17. Fallopian Tubes and Ovary

Question 1

What is an ectopic pregnancy?

Answer 1

Implantation of the foetus outside the uterus

Question 2

What factors increase the risk of an ectopic pregnancy?

Answer 2

PID

Adhesions

Question 3

What benign neoplasms can be found in the fallopian tubes?

Answer 3

Paratubal cysts (glands of Morgagni)
Salpingitis isthmica nodosa
Endosalpiniosis
Adenomatoid tumour (outside of tube)

Question 4

What mutation is associated with fallopian tumours?

Answer 4

BRCA

Question 5

What causes ovarian torsion?

Answer 5

Cysts and tumours

Veins get blocked so congestion and infarction

Question 6

How do ovarian cancers present?

Answer 6

Abdominal distension
GI symptoms
Disturb menstruation
Pelvic pain

Question 7

What are the types of invasive ovarian tumours?

Answer 7

Serous
Endometrioid
Clear cell
Mucinous
Brenner tumours

Question 8

Where do each of the invasive ovarian tumours originate?

Answer 8

Serous: tubes
Endometrioid and clear cell: endometriosis
Mucinous: appendix, colon, pancreas

Question 9

What are the risk factors for ovarian cancer?

Answer 9

Nulliparous

Family history

Question 10

What factors are protective against ovarian cancers?

Answer 10

OCP

Tubal ligation

Question 11

What genetic mutations are associated with ovarian cancer?

Answer 11

BRCA
Her2
p53

Question 12

What are the benign tumours of the ovary?

Answer 12

Cystadenoma
Cystadenofibroma
Adenofibroma

Question 13

What features are seen in malignant ovarian tumours?

Answer 13

Papillae

Psammoma bodies

Question 14

What causes psammoma bodies?

Answer 14

Dystrophic calcification

Question 15

Which malignant ovarian tumour is the highest grade?

Answer 15

Serous

Question 16

What is the appearance of a mucinous ovarian tumour?

Answer 16

Cells full of mucin with nucleus pushed to the side
Often bilateral
Nodular surface

Question 17

What complication is associated with mucinous ovarian tumours?

Answer 17

Pseudomyxoma peritoneii: extensive, non-invasive takeover of the abdominal cavity

Question 18

What marker will be positive if a mucinous tumour originated in the colon?

Answer 18

CK20+

Question 19

What marker will be positive if a mucinous tumour originated in the pancreas?

Answer 19

CK7-

Question 20

What staging system is used for ovarian cancer?

Answer 20

Figo stages

Question 21

What is stage 1 ovarian cancer?

Answer 21

a. one ovary, intracystic
b. 2 ovaries, intracystic
c. Rupture, tumour on the surface

Question 22

What is stage 2 ovarian cancer?

Answer 22

Spread to pelvis

Question 23

What is stage 3 ovarian cancer?

Answer 23

Spread to abdomen/lymph node

Question 24

What is stage 4 ovarian cancer?

Answer 24

Distant spread

Question 25

What are the symptoms of germ cell tumours?

Answer 25

Torsion
Chronic low grade pain, mass
May not present until pregnancy
Early puberty and hCG production

Question 26

What is the most common type of germ cell tumour of the ovary?

Answer 26

Benign cystic teratoma

Question 27

What are the types of germ cell tumour in the ovary?

Answer 27

Teratoma
Dysgerminoma
Yolk sac tumours
Embryonal

Question 28

What is the difference between a mature teratoma and an immature teratoma?

Answer 28

Immature is malignant and occurs in younger patients

Question 29

What is a rockitansky protuberance?

Answer 29

Teratoma grows a tooth

Question 30

What is the most common malignant germ cell tumour?

Answer 30

Dysgerminoma

Question 31

How do dysgerminomas appear on histology?

Answer 31

Clear cells
Fibrous tissue
Lymphocytes

Question 32

What group of sex cord/stromal tumours are associated with effusions?
What is the name given to this syndrome?

Answer 32

Thecoma-fibroma

Maig’s syndrome