Diseases of ovary Flashcards
Young, obese, hirsute female of reproductive age presents with oligomenorrhea after many unsuccessful months of trying to get pregnant. What is the disease?
polycystic ovary disease => Stein-Leventhal syndrome
What is detectable in the lab results for polycystic ovary disease?
elevated LH; elevated testosterone
low FSH
What is the pathology of polycystic ovary disease?
bilaterally enlarged ovaries w/ multiple follicular cysts
Etiology of polycystic ovary disease
increased LH stimulation leads to increased androgen synthesis and anovulatory cycles
How is polycystic ovary disease Tx?
oral contraceptives or medroxyprogesterone;
surgical wedge resection
What is the most common benign ovarian tumor?
cystadenoma
Name the pathology of cystadenoma
unilocular cyst w/ simple serous or mucinous lining
most common malignant ovarian tumor
cystadeno-carcinoma
How will cystadeno-carcinoma present?
often asymptomatic until far advanced => increased abdominal girth due to ascites, bowel or bladder problems
what does a cystadeno-carcinoma produce
pseudomyxoma peritonei
Lab marker for cystadeno-carcinoma? what else is it used for?
CA-125;
used for response to therapy and recurrence
Gross pathology of cystadeno-carcinoma
complex multiloculated cyst w/ solid areas
Micro pathology of cystadeno-carcinoma
serous or mucinous lining w/ tufting, papillary structures w/ psammoma bodies
How does cystadeno-carcinoma spread?
seedings w/in pelvic cavity
genetic risk factors for cystadeno-carcinoma
BRCA-1 (Breast and ovarian cancers);
Lynch syndrome
Tx for cystadeno-carcinoma
surgery;
antineoplastic drugs
What is a Brenner tumor?
rare ovarian epithelial tumor resembling transitioinal carcinoma => benign or malignant
Who is at greatest risk for teratoma?
younger women
What makes up a teratoma?
all 3 germ layers (ecto, meso, endo)
What is the likely invasive ability of a teratoma?
benign
When does a teratoma have greater chances for invasion?
immature teratoma contains primitive cells
Gross pathology of teratoma?
ovarian cyst w/ hair, teeth and sebaceous material
Etiology of teratoma
abnormal differentiation of fetal germ cells that arise from fetal yolk sac
Tx for teratoma
surgery
invasive ability and time of presentation for dysgerminoma
malignant;
affects mainly young adults
micro pathology of dysgerminoma
10% anaplastic with nuclear atypia
Risk factors for dysgerminoma
Turner syndrome;
pseudohermaphroditism
Tx and prognosis for dysgerminoma
Radiosensitive;
good Px
Define ovarian fibroma
common tumor
associated with fibroma + ascites + pleural effusion (Meigs syndrome)
Complications of granulosa cell tumor
endometrial hyperplasia and cancer
Define granulosa cell tumor
potentially malignant;
PRODUCES ESTROGEN
How will a patient with granulosa cell tumor present?
precocious puberty; irregular menses; dysfunctional uterine bleeding
Micro path of granulosa cell tumor
CALL EXNER BODIES => polygonal tumor cells w/ formation of follicle like structures
Define Sertoli-Leydig cell tumor (androblastoma)
Androgen producing tumor => presents w/ virilization
