Chapter 14: Malignant Diseases of the Ovary Flashcards
used as a tumor marker for carcinomas of embryonic origin
Alpha-fetoprotein (AFP)
inherited gene mutation associated with a significant increase in breast and ovarian cancer risk
BRCA 1/BRCA 2
protein found in tumor cells that results in an elevation of blood levels
CA 125
tumor marker for colon, stomach, breast, lung, some thyroid, and ovarian cancers
carcinoembryonic antigen (CEA)
Malignant tumor of the ovary arising from undifferentiated germ cells of the embryonic gonad; histologically identical to seminoma found in the testicle
dysgerminoma
tumor of the ovary containing epithelial or stromal elements resembling endometrial tissue; typically arises from endometriosis; a large percentage are malignant
endometriod tumor
neoplasm involving the surface epithelium of the ovary
epithelial ovarian cancer
gene that produces a protein that regulates normal cell growth found in breast and ovarian cancer cells; identification of this protein enables determination of treatment options
HER2/neu
Carcinoma of the ovary, usually mestastic from gastrointestinal cancer, marked by areas of mucoid degeneration and by the presence of signet-ring cells
Krukenberg tumor
enzyme involved in the production of energy of the cells; elevated levels in the blood indicate tissue damage, cancers, or other diseases
Lactate dehydrogenase (LDH)
surgical incision into the abdomen usually performed to evaluate the organs
laparotomy
finding of pleural effusion, ascites, and an ovarian mass
meigs syndrome
large cystic ovarian mass with thick-walled septations; may have internal debris-layering components
Mucinous cystadenocarcinoma
accumulation of mucinous materian in the peritoneal cavity, either because of rupture of a benign or malignant cystic neoplasm of the ovary or mucocele rupture of the appendix
pseudomyxoma peritonei
surgical removal of the ovary and fallopian tube
salpingo-oophorectomy
type of epithelial ovarian cancer, which presents as partially cystic mass with solid components
serous carcinoma
large multilocular ovarian neoplasm with papilly projections
serous cystadenocarcinoma
related to the sex-cord (cord like masses of gonadal epithelial tissue) stromal tumors seen in ovaries, mostly in young adults
Sertoli-Leydig cell tumors/ androblastoma/arrhenoblastoma
solid ovarian mass originating from the embryonic gonadal ridges and Sertoli cells
Sex-cord stromal tumors
extremely rare neoplasm of the ovary containing thyroid tissue
stuma ovarii
rare malignant form of a common germ cell tumor found in young adults; contains fat, bone, hair, skin, and/or teeth
teratoma/teratocarcinoma
neoplasm originating in the germ cells (ovun)
yolk cell tumor/ endodermal sinus tumor
Select the false statement.
a. Ovarian cancer has a strong family history, making genetic screening important.
b. Studies show that women who used oral contraceptives are at the greatest risk for developing epithelial ovarian cancer.
c. Ovarian malignancy is a disease of low prevalence, accounting for only 5% of all female cancers.
d. Approximately 50% of ovarian cancers occur in women in the sixth generation of life.
b
Which technique is not directed at improving the detection and outcome of ovarian cancer?
pineal studies
Choose the most unlikely risk factor for developing ovarian cancer.
a. living in a developed country
b. late menopause
c. nulliparity
d. menses with early onset
a
Extended ovulatory activity, over 40 years, places women is what risk category for developing ovarian cancer?
high risk
The gene that is related to errors in the replication process resulting in overexpression is:
HER2/neu
A characteristic of most epithelial cancers is the tendency to:
form cystic masses with multiple septa
The major pattern of metastatic spread of ovarian malignancy is direct extension involving the neighboring organs in the pelvis, peritoneal seeding, and ____ spead.
lymphatic
Frequently, the only symptom of ovarian cancer is:
abdominal bloating and pain
To increase specificity in diagnosing ovarian malignancy, laboratory values such as ______ are tested.
CA 125
AFP
hCG
CEA
What imaging method provides the best diagnostic value by presenting calcifications, sometimes in a curvilinear fashion, soft tissue masses, and patterns suggesting abdominal distention?
Plain film radiography
The imaging modality providing the most accurate tissue characterization regarding adnexal masses is:
MRI
Menopausal females utilizing HRT (hormone replacement therapy) will demonstate:
normal sized ovaries
Ovarian malignancy screening utilizing ultrasound should consider all except:
a. ovarian position
b. ovarian size
c. ovarian texture
d. bilateral ovarian comparison
a
Metastasis to the ovary:
a. is rare
b. is common
c. occurs most commonly from primary brain carcinoma
d. causes bladder frequency
b
Compressibility of a mass while scanning can assist in differentiating bowel from malignancy and is performed by:
“hands-on” manuever
Nonneoplastic cystic foci of the ovary are commonly seen in ____ females and are difficult to differentiate from malignant lesions, so should be considered when determining the diagnosis.
menstruating
Epithelial ovarian cancers typically form cystic masses and:
solid papillary growths
Pseudomyxoma peritonei is defined as:
the accumulation of gelatinous material in the peritoneal cavity
Ovarian malignancy is often associated with ascites that first accumulates in the:
dependent portion of the peritoneal cavity
Color Doppler of malignant lesions frequently demonstrates:
prominent flow in the septations
Ovarian masses, whether malignant or benign can result in _____ of the ovary.
torsion
A large number of patients with ovarian malignancy present with or develop ______ bleeding.
uterine
Two inherited gene mutations related to an increase of breast and ovarian cancer are _____ and _____.
BRCA 1/ BRCA 2
HER2/neu
A Krukenberg tumor is a cancerous tumor of the _____ and usually metastasizes from _____ cancer.
ovary
breast
The effect of ovulation is known to cause increased inflammation and wound healing owing to repeated trauma to the ovarian ______.
epithelium
Ascites associated with ovarian malignancy collects in the _____ and ______, mostly on the _____ side.
cul-de-sac
paracolic gutters
right
Ovarian cancer is mostly a disease of ____ menopausal and ____ menopausal women.
peri
post
Ovarian cancer is the most common tumor responsible for _____ malignancy in women.
peritoneal
Symptoms of abnormal _____ activity are sometimes a clue to the presence of an ovarian malignancy that is hormonally active.
endocrine
Benign processes, such as ______, ______, and even pancreatitis result in an increased CA 125, as does ovarian cancer.
endometriosis
fibroids
AFP is alpha-protein; LDH is ______; CEA is _______; and hCG is _______
lactate dehydrogenase
carcinoembryonic antigen
human chorionic gonadotropin
A CT examination can demonstrate pelvic sidewall masses, lymph node enlargement in the retroperitoneum, liver metastasis, and calcifications, especially when _____ and ____ contrast is given.
intravenous
oral
Although it cannot always distinguish a malignant process from benign, ____ remains the diagnostic method of choice as a screening technique for adenexal processes.
MRI
The effective method to investigate for ovarian cancer includes ______ ultrasound, ______ examination, and the tumor marker _____.
transvaginal
physical
CA 125
To determine pelvic mass from possible bowel, _____ must be identified.
peristalsis
PET should only be used in a select group of patients in whom both ______ and ____ have failed to yield unequivocal results.
ultrasound
MRI
Fallopian tube neoplasms are rare and malignant. These lesions are mistaken for _____ malignancies.
ovarian
Ovarian cancer is one of the most lethal forms of cancer owing to:
late stage diagnosis and low cure rate
Exploratory _______ remains the gold standard in the visualization of adnexal malignancy. _____ imaging is most helpful in staging ovarian cancer.
laparotomy
CT
Eighty percent of ovarian malignancies originate from the _____ covering the ovaries
epithelium
