invades peritoneum, entire belly filled w/ mucus.

Answer 28

Pseudomyxoma peritonei

Question 29

Yellow jelly

Answer 29

Mucinous Cystadenoma

Question 30

Barnicles

Answer 30

Mucinous Cystadenocarcinoma

Question 31

Answer 31

**Pseudomyxoma peritonei** * ruptured tumor * malignant tumor invading peritoneum --\> belly filled w/ mucous from Mucinous Tumor of Surface Epithelium

Question 32

* Solid tumor * Composed of glands which resemble endometrial glands * 15-30% w/ carcinoma of endometrium * 15% w/ benign endometriosis * Surface epithelium is solid / char by dense fibrous stroma w/ scattered nests of transitional epithelium

Answer 32

Endometroid & Brenner Tumors

Question 33

Brown balls

Answer 33

Brenner Tumor

Question 34

* Tumors which produce no sxs, so once recognized is usually too late to treat pt * Surgery / Chemo don't help much... * Benign tumors w/ excellent prognosis w/ 5 yr survival rate of 100% * Prognosis depends on stage of tumor

Answer 34

**Surface Epithelium Tumors** | (Ovarian Neoplasms)

Question 36

**Which ovarian neoplasm?** * Have good prognosis, but 5 yr survival is 80%

Answer 36

"Borderline" Surface Epithelial Tumors

Question 37

**Which ovarian neoplasm?** * 5 yr survival is 10-40% depending on stage

Answer 37

Malignant Surface Epithelial Tumor

Question 38

* Tumor occurs in women younger than 25 yrs * Most common ovarian tumor in women under 25 yrs * Dermoid cyst is 95% of these tumors * MIDLINE tumors

Answer 38

Germ Cell Tumors

Question 39

What is the most common Germ Cell Tumor?

Answer 39

Benign Cystic Teratoma (95%) | (Dermoid Cyst)

Question 40

* Cyst that is lined on inside w/ hairy skin * Wall contains teeth, bone, cartilage, skin appendages (sweat/sebacceous glands) = bad odor * Benign, but should be resected bc/ if left in place may become malignant

Answer 40

Benign Cystic Teratoma | (Dermoid Cyst)

Question 41

Answer 41

Mature Cystic Teratoma (Benign Cystic Teratoma) (dermoid cyst)

Question 42

Answer 42

Mature Cystic Teratoma (Benign Cystic Teratoma) (Dermoid Cyst)

Question 43

"White foot stepping on crunchy soil"

Answer 43

Mature Cystic Tertoma (Benign Cystic Teratoma) | (Dermoid Cyst)

Question 44

* **Ovarian counterpart of male Seminoma** * Uncommon, but makes up half of all malignant germ cell tumors * Usually occurs in childhood * ALL are malignant! But only 1/3 are aggressive

Answer 44

Dysgerminoma

Question 45

* Ovarian counterpart of Yolk Sac Tumor of male testes * Too rich in AFP (alpha fetoprotein) * Rare, grows aggressively/rapidly * Predominantly in children and young adults

Answer 45

Endodermal Sinus Tumor

Question 46

* Usually exists in combination w/ other germ cell tumors of ovaries (teratocarcinomas) * Identical to placenta or testicular lesions * Elaborates HCG to help w/ diagnosis * "ugly" and bulky * highly lethal

Answer 46

Choriocarcinoma