5 - Gynae - The Ovary and its disorders - Ovarian Tumours

Question 1

common ovarian masses

• premenopause - 4
• postmenopause - 2

Answer 1

• follicular/lutein cysts, dermoid cysts, endometriomas, benign epithelial tumour
• benign epithelial tumour, malignancy

Question 2

secondary malignancies

• the ovary is a common site for mets esp from ? and ?
• 2’ tumours account for ? of malig ov masses. a few contain ? ? cells, if from gut known as ? tumours.

Answer 2

breast and GIT
10%
signet ring cells
krukenberg tumours

Question 3

Tumour like conditions - cysts.

2 main types of cysts in ovary? what is an endometrioma? rupture is ? but very ?

Answer 3

endometriotic cysts and functional cysts

endometrioma = endometriotic cyst in ovary, rupture rare but v painful

Question 4

Functional cysts - ? and ? cysts are persistently enlarged ? and ??
- only found in ? women? what is protective and why?

Answer 4

follicular and lutein cysts - follicles and CL

premen women
COCP protects by inhib ovulation

Question 5

Which functional cysts tend to cause more Sx? if Sx absent, trt? how monitored?

but due to remote poss of malig if >?cm and >?cm what is measured? and what is considered? to do what?

Answer 5

lutein
no Sx = no trt just serial observation with USS

5 and 2
CA125 measured and laparoscopy considered to remove/drain

Question 6

3 types of primary neoplasms? all can be ? or ? and all can have ? change

Answer 6

epithelial tumours
germ cell tumours
sex cord tumours

ben or mal
mal change

Question 7

Sex cord tumours - originate from ? of gonad.

3 types?

Answer 7

stroma

granulosa cell tumours, thecomas, fibromas

Question 8

Thecomas and fibromas are both ? and both ?
thecomas can secrete ? and ?
fibromas can cause ? syndrome giving ? and right pleural effusion. the effusion is benign and cured by ?

Answer 8

rare and benign (thecomas rarely can be mal)
oestr and androgens
meigs’ w ascites and r pl eff
removal of mass

Question 9

Germ cell tumours - 3 types? which one is rare but most common ov mal in younger women? this one is also sensitive to ?

Answer 9

teratoma, dermoid cysts, dysgerminoma
dysgerminoma
RTx

Question 10

describe a dermoid cyst? age group? may contain what? commonly contain what? where found? size and Sx? what is mal form?

Answer 10

common benign tumour commonly in young premenopausal women

fully diff tissue of all cell types, commonly hair and teeth

commonly bilat, seldom large, often aSx but rupture is v painful

solid teratoma, v rare

Question 11

Epithelial tumours - most common in ?? may become ?? - what is advised?
in younger women with borderline cyst, what offered following removal of cyst/affected ovary to retain ? can recur up to ? later

Answer 11

post menopausal women
frankly malignant- surgery advised
offer close obs
retain fertility
20y later

Question 12

5 types of epithelial tumours?

which one is rare and usually small and benign? which has v poor prog and accounts fro <10% of ov mals?

Answer 12

serous cystadenoma or adenocarcinoma

mucinous cystadenoma or adenocarcinoma

endometrioid carcinoma

clear cell carcinoma - v poor prog and <10% of ov mals

brenner tumours - rare small benign

Question 13

serous cystadenoma or adenocarcinoma

• most common ? ovarian neoplasm - %?
• what forms also exist?

Answer 13

malignant ov neo
50% of mals
benign and ‘borderline’ forms also

Question 14

Endometrioid ca - malig variant accounts for ? ov mals? similar histo to ? ? - ass with this in ?% cases

Answer 14

25% ov mals

similar histo to endometrial ca - ass w in 20% cases

Question 15

mucinous cystadenoma or adenocarcinoma - can become ? ?

• less frequently malignant - ?% of mals?
• what should be excluded?

Answer 15

v large
10%
an appendiceal 1’ tumour should be excluded