Adnexal masses Flashcards
____ are small organs in the pelvis on either side of
Single layer of ___ cells covers the majority of the outer surface
___ epithelium, aka ___ epithelium/___ epithelium
Derived from embryonic ___
ovaries, the uterus
epithelial
surface, coelomic/germinal
coelomic tissue
Inner core of ovary is __
made of ___, ___, ___
clinically ___
Outer portion surrounding medulla is ___
contains ____ aka
stroma
Comp mainly of ___ cells, as well as ____ cells
arise from ____ embryonic tissue
medulla
CT, smooth muscle, blood vessels
inert
cortex
sex cord
fibroblast like, granulosa/theca
sex cord
Ovarian cortex
Germinal follicles found ___
contain __ cells, precursor to gametes
via meiosis produce ___
as they mature, follicles become ___, surrounded by ____
inner layer composed of
Outer layer is ___, which produce ___ that granulosa cells convert to ___
Corpora lutea found ___
created from ____, secretes ____
throughout stroma
germ cells
ova
larger/complex, 2 layers of cells
granulosa cells
theca cells
androstenedione, estradiol
throughout stroma
ovulated follcle, progesterone
Non neoplastic cysts
Follicular- follicle ____ and develops ___ that fills w clear fluid
if <2 cm, referred to as
clinically ___
If >2cm, ruled a ___ and become ___
Comps include
H____ hyperlasia of surrounding ___ w inc andro
eventual ___ causes menstrual problems
___ releases fluid causing ___
Luteal cyst arises from __
Contains ___
Can also __ and __, leading to peritonitis
enlarges, cystic/hollow/central space
cystic follicle, asx
follicular cyst, large
hyperthecosis, theca cells
estrogen inc
Rupture, peritonitis
corpus luteum
cystic fluid
enlarge and rupture
PCOS aka
Excess ___ prodxn
common sx
Dec fertility due to __
RF
Polycystic ovaries are numerous ___
MX starts w
Meds such as
Tx
Stein Leventhal Syndrome
androgen
hirsutism, acne, mens abnormal, dec fertility
chronic anovulation
Obesity, T2DM, premature athero
cystic follicles/follicular cysts
Diet to lose weight
OCP (control menstruation)
DM
Majority of ovarian tumors are
Benign tumors most likely in ___ age ___
Malignant tumor more likely in ____ age ___
Malig ovarian tumors have high ___, due to ___ until tumor has grown/spread
benign
young women, 20-45
older women, 40-65
mortality rate, lack of sx
Sx and signs
Pelvic mass- usually ___ on exam/imaging
___ pain
__ distension, as tumor extends into
__ sx due to compression of other organs
___ bleeding, due to erosion through ____ (think malig)
incidental finding
pelvic/ab
ab, abdomen
GI/GU
Vaginal, uterus
RF for ovarian cancers
Inc number of uninterrupted (ie preg) ___ over life
such as
Positive ___ particularly
Genes such as
menstrual cycles
early menarche, late menopause, nulliparity
FH, 1st degree relative
BRCA1/HNPCC
Classification of tumor depends on
Surface epithelial tumors (MC) arise from
can be __, ___ (low malig potential) or ___ (low grade w ___ or high grade w ___)
Tumors are typically __
Subtypes
Serous Epithelial Tumor
cysts filled w ___, exhibits ___ lined w columnar epithelium
___ of surface epithelial tumor
Often ___
Can be benign (__), borderline, malig (___)
Possible for high grade serous adenocarcinomas to arise from ____ and finds its way to ovary
surface epithelium
benign, borderline, malignant (well diff, mod/poor diff)
multicystic
watery/serous, papillae
MC
bilateral
cystadenoma, cystadenocarcinoma
fallopian epithelium
Mucinous epithelial tumor
cysts filled w ___
resembles __ micro
Can be __
Can be benign (___), borderline, malign ( ___)
Endometriod epithelial tumor resembles
can be __
Can be benign (__), borderline, malig (___)
some pts have malig endometrioid tumor w/in ___
can have ___ (thought for cancer to arise from __ on ovary)
thick, gelatinous mucus
stomach/intestine
bilateral
mucinous cystadenoma, mucinous cystadenocarcinoma
endometrium
bilateral
endometrioid adenofibroma, endometrioid carcinoma
uterus
endometriosis
Germ cell tumors arise from
Majority are ____ aka mature teratoma, ___ cyst
usually occurs in __ during repro yrs
Typically ____ cyst
wall of cyst has variety of ___ including epidermis (hair shafts), bone, cartilage, __, __, __
relatively few have ___, usually in___
cancer arises from mature tissues w/in ___ (SCC MC) but also ___
germ cells of follicles
benign cystic teratomas, dermoid
youung women
unilocular, mature adult tissues
thyroid, brain, teeth
malignant transform, older women
epidermis, thyroid carcinoma
Other germ cell tumors
D___ occurs from childhood to ___
some may produce __ which is normally produced by placenta/LDH
All are __ but curable
Yolk sac tumor aka
occurs in __ and __, producing ___
all are ___ but curable
C____ usually seen w other germ cell tumors
typically arise from ___ called GTN, producing
Ovarian choriocarcinomas are __ quickly, often ___
Placental chroiocarcinoma is typically ___
dysgerminoma, 3rd decade
chorionic gonadotropin
malignant
endometrial sinus tumor
children/YW
AFP
malignant
Choriocarcinoma
placenta, chorionic gonadotropins
metastasize, fatal
curable
Sex cord stromal tumors
Granulosa/Thecal cell tumor- most are __ but have ___
typically occur in ___
can secrete large amts of ___
this can lead to ___ in YG, ___ in YW, ___ in OW, and ___
Fibromas/Thecomas consist of ___
almost always ____
can secrete ___ w similar comps
Meigs syndrome- F___, h___, and ____
benign, malig transform
post menopausal women
estrogen
PP, irregular menses, post menopausal bleeding, endometrial carcinoma
stromal fibroblasts/theca cells
benign
estrogen
Fibroma/Thecoma, hydrothorax, ascites
Metastatic tumor MC arises from
U
F
O
uterus
fallopian tube
other ovary
Fallopian Tube
Adenocarcinoma of ___
Can be origin of ___ cancers
Prognosis is
tubal epithelium
high grade ovarian cancer
poor (sx late)
