Female Genital Tract 3 - Dobson Flashcards
What has the morphology of unilateral, cut-surface is solid yellow-white to gray pink and made of large vesicular cells w/clear cytoplasm and 1/3 are malignant?
Prognosis?
Dysgerminoma
Excellent
What are the 3 types of serous epithelial tumors?
Benign (60%)
Borderline
Malignant (25-30%) aka Cystadenocarcinoma
What causes extensive mucinous ascites, cystic epithelial implants on the peritoneal surfaces, adhesions, and frequent involvement of the ovaries?
Origin?
Pseudomyxoma peritonei
Appendiceal
Morphology of serous ovarian tumors in general?
Bilateral
Involves the surface
What Mullerian tumors are metastatic to the ovary?
Uterus
Fallopian tube
Opposite ovary
Pelvic peritoneum
Teratoma karyotype?
B/l or unilateral?
46 XX
Uni
What is the triad of ovarian tumor, hydrothroax Right side, and ascites?
Meigs syndrome
What presents w/bleeding not related to cycle, watery/blood vaginal discharge, abnormal Pap, abdominal swelling and occurs in postmenopausal Whites?
Prognosis?
Adenocarcinoma of the fallopian tube
Poor prognosis
Most ovarian carcinomas present w/what symptoms?
Metastasize where?
Weakness
Weight loss –> cachexia
Liver, lungs, GI, other ovary
What tumor presents in children or young women that c/o abdominal pain and a rapidly growing pelvic mass?
Survival w/chemo?
Yolk sac tumor
80%
High grade serous ovarian tumor morphology?
Atypia, pleomorphism, multinucleation
What functional tumor produces masculinization or defeminization w/a peak incidence in women 20-30?
Sertoli-Leydig cell tumor
Ovarian neoplasms are 80% what and occur in whom?
Benign, young women
Yolk sac tumor secretes what?
Has what?
Alpha-FP
Schiller Duval bodies
What are RFs for malignant serous ovarian tumors?
Low parity
FMH
BRCA1/2 mutation
What has a mutation in DICER1?
Sertoli-Leydig cell tumor
Mucinous ovarian tumors have what mutation?
KRAS
PCOS is characterized by multiple cysts and what clinically?
Hyperandrogenism
Menstrual irregularities
Chronic anovulation
Decreased fertility
What presents w/infrequent but significant cause of acute lower abdominal pain presents at median age 28 w/a second peak postmenopausal with a tube often involved?
Ovarian torsion
Mature teratoma/Dermoid cyst b/l %?
Found in whom? When?
Arise from what?
10-15%
Young women incidentally OR in inflammatory condition like limbic encephalitis
Ovum after 1st meiotic division
What is the clinical presentation of ovarian epithelial tumors?
Lower abdominal pain and enlargement
Can impinge on other organs
High grade serous ovarian tumors have mutations in what?
TP53
Rb
What tumor may cause hyperthyroidism?
Struma ovarian (monodermal teratoma)
Always unilateral
Granulosa cell tumors occur in whom?
Clinical course?
May cause what?
2/3 occur in postmenopausal women
Indolent
Precocious puberty, breast disease, endometrial hyperplasia and cancer
Poorly diff sertoli-leydig cell tumors have what pattern?
Sarcomatous
Unilateral
Mucinous ovarian tumors bolded morphology?
Don’t involve the surface
Only 5% b/l
What tumor has a mutation in FOXL2 in the adult version only?
Granulosa cell tumor
What has Reinke crystalloids and women present w/masculinization?
Benign or malignant?
Hilus cell tumor
Benign
Serous ovarian Borderline tumor morphology?
Stromal papillae w/epithelial proliferation growing as “micropapillary carcinoma”, precursor to low-grade cancer
What has strong (+) to inhibin and secretes estrogen?
Granulosa cell tumor
What are fallopian tubes formed from?
Upper infused Mullerian (paramesonephric) duct
What extra-Mullerian tumors are metastatic to the ovary?
Colon Stomach Pancreas Biliary tract Breast
Endometrioid ovarian tumors arise in the setting of what?
15-30% accompanied by what?
Endometriosis, can have a chocolate cyst
Uterine endometrial carcinoma
What morphology is described by unilateral, stroma marked by sharply demarcated nests of epithelioid cells?
Transitional cell tumor
What forms Hydatids of Morgagni?
What are they?
Remnants of Wolffian/mesonephric duct
Paratubal cyst, paraovarian cyst
What tumor is made of immature neuroepithelium, has areas of necrosis and hemorrhage and is found in teens w/a mean age of 18?
Prognosis?
Immature (malignant) teratoma
Excellent for stage 1 grade 1
What are sx of PCOS?
Amenorrhea Acne Hirsutism Acanthosis nigricans Deepening voice
Mucinous ovarian tumors what morphology?
Large cystic masses (>25kg)
Fluid rich in glycoproteins
Columnar epithelium
What has the morphology of unilateral, yellow, made of small cuboidal to polygonal cells and has Call-Exner bodies?
Granulosa cell tumor
Pts w/PCOS also have what underlying disorders?
Obesity
T2DM
Early atherosclerosis
Increased E1
What tumor presents w/increased hCG, occurs in prepubertal females and does not respond to chemo, meaning it is fatal?
Choriocarcinoma
Dysgerminoma occurs in whom?
Increased levels of what?
What mutation?
75% in 20-30s, pseudohermaphroditism
hCG
KIT, OCT-3, OCT4, NANOG
Transitional cell tumor is aka what?
Malignant version is what grade and type?
Brenner tumor - Benign
Low-grade type 1 carcinoma
What is a very common (incidental) finding which may be palpable or may cause pain and is benign?
Cystic follicle
If > 2cm then called follicle cyst
What tumor has a smooth glistening cyst wall with no epithelial thickening or only small papillary projections w/cilia present?
Benign ovarian tumor –> serous cystadenoma
Mucinous carcinoma has what morphology?
Glandular growth and expansile invasion
What tumor marker is used to monitor recurrence and progression of ovarian tumors?
What other new one?
CA-125
HE4
Endometrioid ovarian tumors have what mutations?
Morphology?
5yr survival rate in pt w/stage 1?
PTEN, PIK3CA, ARID1A, KRAS, CTNNB1
40% b/l, low-grade, rarely benign (adenofibroma)
75%
What is adnexa?
Fallopian tube and ovary together
Malignant ovarian serous tumors spread where?
Peritoneum and omentum
Low grade serous ovarian tumors have mutations in what?
KRAS
BRAF
ERBB2
What causes salpingitis?
N. Gonorrhea or chlamydia via ascending infection
