Diseases of ovary

Question 1

Young, obese, hirsute female of reproductive age presents with oligomenorrhea after many unsuccessful months of trying to get pregnant. What is the disease?

Answer 1

polycystic ovary disease => Stein-Leventhal syndrome

Question 2

What is detectable in the lab results for polycystic ovary disease?

Answer 2

elevated LH; elevated testosterone

low FSH

Question 3

What is the pathology of polycystic ovary disease?

Answer 3

bilaterally enlarged ovaries w/ multiple follicular cysts

Question 4

Etiology of polycystic ovary disease

Answer 4

increased LH stimulation leads to increased androgen synthesis and anovulatory cycles

Question 5

How is polycystic ovary disease Tx?

Answer 5

oral contraceptives or medroxyprogesterone;

surgical wedge resection

Question 6

What is the most common benign ovarian tumor?

Answer 6

cystadenoma

Question 7

Name the pathology of cystadenoma

Answer 7

unilocular cyst w/ simple serous or mucinous lining

Question 8

most common malignant ovarian tumor

Answer 8

cystadeno-carcinoma

Question 9

How will cystadeno-carcinoma present?

Answer 9

often asymptomatic until far advanced => increased abdominal girth due to ascites, bowel or bladder problems

Question 10

what does a cystadeno-carcinoma produce

Answer 10

pseudomyxoma peritonei

Question 11

Lab marker for cystadeno-carcinoma? what else is it used for?

Answer 11

CA-125;

used for response to therapy and recurrence

Question 12

Gross pathology of cystadeno-carcinoma

Answer 12

complex multiloculated cyst w/ solid areas

Question 13

Micro pathology of cystadeno-carcinoma

Answer 13

serous or mucinous lining w/ tufting, papillary structures w/ psammoma bodies

Question 14

How does cystadeno-carcinoma spread?

Answer 14

seedings w/in pelvic cavity

Question 15

genetic risk factors for cystadeno-carcinoma

Answer 15

BRCA-1 (Breast and ovarian cancers);

Lynch syndrome

Question 16

Tx for cystadeno-carcinoma

Answer 16

surgery;

antineoplastic drugs

Question 17

What is a Brenner tumor?

Answer 17

rare ovarian epithelial tumor resembling transitioinal carcinoma => benign or malignant

Question 18

Who is at greatest risk for teratoma?

Answer 18

younger women

Question 19

What makes up a teratoma?

Answer 19

all 3 germ layers (ecto, meso, endo)

Question 20

What is the likely invasive ability of a teratoma?

Answer 20

benign

Question 21

When does a teratoma have greater chances for invasion?

Answer 21

immature teratoma contains primitive cells

Question 22

Gross pathology of teratoma?

Answer 22

ovarian cyst w/ hair, teeth and sebaceous material

Question 23

Etiology of teratoma

Answer 23

abnormal differentiation of fetal germ cells that arise from fetal yolk sac

Question 24

Tx for teratoma

Answer 24

surgery

Question 25

invasive ability and time of presentation for dysgerminoma

Answer 25

malignant;

affects mainly young adults

Question 26

micro pathology of dysgerminoma

Answer 26

10% anaplastic with nuclear atypia

Question 27

Risk factors for dysgerminoma

Answer 27

Turner syndrome;

pseudohermaphroditism

Question 28

Tx and prognosis for dysgerminoma

Answer 28

Radiosensitive;

good Px

Question 29

Define ovarian fibroma

Answer 29

common tumor

associated with fibroma + ascites + pleural effusion (Meigs syndrome)

Question 30

Complications of granulosa cell tumor

Answer 30

endometrial hyperplasia and cancer

Question 31

Define granulosa cell tumor

Answer 31

potentially malignant;

PRODUCES ESTROGEN

Question 32

How will a patient with granulosa cell tumor present?

Answer 32

precocious puberty; irregular menses; dysfunctional uterine bleeding

Question 33

Micro path of granulosa cell tumor

Answer 33

CALL EXNER BODIES => polygonal tumor cells w/ formation of follicle like structures

Question 34

Define Sertoli-Leydig cell tumor (androblastoma)

Answer 34

Androgen producing tumor => presents w/ virilization