Clinical Perspective - Ovarian Cancer

Question 1

From where do most (80%) of ovarian cancers arise?

Answer 1

Surface epithelium-stroma

Question 2

True/False. Screening tests are regularly utilized for ovarian cancer.

Answer 2

False - no screening tests exist. Ovarian cancer is relatively asymptomatic at early stages

Question 3

This tumor marker is positive in patients with serous ovarian cancer.

Answer 3

CA125

Question 4

True/False. CA125 is most useful in post-menopausal women and in surveillance of ovarian cancer patients.

Answer 4

True - CA125 is not useful for screening, however

Question 5

This ovarian cancer most often begins in the distal fallopian tube.

Answer 5

Serous overian cancer

Question 6

What mutations are most associated with serous ovarian cancer?

Answer 6

p53, BRCA, MMR (Lynch Syndrome)

Question 7

What mutations are most associated with mucinous ovarian cancer?

Answer 7

KRAS, HER2

Question 8

True/False. Serous cancer is most often detected in early stages.

Answer 8

False. Serous cancer is usually detected at Stage 3. Mucinous cancer is usually detected at Stage 1.

Question 9

This cancer is often concurrent with endometrial cancer and has a “hob-nail” appearance.

Answer 9

Clear cell ovarian cancer

Question 10

This is a type of non-malignant transitional cell ovarian tumor with “coffee bean” nuclei.

Answer 10

Brenner tumor

Question 11

These chemotherapuetic drugs are most often used in the treatment of ovarian cancer.

Answer 11

Carboplatin, Paclitaxel, bevacizumab (VEGF inhibitor)

Question 12

True/False. Oral contraceptives reduce cancer by 50%.

Answer 12

True

Question 13

What is the common clinical presentation of a patient with a germ cell ovarian cancer?

Answer 13

Young female presenting with sudden pain, fever, and an abdominal mass. Hypotension may also be present if there is internal bleeding

Question 14

What are the serum markers for germ cell ovarian cancers?

Answer 14

hCG, AFP, LDH

Question 15

Dysgerminoma is the most common germ cell tumor of the ovary. What serum marker is positive in these patients?

Answer 15

LDH - the tumor is too undifferentiated to produce AFP or hCG

Question 16

True/False. Immature teratomas are generally discovered early and require only surgical resection, without chemotherapy.

Answer 16

True

Question 17

This histologic finding is characteristic of endodermal sinus/yolk sac tumors.

Answer 17

Shiller-Duval Bodies

Question 18

hCG is high in patients with this ovarian cancer and death usually occurs within months, even with treatment.

Answer 18

Choriocarcinoma

Question 19

What marker is useful for granulosa cell tumors?

Answer 19

Inhibin