13.6 Ovarian Tumors Flashcards
What is the tumor that can arise from an oocyte?
Germ cell tumors
What are the cells of the ovary that can develop into sex cord stromal tumors? (3)
Granulosa cells
Theca cells
Fibroblasts
What is the most common type of ovarian tumor?
Surface epithelial tumors
What are surface epithelial tumors derived from?
Coelomic epithelium that lines the ovary
What are the two different subtypes of surface epithelial tumors?
Serous and mucinous cystadenomas
What are the benign form of serous and mucinous ovarian cysts? Malignant?
Cystadenomas - benign
Cystadenocarcinoma - malaign
What ages do cystadenomas usually arise in?
30-40 years
What is the age range that is usually affected with cystadenocarcinoma?
60-70 year old women
What is the difference in the lining of the cystadenomas vs cystadenocarcinoma?
Cystadenomas = smooth
Cystadenocarcinoma = shaggy
What are borderline tumors? Are they benign or malign?
Tumors that have both benign and malignant tumors. They are malignant, but behave better than malignant ones
What are the types of gyn CA that occurs in women with a BRCA1 mutation? (2)
Serous cystadenocarcinoma
fallopian tube carcinoma
What is the endometrioid type of ovarian tumor? Are these usually benign or malignant?
Ovarian cyst that contains endometrium like tissue
Malignant
What condition are endometrioid tumors associated with?
Endometriosis
Separate endometrial cancer
What are Brenner tumors of the ovary? What type of epithelium is contained in them?
Uroepithelium
Do ovarian surface tumors usually present early or late? What is the prognosis?
Usually present late, and carry a poor prognosis
Where do surface ovarian tumors tend to spread?
Locally, especially to the peritoneum
What are the s/sx of surface ovarian tumors?
Vague abdominal symptoms (pain, fullness)
urinary frequency 2/2 compression
What is the surface marker that is classically elevated in ovarian tumors?
CA-125
Who do germ cell tumors of the ovary usually occur in?
Women of reproductive age
What are the two major types of fetal-like tissue ovarian tumors?
- Cystic teratoma
- Embryonal CA
What are the cells that give rise to dysgerminomas?
Germ cells
What type of cancer arises from the placenta?
Coriocarcinoma
What is the most common germ cell tumor?
Cystic teratoma
What are cystic teratomas? Are they benign or malign?
Tumor comprised of fetal tissue, derived from 2+ embryological germ layers
Benign
What percent of cystic teratomas are bilateral?
10%
When in particular do cystic teratomas have a malignant potential?
When there is immature tissue
What is the most common type of immature tissue type that is found in immature teratomas?
Neuroectoderm
What is a somatic malignancy?
A cancer that is within a tissue type in a teratoma
What is the most common somatic malignancy that arises within a teratoma?
SCC of the skin
What is a struma ovarii?
Cystic teratoma composed primarily of thyroid tissue
What are dysgerminomas?
ovarian tumor composed of germ cells
What is the most malignant germ cell ovarian tumor?
dysgerminoma
What are the histological characteristics of dysgerminomas?
large cells with clear cytoplasm and central nuclei (looks like oocyte)
What is the testicular counterpart of a dysgerminoma?
Seminoma
What is the prognosis for a dysgerminoma?
Good–responds to radiotherapy
What lab may be elevated with dysgerminomas?
LDH
Ovarian tumor composed of large cells with clear cytoplasm and central nuclei = ?
Dysgerminoma
What is the most common germ cells tumor in children?
Endodermal sinus tumors
What are endodermal sinus tumors?
Tumors that mimic the yolk sac
What are the histological characteristics of endodermal sinus tumors?
Schiller-Duval bodies–glomerular like structures
What is the lab that may be elevated with endodermal sinus tumors?
AFP
Glomeruloid structures on histological examination of a ovarian tumors = ?
Endodermal sinus tumor
What, generally, are choriocarcinomas?
Malignant proliferation of placenta-like tissue (composed of trophoblasts and syncytiotrophoblasts) NOT villi
What lab is elevated with choriocarcinoma?
beta-HCG
What is the prognosis for de novo choriocarcinoma?
Poor response to chemotherapy
What comprises the functional unit of the placenta?
Villi with surrounding cytotrophoblasts, syncytiotrophoblasts,
What is the key cell that surrounds a placental villus?
trophoblasts
What cells of the placenta are malignant with choriocarcinoma?
trophoblasts (NOT villi)
What are the characteristic of the choriocarcinomas?
Small, hemorrhagic tumor that mets early
Why is it that choriocarcinomas spread early?
It is programmed to invade the endometrium and find blood vessels
What are embryonal carcinomas?
Tumors that are composed of large primitive cells
What are the characteristics of embryonal carcinomas?
Aggressive with early metastasis
What are the histological characteristics of embryonal carcinomas?
Tumors composed of large, primitive cells (embryo-like)
What are the sex cord-stromal tumors composed of?
Cells that resemble the sex cord stromal tissue of the ovary (e.g. Granulosa cells, theca cells)
What do granulosa-Theca cell tumors produce? What, then, are the usual s/sx of these tumors?
Estrogen
Excess estrogen (thus s/sx vary with age)
What are the s/sx of granulosa cell tumors in children, child bearing, and postmenopausal women?
Children = precocious puberty
Adults = menometrorrhagia
Older = resumption of bleeding after menopause
What are Sertoli-Leydig cell tumors?
Tumors composed ot sertoli-Leydig cells that form tubules
What are the histological characteristics of Sertoli-Leydig cell tumors?
Leydig cells that contain characteristics Reinke crystals
What do Sertoli-Leydig cells produce? When, then, are the s/sx of these tumors?
Produce androgen, thus may be associated with hirsutism or virilization
What comprises the functional unit of the testicle?
Sertoli cells surrounded by Leydig cells
Reinke crystals on histological exam = ?
Leydig cell tumor
What are fibromas?
Benign proliferation of fibroblasts
What are the classic symptoms of ovarian fibromas? What is this syndrome called?
Pleural effusions and ascites
Meig’s syndrome
What are Krukenberg tumors? Histological characteristics? Why?
Mucinous ovarian tumors derived from the GI tract (diffuse CA)
Signet ring cells since the mucus produced from these cells pushes the nuclei toward the periphery
What is pseudomyxoma peritonei?
Mucinous material in the peritoneum (“jelly belly”)
What mucinous tumor usually affects only one ovary, and which affects both?
One = mucinous cystadenoma
Two = Krukeburg met
What is the usual cause of pseudomyxoma peritonei?
Appendiceal tumor–mucinous
