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OB/GYN > EXAM #1: OVARIAN DISEASE > Flashcards

EXAM #1: OVARIAN DISEASE Flashcards

1
Q

How do ovarian diseases present?

A

1) Abdominal pain and enlargement
2) Abnormal bleeding
3) Bowel or bladder symptoms

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2
Q

What is the most common: endometrial, ovarian, or cervical cancer in the US? Worldwide?

A 
US= endometrial
World= cervical is most common
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3
Q

What has the worst prognosis: endometrial, ovarian, or cervical cancer?

A

Ovarian

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4
Q

What is the most common ovarian mass in young women?

A

Follicular cyst

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5
Q

What is a follicular cyst?

A

Distention of unruptured graafian follicle

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6
Q

When are follicular cysts significant?

A
  • If it lines granulosa cells and secretes estrogen

- Estrogen induces endometrial hyperplasia

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7
Q

What is a corpus luteum cyst?

A

Cystic enlargement of the corpus luteum with central hemorrhage

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8
Q

What condition may a corpus luteum cyst mimic?

A

Endometriosis

*If the cyst ruptures it may cause a peritoneal reaction with fibrosis and hemorrhage

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9
Q

What is a theca-lutein cyst?

A

A BILATEARL/ MULTIPLE cyst induced by Gonadotropin stimulation

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10
Q

What are theca-lutein cysts associated with?

A

Choriocarcinoma and moles

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11
Q

What is a hemorrhagic cyst?

A
  • Ovarian cyst with a blood vessel that ruptures

- Cyst may grow due to bleeding

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12
Q

What is a dermoid cyst?

A
  • Mature teratoma/ germ cell tumor

- Contains elements from all 3 germ layers i.e. teeth, hair, sebum, bone, cartilage…etc.

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13
Q

What is the most common ovarian tumor in women between 20-30 y/o?

A

Dermoid cyst or “Cystic teratoma”

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14
Q

When a dermoid cyst contains functional thyroid tissue, what is it called? How will this patient present?

A

Stuma ovarii

*This will cause HYPERTHYROIDISM

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15
Q

How do dermoid cysts present clincally?

A

1) Abdominal pain

2) Ovarian torsion

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16
Q

What is an endometrioid cyst?

A

Endometriosis in the ovary with cyst formation

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17
Q

What description is pathognomonic for an endometrioid cyst that is filled with blood?

A

Chocolate cyst

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18
Q

What age group is most affected by ovarian cancer?

A

Women older than 45-65

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19
Q

What are the risk factors for ovarian cancer?

A

1) Family history
2) BRCA1/2 mutations
3) Nulliparity

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20
Q

What is the most common ovarian tumor?

A

Serous cystadenoma

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21
Q

What age range is most common for a serous cystadenoma?

A

20-50 y/o

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22
Q

How are serous cystadenomas described? What are these tumors lined with? Are they unilateral or bilateral?

A
  • Filled with serous fluid; not gel-like fluid
  • Lined with fallopian-like epithelium
  • Bilateral
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23
Q

What is the fallopian-like epithelium?

A

Tall, ciliated, secretory columnar epithelium

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24
Q

How are mucinous cystadenomas commonly described? What are these tumors lined with? Are they unilateral or bilateral?

A
  • Unilateral
  • Multilocuated
  • Mucus-secreting epithelium (cervix-like)
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25
Q

What type of epithelium is seen in a mucinous cystadenoma?

A

Tall-mucus secreting columnar epithelium (similar to the cervix)

26
Q

Which is more commonly malignant, serious or mucinous cystadenomas?

A

Serous

27
Q

What is an endometrioma?

A

Typically malignant mass arising from the growth of ectopic endometrial tissue

28
Q

How does an endometrioma present?

A

1) Pelvic pain
2) Dysmenorrhea
3) Dyspareunia

29
Q

What is a Brenner Tumor?

A

This is a surface epithelial tumor composed by a transitional type epitheliumn (bladder-like)

30
Q

How does a Brenner Tumor appear on gross evaluation?

A

Solid tumor that is

  • Pale- yellow/tan
  • Appears encapsulated
31
Q

What type of nuclei are seen in a Brenner Tumor?

A

“Coffee Bean”

32
Q

What other disease, aside from Brenner Tumors, has coffee bean nuclei?

A

Papillary Carcinoma of the Thyroid

33
Q

What are Brenner Tumors commonly associated with?

A

Terataomas

34
Q

What is a fibroma?

A

This is a benign tumor of fibroblasts that contains bundles of spindle-shaped fibroblasts

*Can cause a “pulling” sensation in the groin

35
Q

What is Meigs Syndrome?

A

This is the triad of and ovarian fibroma, PLUS

1) Ascites
2) Hydrothorax/ pleural effusion

36
Q

What is a thecoma?

A

Benign tumor like a granulosa tumor that may produce estrogen

37
Q

How do Thecomas present?

A

Post-menopausal woman with abnormal uterine bleeding

38
Q

What is the most common ovarian malignancy?

A

Serous cystadenocarcinoma

39
Q

What histologic finding is seen in Serous cystadenocarcinomas? What other cancer has this feature?

A

Psammoma bodies (as seen in Papillary Carinoma of the Thyroid)

40
Q

What is the gross appearance of a Serous Cystadenocarcinomas?

A

Complex cyst with thick shaggy lining

41
Q

What is the histoliogc appearance of a Serous Cystadenocarcinomas?

A
  • Papillary growth

- Hyperchromic cells

42
Q

What do psammoma bodies represent?

A

Dystrophic calcification

43
Q

How are mucunous cystadenocarcinomas described histologically?

A

1) Complex architecture
2) Nuclear atypia
3) Stromal invasion

44
Q

What is pseudomyxoma peritonei?

A

Intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor

*Most commonly this represents a mucinous tumor of the appendix that metastesizes to the ovary

45
Q

What is an immature teratoma?

A

Very rare , solid tumor, most commonly containing neuroectoderm

46
Q

How do mature and immature teratomas differ in terms of the tissue that they most commonly contain?

A 
Mature= thyroid tissue
Immature= neuroectoderm
47
Q

What is the most common sex-cord stromal tumor?

A

Granulosa cell tumor

48
Q

When are Granulosa Cell Tumors most commonly seen?

A

Women in their 50s

49
Q

What is unique about Granuloas Cell Tumors?

A

Produce estrogen/or progesterone that causes

  • Abnormal uterine bleeding
  • Sexual precocity (young women)
  • Breast tenderness
50
Q

What is pathognomonic for a Granulosa Cell Tumor?

A

Call-Exner body

51
Q

What are Call-Exner bodies?

A

Small eosinophilic fluid-filled spaces between granulosa cells

52
Q

What is a dysgerminoma?

A

This is a tumor of large cells with a clear cytoplasm and central nuclei (cells resemble oocytes)

*Most common tumor in adolescents (most common malignant germ cell tumor)

53
Q

What is pathognomonic for a dysgerminoma?

A

Sheets of uniform “fried egg cells”

54
Q

What are the tumor markers for dysgerminomas?

A

LDH*

HCG

55
Q

What is a chroiocarcinoma?

A

Malignant trophoblastic tissue (placenta)

56
Q

How do choriocarcinomas present?

A

1) Elevated B-HCG
2) Dyspnea
3) Hemoptysis

57
Q

What should you remember about choriocarcinomas?

A

Respond well to chemotherapy

58
Q

What is a Yolk sac tumor?

A

Malignant tumor that mimics the yolk sac; it is an aggressive tumor of the ovaries

59
Q

What is associated with Yolk Sac Tumors?

A

Schiller Duval Bodies, which are “glomerulus-like structures”

60
Q

What is the tumor marker for Yok Sac Tumors?

A

AFP

61
Q

What is a Krukenberg Tumor?

A
  • GI malignancy that mets to the ovaries

- Causes mucin-secreting signet cell adenocarcinoma

OB/GYN (19 decks)

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