Week 4: Ovary Flashcards

Question

Serous tumors of the ovary gross histology

Answer 1

D. Mucinous tumor

Answer 2

B and D Granulosa cell tumor (estrogen and inhibin) Thecoma (estrogen) both can be functional tumors

Answer 3

* Coelomic epithelium -\> ovary surface

Answer 4

Primordial germ cells

Answer 5

Undifferentiated mesenchyme

Answer 6

Characterized by High LH and Low FSH ( LH:FSH \> 2)

Answer 7

* Anovulation, Oligomenorrhea and/or infertility * Obesity * Hirsutism, Acne * Non-insulin dependent diabetes * HTN * Sclerocystic change

Answer 8

Ovarian epithelial neoplasms

Answer 9

* most common in women over 50

Answer 10

May be bilateral Multiple histologic types: * Serous * Mucinous * Endometrioid Has three stages of biologic behavior 1. Benign 2. Borderline 3. Malignant

Answer 11

Sever theories of origin exist: * MEtastasis from fallopian tube primary tumor * Possibly via ovulation with ovarian surface breaks to release Ova and heals to include cysts of surface epithelium inside ovarian parenchyma * This followed by tissue metaplasia where one tissue type changes into another

Answer 12

cortical inclusion cyst (includes some ovary surface stuff)

Answer 13

Healed ruptured follicle from ovulation which includes some surface cells and material

Answer 14

* Serous (tubal) * Mucinous * Endometrioid * Clear cell * Transitional (bladder)

Answer 15

* Benign cystadenoma (70%) \*Single-cell layer\* * Borderline (low-malignant potential) * Malignant invasive carcinoma

Answer 16

More than 50% are Serous tumors of the ovary

Answer 17

most common is Serous tumors of the ovary * Nulliparity * FHx: BRCA₁ mutation (40% lifetime risk) * BRCA₂ (10% lifetime risk)

Answer 18

* High parity * OCPs

Answer 19

* most common type of ovarian epithelial tumor * Tubal/surface epithelium sometimes with psammoma bodies * Can be nenign, borderline or malignant adenocarcinoma * Serous adenocarcinomas may spread diffusely throughout the abdomen * CA-125 useful serum marker to monitor treatment and recurrence * often bilateral, typically cystic filled with watery serous fluid

Answer 20

25% of ovarian tumors

Answer 21

* Usually unilateral * mucinous endocervical or enteric-type epithelium * can be benign, borderline or adenocarcinoma * often large cystic masses filled with mucinous fluid * Uncommonly spreads outside the ovary * Pseudomyxoma peritonei

Answer 22

* a Mucinous tumor of the ovary metatastic to the peritoneum * mucinous ascites and tumor implants on peritoneal surfaces * may cause intestinal obstruction and death * Mimicked by metastasis from appendix/colon * Check colon and perform appendectomy at time of surgery

Answer 23

20% of ovarian tumors

Answer 24

* microscopic appearance of uterine endometrial carcinoma * 15-20% arise associated of uterine endometrial carcinoma * 15-20% arise associated with ovarian endometriosis * Can be benign, borderline or adenocarcinoma * Ovarian and uterine endometrial carcinoma iften occur together (15-20%) * concurrent independent primaries or Metastases?

Answer 25

* Borderline and carcinoma forms are rare * may be solid or cystic with mucinous component * Rare ovarian transitional carcinomas resemble bladder carcinoma

Answer 26

Benign form = Brenner tumor which is the most common form of Transitional cell tumors of the ovary

Answer 27

Brenner tumor (benign form)

Answer 28

* The most common and benign form of Transitional cell tumors of the ovary * Resembles bladder epithelium

Answer 29

CA-125 useful to monitor treatment and recurrence

Answer 30

Mature Teratomas

Answer 31

Coelmic epithelium

Answer 32

Primordial germ cells

Answer 33

Undifferentiated mesenchyme

Answer 34

Extraembryonic membranes

Answer 35

Germ cells

Answer 36

Germ cells

Answer 37

Primitive tissue

Answer 38

Mature Teratomas

Answer 39

Seen in reproductive aged women

Answer 40

All three fetal germ cell layers: Mature endoderm Mature ectoderm Mature endoderm

Answer 41

can be diagnosed radiologically by the presence of bone or teeth

Answer 42

A form of teratoma comprised of thyroid tissue, may be functional with hyperthyroidism

Answer 43

* malignant transformation of mature teratoma: squamous cell carcinoma, adenocarcinoma, chondrosarcoma, etc. * Immature (and malignant) tissues rather than mature; embryonic tissues * Very aggressive tumors often wth poor prognosis

Answer 44

Dysgerminoma

Answer 45

Dysgerminoma

Answer 46

Turner Syndrome

Answer 47

solid tumor with sheets of uniform cells admixed with lymphocytes

Answer 48

Serum LDH may be elevated

Answer 49

usually pregnancy related

Answer 50

Elevated bhCG

Answer 51

placental-like with malignant trophoblasts

Answer 52

* Aggressive malignant tumor

Answer 53

* Schiller-Duval bodies * PSA+ hyaline-like globules * glomerulus like structures

Answer 54

aggressive malignant tumor with large primitive cells

Answer 55

embryonic tissues which produce the gonadal stroma (background support tissue) in females give rise to granulosa and theca cells In males give rise to Sertoli and Leydig cells in both sexes background stroma is composed of fibroblasts

Answer 56

* Granulosa cell tumor * Thecoma * Sertoli-Leydig cell tumor (can also be in men) * fibroma and fibrosarcoma

Answer 57

* Sertoli-Leydig cell tumor (also in women) * Fibroma and fibrosarcoma

Answer 58

functional refers to the ability of a tumor to produce sex hormones and the clinical effects of hyperestrinism and hypertestosteronism

Answer 59

* Granulosa cell tumor - Estrogen and inhibin * Thecoma - estrogen * Sertoli-Leydig cell tumor - testosterone

Answer 60

elevated estrogen typically produces abnormal uterine bleeding in post-menopausal women

Answer 61

loss of female secondary sex characteristics, hirsutism, balding, breast atrophy, coive deepining, amenorrhea

Answer 62

* seen at any age but more common in post-menopausal women * Juvenile Granulosa cell tumors seen in girls with precocious puberty

Answer 63

Rare malignant tumor

Answer 64

Abnormal uterine bleeding which may indicate concurrent endometrial hyperplasia or carcinoma Solid tumors secrete inhibin which can be used as a biomarker for monitoring

Answer 65

* "coffee bean" nuclei with nuclear grooves * Call-Exner bodies * small follicles with eosinophilic secretions

Answer 66

seen in girls with precocious puberty

Answer 67

seen in young women (average age of 25 years)

Answer 68

about 30% are virilizing with elevated serum testosterone; remainder with no hormonal effects

Answer 69

solid tumors with two cell types: Sertoli cells Leydig cells (Reinke crystals)

Answer 70

Sertoli-Leydig cell tumors in the Leydig cells

Answer 71

may be poorly differentiated and at an advanced stage when discovered for a poor prognosis

Answer 72

* Ovarian fibroma is the most common stromal tumor

Answer 73

typically seen in middle-age and often combined with thecomas (functional)

Answer 74

solid very firm benign tumors composed of fibroblasts Malignant variants may occur and are called fibrosarcomas

Answer 75

benign but malignant variants may occur and are called fibrosarcomas

Answer 76

* Often occur along with functional thecomas * May be associated with pleural effusions and ascites (Meigs Syndrome)

Answer 77

* majority are bilateral * often intramullerian (fallopian tube and endometrium) * Extramullerian (GI tract, colon, appendix, stomach (Krukenberg), breast)