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Gynaecology > 1: Gynaecological cancers - Ovarian Cysts and Cancer > Flashcards

1: Gynaecological cancers - Ovarian Cysts and Cancer Flashcards

1
Q

What is an ovarian cysts

A

Fluid-filled sac of the ovary

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2
Q

What is a simple ovarian cyst

A

Solely contains fluid

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3
Q

What is a complex ovarian cyst

A

Contains solid components

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4
Q

How are ovarian cysts usually divided

A

Neoplastic

Non-neoplastic

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5
Q

What are neoplastic ovarian cysts

A

Ovarian cysts that have potential to become malignant

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6
Q

What are non-neoplastic ovarian cysts

A

Ovarian cysts with no malignant potential

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7
Q

Name two functional non-neoplastic ovarian cysts

A

Follicular cyst

Corpus luteal cyst

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8
Q

What size are follicular cysts

A

<3cm

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9
Q

What are follicular cysts and when are they present

A

Cysts due to developing follicles in the ovaries. Present during first-half of the menstrual cycle

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10
Q

What size are corpus luteal cysts

A

<5cm

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11
Q

When are corpus luteal cysts present

A

During second-half (luteal phase) of the menstrual cycle

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12
Q

What are 3 pathological non-neoplastic ovarian cysts

A

Endometrioma
Theca lutein cyst
PCOS

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13
Q

What is an endometrioma

A

‘Chocolate’ cyst seen in ovaries in endometriosis

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14
Q

What is the criteria for PCOS

A

> 12 cysts in each follicle

Or, ovarian volume >10ml

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15
Q

How do cysts appear in PCOS on US

A

Ring of pearls - as all the cysts are in the outer aspect

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16
Q

What causes theca lutein cysts

A

High levels of bHCG

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17
Q

When may theca lutein cysts of the ovary be present

A

Molar pregnancies

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18
Q

What are 3 benign neoplastic epithelial cysts

A
  1. Mucinous Cystoadenoma
  2. Serous Cystoadenoma
  3. Brenner tumour
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19
Q

What can serous cystoadenoma become

A

Become most common malignant ovarian tumour (serous)

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20
Q

Are serous cystoadenomas usually unilateral or bilateral

A

Unilateral

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21
Q

what is a feature of mutcnous cystoadenoma

A

Unilateral

Several in one ovary

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22
Q

how does a brenner tumour present

A

Solid white-yellow mass

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23
Q

what is a benign neoplastic germ cell tumour of the ovary

A

dermoid cyst

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24
Q

what is a dermoid cysts also known as

A

mature cystic teratomas

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25
is mature cystic teratoma unilateral or bilateral
unilateral
26
when do mature cystic teratomas often occur
during pregnancy
27
describe features of mature cystic teratomas
due to 'embryologically' being derived from other tissue - can contain teeth, hair and skin cells
28
what is a benign neoplastic sex-chord stromal tumour
fibroma
29
what is the most common stromal tumour
fibroma
30
what do 40% of individuals with fibromas present with
Meig's syndrome
31
what is meig's syndrome
Fibroma and pleural effusion or ascites
32
in which individuals are ovarian cysts more common
Pre-menopausal individuals
33
how do most ovarian cysts present
asymptomatically
34
why may ovarian cysts present with chronic pelvic pain
pressure on bladder or bowel
35
in a pre-menopausal women, what blood tests should be performed and why
LDH AFP bHCG = due to higher risk of germ-cell tumours in under 40's
36
explain next-step in work-up of pre-menopausal women with an ovarian cysts
Re-scan cyst as 6W
37
if the scan is still present at 6W, what monitoring should be offered
Ca125: every 3-6 months | Calculate risk malignancy index (RMI)
38
if the cyst is >5cm at the 6W follow up scan what should be considered
Cystectomy or oophorectomy
39
if post-menopausal women have an ovarian cyst what should first be calculated
Risk malignancy index
40
what defines a low RMI
<25
41
if a post-menopausal women has an RMI <25 what is offered
US at 1-year | Ca125
42
what defines moderate RMI
25-250
43
if an individual has a moderate RMI what is offered
bilateral oophorectomy
44
what defines a high RMI
>250
45
how is high RMI managed
staging laparotomy
46
in which age-group are ovarian cancers more common
>65
47
what is thought to cause ovarian cancer
irritation of epithelium during ovulation
48
what are 5 RF for ovarian cancer
1. Early menarche 2. Late menopause 3. Nulliparous 4. Obesity 5. Smoking 6. FH
49
What two genetic syndromes are associated with ovarian cancer
Lynch | BRCA
50
What cancers does BRCA 1 and 2 increase risk of
Breast and Ovarian cancer
51
What is offered in BRCA1 and 2 carriers
Prophylactic bilateral salpingoopherectomy
52
What is BRCA 2 mutation associated with in men
Prostate cancer
53
What chromosome is BRCA 1
Chromosome 13
54
What chromosome is BRCA 2
Chromosome 17
55
What are 3 protective factors for ovarian cancer
1. Multiparous 2. Breast Feeding 3. COCP
56
How do majority of ovarian cancers present
Asymptomatically Chronic pain PV bleed
57
When is the problem with ovarian cancer
Often presents with non-specific symptoms leading to late diagnosis
58
When should ovarian cancer be suspected
Post-menopausal women with: - PV Bleed - Change in bowel habit - Change in urinary habit - Bloating - Weight loss - New-onset IBS symptoms
59
What are ovarian cancers usually
Epithelial sub-types
60
What are the two types of ovarian cancers
Serous cystoadenomas | Mucinous cystoadenomas
61
What are serous cystoadenomas characterised by
psammoma bodies
62
What are mucinous cystoadenomas characterised by
mucin vacuoles
63
what blood tests should all women with suspected ovarian cancer receive
``` FBC LFT U+E Albumin CA125 ```
64
what imaging is used for ovarian cancer
AUS and pelvic-US
65
what tool is used to determine risk of ovarian cancer
Risk Malignancy Index (RMI)
66
how is the risk malignancy index calculated
Menopausal status x US score x CA125
67
when are individuals referred to gynaecology under 2W rule
RMI >250
68
if ovarian cancer is confirmed what investigations are performed for staging
CT CAP | CXR
69
if individuals have a high-risk RMI what will be performed
De-bulking laparotomy
70
what should all patients with ovarian cancer receive
Chemotherapy
71
explain follow-up for ovarian cancer
CA-125 and Clinical exam follow-up for the next 5-years

Gynaecology (22 decks)

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