Adnexal/Pelvic masses Flashcards
Consideration for masses E E U Pelvic infect such as T or D/A Non gyn malignancies of C, A, B
Non neoplastic cysts usually do not have a ___, though __ can give a similar appearance
May __ on own
Can follow w ___
Suppressed w
ectopic preg endometrioma (chocolate cyst) uterine fibroids TOA, divertucular/appendiceal abscess Colon/appendix/bladder
solid component, hemorrhage
resolve
US
OCP
Serous epithelial tumors resemble ____
mucinous resembles __
Borderline tumors can __ and __ like malignancy and are _ the same
Rarely __/__ tissue, typically __ growing, do not respond to ___
most common variations are __ and ___
fallopian epithelium
GI epithelium
spread, recur, staged
invade/destroy, slow, chemo
serous/mucinous
Endometrioid and ___ car arise from ____
Most common histology of epithelial ovarian cancer
Serous epithelial ovarian Cancer
now thoght to arise from ___ end of FT
usually stage ___ or ___ at dx
Due to ___ cell type, often present w __ and ___
theorized to spread by ___ into peritoneal cavity and ___ to peritoneal/serosal surfaces
Common appearance on CT scan ___ and ___
__ often elevated
Primary peritoneal ca and __ ca are histologically __
clear cell, endometriosis
high grade serous, papillary serous
distal/fibriated
3C, 4
fluid producing, ascites/pleural effusion
shedding, attaching
omental caking, carcinomatosis
Ca125
FT primary ca, indistinguishable
Ovarian Ca RF A N I Gene mutations
Protective factors
___ screening method for ovarian ca
risk reduced w ___ at age 35-40 or when
new cancer therapeutics target
age
nulliparity
infertility
BRCA1/BRCA2/HNPCC
OCP, tubal ligation
no proven
BSO. child bearing complete
BRCA pathway
Epithelial ovarian cancer tx
___ or ___ srgery
may be __ w goal of complete ___
__ and ___ based chemo
often becomes __, __ cx w gradual development of ___
death results from ___ due to __ or ___ bowel obstructioon
cytoreductive, debulking
ultra radial, resection of dz
platinum, taxane
chronic, relapsing, chemo resistance
malnutrition, mechanical/fxnal
Germ cell tumors often occur in
often are __
may present w sx due to __ or ____
Immature teratomas are ____ of dermoid cyst
staged by amount of ___ present
YW/children
solid
rapid growth, torsion
malignant version
immature neural tissue
Granulosa/theca cell tumors are usually ___
fibroma/thecoma mostly ___
Sertoli leydig tumors are ___
Granulosa/theca cell tmors often ____ and may be __
common in both -__ women
secrete __
poorly __, may ___
malignant
benign
malignant
solid, hemorrhagic
young/older
inhibin
cheo responsive, recur
Sertoli Leydig tumors arise from
__ producing
May cause __ or ___
relatively ___
testosterone
hirsutism, virilization
rare
Ca125 associated w ___, usually
very __, may be elevated in ___
such as ___ or any path causing ___ ie
not useful for ___
may be useful for determining __
useful for ___ in pt w known cancer
epithelial ovarian ca (serous)
non specific, gyne patho
endometriosis, peritoneal inflam, liver dz
screening
gyne/gyno
monitoring tx
Tumor markers Ca125 for CEA for CA 19.9 for Inhibin for HCG for AFP for LDH for Testosterone for
epithelial ovarian ca mucinous tumor of ovary/GI tract panc ca granulosa cell tumors choriocarcinoma (ovarian/placental) endometrial sinus tumor dysgerminoma sertoli leydig tumor
CT scan can show A P A C O
best modality for detail of ovarian tumor
__ and __ of ovarian cysts are important
___ architecture and ___ worrisome
Pt with morphology score less than ___ has very very low risk of
morphology index takes into account
ascites pleural effusion adenopathy carcinomatosis omental caking
US
size/morphology
solid, papillary projections
5, malignancy
tumor volume/structure
