13.6 Ovarian Tumors Flashcards
what are the three cell types in an ovary
surface epithelium, germ cells, sex cord-stroma
What cell type(s) of the 3 in an ovary can cancer arise from ?
all 3
what is the MC cell type of ovarian tumor?
surface epithelial tumors
what is the surface epithelium of the ovary derived from
coelemic epithelium
coelemic epithelium gives rise to the lining of what 3 structures (and produces their epithelium as well)
fallopian tube
endometrium
endocervix
What type of cells are the epithelium of the fallopian tube
serous cells
What type of cells are the epithelium of the endocervix
mucinous cells
Serous tumors are full of what? Mucinous tumors are filled with?
serous - watery fluid
mucinous - mucus-like fluid
serous and mucinous tumors can be classified how (3)
benign, borderline, malignant
what does one call a benign surface epithlial ovarian tumor
cystadenoma
what does one call a malignant surface epithlial ovarian tumor
cystadenocarcinoma
cystademonas (benign) have how many cysts and simple (single cell layer) or complex (multiple cell layer) lining?
single layer of epithelial cells
single cyst
MC age for cystadenomas (pre or post menopause)
30-40 yo premenopause
MC age for cystadenocarcinomas (pre or post menopause)
60-70 postmenopause
describe cystadenocarcinoma (number of cysts and cell lining)
multiple cysts complex lining (thick, shaggy)
are borderline surface epithelial tumors benign or malignant? px?
clearly malignant (can metastasize) but have better px than malignant
what 2 cancers do BRCA1 carriers have an increased risk for?
serous carcinoma of the ovary and fallopian tube
if an ovarian tumor has cells that resemble urothelium what is it called
Brenner tumor
Are Brenner tumors usually benign or malignant?
benign
are endometroid tumors usually benign or malignant
malignant
what type of tumor is an endometrioid tumor
surface epithelium tumor
what type of tumor is a Brenner tumor
surface epithelium tumor
what condition can give rise to endometrioid tumor
endometriosis
surface epithelial tumor present early or late and why?
late- lots of room to grow
What does late presentation of surface epithelium tumors say about prognosis
poor prognosis - THE WORST px of the female genital tract cancers
what sx do surface epithelium tumors present with (2)
vague abdominal sx, signs of compression (urinary frequency)
where do surface epithelium carcinomas spread
locally (peritoneum)
what is the marker for surface epithelium tumors
CA-125
what is the second MC tumor of ovaries?
germ cell tumors
what tumor is MC in following ages:
15-30 (reproductive age)
35-40
60-70
15-30 - germ cell tumor
35-40 benign surface epithelium tumor
60-70 - malignant surface epithelium tumor
what are the 4 types of tissue associated with germ cell tumors
oocytes
fetal tissue
yolk sac
placental tissue
what germ cell tumor mimics fetal tissue (2)
cystic teratoma
embryonal carcinoma
what germ cell tumor mimics oocyte tissue
dysgerminoma
what germ cell tumor mimics yolk sac tissue
endodermal sinus tumor
what germ cell tumor mimics placntal tissue
choriocarcinoma
what is MC germ cell tumor in females
Cystic teratoma
Are cystic teratomas usually benign or malignant
benign
What 2 findings would indicate malignant potential in a cystic teratoma
immature tissue somatic malignancy (cancer of the tissuee inside the teratoma)
what is the MC immature tissue ina an immature cystic teratoma
Neural ectoderm
What is MC cancer in smatic malignancy of cystic teratoma
SqCC of skin
What is struma ovarii
a teratoma comprised primarily of thyroid tissue
What is MC malignant germ cell tumorq
dysgerminoma
what is the histo appearance of cells of dysgerminoma (3)
large cells, clear cytoplasm, central nuclei
what is testicular counterpart of dysgermonoma called
seminoma
px of dysgerminoma
good- responds to radiothx
what marker is elevated in dysgerminoma
serum LDH
what is MC germ cell tumor in children
Endodermal sinus tumor (yolk-sac tumor)
what would the histological appearance of a Endodermal sinus tumor (yolk-sac tumor) resemble
a glomerulus
what is a glomerulus like structure called in an Endodermal sinus tumor (yolk-sac tumor)
Schiller-duvall bodies
What marker is elevated in Endodermal sinus tumor (yolk-sac tumor)
serum AFP
2 cell types present in Choriocarcinoma and what structure is absent
trophoblasts - syncytiotrophoblasts and cytotrophoblasts are both present
villi are absent!!!
is Choriocarcinoma malignant? why?
yes- trophoblasts are programmed to find blood from mother and invade tissues to do it so they spread early
what marker is elevated in Choriocarcinoma (produced by what cell?)
B-hCG produced by syncytiotrophoblasts
WHat might elevated B-hCG in Choriocarcinoma lead to
thecal cysts in ovary
what is Choriocarcinoma response to chemo
poor
is embryonal carcinoma benign or malignant
malignant
what is the only benign germ cell tumor
cystic teratoma
is embryonal slow or aggressive
aggressive with early metastasis
what type of tumor is embryonal?
germ cell tumor of ovary
What type of tumor is a granulosa-theca cell tumor?
sex-cord stromal tumor
granulosa-theca cell tumor presents with signs of what excess
estrogen
Prior to puberty how does granulosa-theca cell tumor present
early puberty
at reproductive age how does granulosa-theca cell tumor present (2)
menorrhagia, metrorrhagia- bleeding bt periods
post-menopause how does granulosa-theca cell tumor present
endometrial hyperplasia with abnormal bleeding
what is the MC age range (not numbers but a period) FOR granulosa-theca cell tumor presentaiton
post-menopause
Is granulosa-theca cell tumor beingn or malignant
malignant
what type of tumor presents with Reinke crystasl
Sertoli-Leydig cell tumor
what homo does a Sertoli-Leydig cell tumor produce and how does it present (2ways)
androgen
hirsutism
virilization
Meigs syndrome: associated with what tumor,
Fibroma
Meigs syndrome: associated with what 2 sx
Ascites, pleural effusion
Fibroma: beingn or malignant?
benign
Fibroma: a tumor of what cell type
fibroblasts
What are the 3 sex cord-stromal tumors of the ovaryq
fibroma, Granulosa-theca cell, Sertoli-Leydig cell tumors
What are the 2 types of metastatic tumors of the ovary
Krukenberg, PSeudomyxoma peritonei
Krukenberg tumor: Serous or mucinous
mucinous
Krukenberg tumor: what chc cell type and how it is formed
signet ring cell- mucous in cyto pouches nucleus to edge
Krukenberg tumor: Most often dt metastatsis of what Cancer (3 words)
diffuse gastric carcinoma
What distinguishes Krukenberg tumor from primary mucinous carcinoma of the ovary
Krukenberg tumor is bilateral
What cell type is involved in a primary mucinous carcinoma of the ovary
surface epithelial tumor
PSeudomyxoma peritonei is also called what? Why?
aka “jelly belly” dt large amounts of mucous in the peritoneum
tumor from what site usually metastasizes to produce PSeudomyxoma peritonei
appendix
