Female Genital Tract 3 - Dobson

Question 1

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?

Answer 1

Dysgerminoma

Excellent

Question 3

What are the 3 types of serous epithelial tumors?

Answer 3

Benign (60%)
Borderline
Malignant (25-30%) aka Cystadenocarcinoma

Question 4

What causes extensive mucinous ascites, cystic epithelial implants on the peritoneal surfaces, adhesions, and frequent involvement of the ovaries?

Origin?

Answer 4

Pseudomyxoma peritonei

Appendiceal

Question 6

Morphology of serous ovarian tumors in general?

Answer 6

Bilateral

Involves the surface

Question 7

What Mullerian tumors are metastatic to the ovary?

Answer 7

Uterus
Fallopian tube
Opposite ovary
Pelvic peritoneum

Question 8

Teratoma karyotype?

B/l or unilateral?

Answer 8

46 XX

Uni

Question 9

What is the triad of ovarian tumor, hydrothroax Right side, and ascites?

Answer 9

Meigs syndrome

Question 12

What presents w/bleeding not related to cycle, watery/blood vaginal discharge, abnormal Pap, abdominal swelling and occurs in postmenopausal Whites?

Prognosis?

Answer 12

Adenocarcinoma of the fallopian tube

Poor prognosis

Question 14

Most ovarian carcinomas present w/what symptoms?

Metastasize where?

Answer 14

Weakness
Weight loss –> cachexia

Liver, lungs, GI, other ovary

Question 15

What tumor presents in children or young women that c/o abdominal pain and a rapidly growing pelvic mass?

Survival w/chemo?

Answer 15

Yolk sac tumor

80%

Question 17

High grade serous ovarian tumor morphology?

Answer 17

Atypia, pleomorphism, multinucleation

Question 18

What functional tumor produces masculinization or defeminization w/a peak incidence in women 20-30?

Answer 18

Sertoli-Leydig cell tumor

Question 19

Ovarian neoplasms are 80% what and occur in whom?

Answer 19

Benign, young women

Question 20

Yolk sac tumor secretes what?

Has what?

Answer 20

Alpha-FP

Schiller Duval bodies

Question 21

What are RFs for malignant serous ovarian tumors?

Answer 21

Low parity
FMH
BRCA1/2 mutation

Question 22

What has a mutation in DICER1?

Answer 22

Sertoli-Leydig cell tumor

Question 25

Mucinous ovarian tumors have what mutation?

Answer 25

KRAS

Question 28

PCOS is characterized by multiple cysts and what clinically?

Answer 28

Hyperandrogenism
Menstrual irregularities
Chronic anovulation
Decreased fertility

Question 31

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?

Answer 31

Ovarian torsion

Question 34

Mature teratoma/Dermoid cyst b/l %?

Found in whom? When?

Arise from what?

Answer 34

10-15%

Young women incidentally OR in inflammatory condition like limbic encephalitis

Ovum after 1st meiotic division

Question 35

What is the clinical presentation of ovarian epithelial tumors?

Answer 35

Lower abdominal pain and enlargement

Can impinge on other organs

Question 37

High grade serous ovarian tumors have mutations in what?

Answer 37

TP53

Rb

Question 38

What tumor may cause hyperthyroidism?

Answer 38

Struma ovarian (monodermal teratoma)

Always unilateral

Question 39

Granulosa cell tumors occur in whom?

Clinical course?

May cause what?

Answer 39

2/3 occur in postmenopausal women

Indolent

Precocious puberty, breast disease, endometrial hyperplasia and cancer

Question 41

Poorly diff sertoli-leydig cell tumors have what pattern?

Answer 41

Sarcomatous Unilateral

Question 43

Mucinous ovarian tumors bolded morphology?

Answer 43

Don't involve the surface | Only 5% b/l

Question 44

What tumor has a mutation in FOXL2 in the adult version only?

Answer 44

Granulosa cell tumor

Question 45

What has Reinke crystalloids and women present w/masculinization? Benign or malignant?

Answer 45

Hilus cell tumor Benign

Question 46

Serous ovarian Borderline tumor morphology?

Answer 46

Stromal papillae w/epithelial proliferation growing as "micropapillary carcinoma", precursor to low-grade cancer

Question 47

What has strong (+) to inhibin and secretes estrogen?

Answer 47

Granulosa cell tumor

Question 48

What are fallopian tubes formed from?

Answer 48

Upper infused Mullerian (paramesonephric) duct

Question 49

What extra-Mullerian tumors are metastatic to the ovary?

Answer 49

``` Colon Stomach Pancreas Biliary tract Breast ```

Question 50

Endometrioid ovarian tumors arise in the setting of what? 15-30% accompanied by what?

Answer 50

Endometriosis, can have a chocolate cyst Uterine endometrial carcinoma

Question 53

What morphology is described by unilateral, stroma marked by sharply demarcated nests of epithelioid cells?

Answer 53

Transitional cell tumor

Question 54

What forms Hydatids of Morgagni? What are they?

Answer 54

Remnants of Wolffian/mesonephric duct Paratubal cyst, paraovarian cyst

Question 55

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?

Answer 55

Immature (malignant) teratoma Excellent for stage 1 grade 1

Question 56

What are sx of PCOS?

Answer 56

``` Amenorrhea Acne Hirsutism Acanthosis nigricans Deepening voice ```

Question 58

Mucinous ovarian tumors what morphology?

Answer 58

Large cystic masses (>25kg) Fluid rich in glycoproteins Columnar epithelium

Question 60

What has the morphology of unilateral, yellow, made of small cuboidal to polygonal cells and has Call-Exner bodies?

Answer 60

Granulosa cell tumor

Question 62

Pts w/PCOS also have what underlying disorders?

Answer 62

Obesity T2DM Early atherosclerosis Increased E1

Question 63

What tumor presents w/increased hCG, occurs in prepubertal females and does not respond to chemo, meaning it is fatal?

Answer 63

Choriocarcinoma

Question 64

Dysgerminoma occurs in whom? Increased levels of what? What mutation?

Answer 64

75% in 20-30s, pseudohermaphroditism hCG KIT, OCT-3, OCT4, NANOG

Question 65

Transitional cell tumor is aka what? Malignant version is what grade and type?

Answer 65

Brenner tumor - Benign Low-grade type 1 carcinoma

Question 68

What is a very common (incidental) finding which may be palpable or may cause pain and is benign?

Answer 68

Cystic follicle | If > 2cm then called follicle cyst

Question 72

What tumor has a smooth glistening cyst wall with no epithelial thickening or only small papillary projections w/cilia present?

Answer 72

Benign ovarian tumor --> serous cystadenoma

Question 74

Mucinous carcinoma has what morphology?

Answer 74

Glandular growth and expansile invasion

Question 75

What tumor marker is used to monitor recurrence and progression of ovarian tumors? What other new one?

Answer 75

CA-125 HE4

Question 76

Endometrioid ovarian tumors have what mutations? Morphology? 5yr survival rate in pt w/stage 1?

Answer 76

PTEN, PIK3CA, ARID1A, KRAS, CTNNB1 40% b/l, low-grade, rarely benign (adenofibroma) 75%

Question 80

What is adnexa?

Answer 80

Fallopian tube and ovary together

Question 83

Malignant ovarian serous tumors spread where?

Answer 83

Peritoneum and omentum

Question 84

Low grade serous ovarian tumors have mutations in what?

Answer 84

KRAS BRAF ERBB2

Question 89

What causes salpingitis?

Answer 89

N. Gonorrhea or chlamydia via ascending infection