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Female Reproductive System Tumors Flashcards

Withrow 2019 - Chapter 27

1
Q

What is the most common feline ovarian tumor?

A

GTCTs (granulosa thecal cell tumors)

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2
Q

Are feline ovarian tumors typically functional or not? If yes what hormones?

A

Yes - estrogen, progesterone, or testosterone

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3
Q

What clinical signs are most common with canine ovarian tumors?

A

Space occupying abdominal mass signs

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4
Q

Describe the typical ultrasonographic appearance of malignant ovarian tumors? Benign?

A

Malignant - solid
Benign - cystic with smooth borders

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5
Q

What is the treatment of choice for ovarian tumors?

A

Complete OHE

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6
Q

What role does chemotherapy play in the treatment of ovarian tumors?

A

Unclear, may use intra-abdominal carboplatin to treat malignant effusions

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7
Q

Which factors for human ovarian cancer are linked to lower rates of occurrence?

A

Women who have given birth to children, breastfeeding, oral contraceptive use

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8
Q

Other clinical signs noted for vaginal/vulvar tumors

A

Vaginal bleeding/discharge, dysuria, hematuria, tenesmus, constipation, excessive vulvar licking, dystocia

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9
Q

Germline mutations of which gene(s) are linked to familial ovarian cancer?

A

BRCA1, BRCA2

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10
Q

Why is epithelial ovarian cancer the leading cause of gynecologic cancer mortality?

A

70% women present with advanced disease

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11
Q

Diagnostics for vaginal/vulvar tumors

A

Vaginal and rectal palpation, vaginoscopic examination, vaginal cytology, retrograde vaginography or uretheocystography, TXR, AUS

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12
Q

Which chemotherapy agents are used in human medicine for treatment of ovarian tumors?

A

Platinum agents, taxanes

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13
Q

What is the most important predictor of prognosis for women with ovarian cancer?

A

Stage

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14
Q

Treatment of choice for most vaginal/vulvar tumors

A

Surgical excision with OHE

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15
Q

Prognosis for vaginal/vulvar tumors

A

Surgical excision and OHE - curative for benign tumors
Guarded for malignant tumors d/t high rates of local recurrence and metastasis

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16
Q

Epithelial tumors of the ovary arise from which surface?

A

outer surface

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17
Q

List the malignant histological patterns of epithelial ovarian tumors (3)

A
  1. papillary adenocarcinoma
  2. tubular adenocarcinoma
  3. undifferentiated carcinoma
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18
Q

List three benign epithelial ovarian tumors

A
  1. rete adenoma
  2. papillary adenoma
  3. cystadenoma
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19
Q

What percent of ovarian adenocarcinomas metastasize? What location is most likely?

A

48%; peritoneal cavity (intrabdominal lymph nodes, omentum, and liver)

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20
Q

Are ovarian carcinomas most commonly unilateral or bilateral?

A

unilateral (bilateral has been described)

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21
Q

What biomarkers are routinely expressed by ovarian carcinomas? What are two additional markers that can also be demonstrated in papillary adenocarcinomas?

A
  1. cytokeratin AE1/AE3
  2. vimentin
  3. desmin
  4. placental alkaline phosphatase (papillary)
  5. cytokeratin 7 (papillary)
22
Q

What three biomarkers are variably expressed in ovarian adenocarcinoma?

A
  1. alpha-fetoprotein (AFP)
  2. S-100
  3. endothelin A
23
Q

Faint to strong expression of cox-2 and endothelin-1 immunoreactivity has been reported in what percent of ovarian carcinomas?

A

81% and 83% respectively

24
Q

What biomarker is specific to granulosa-theca cell tumors?

A

Inhibin-alpha (INH-a)

25
This biomarker has been used in human medicine to aid in the diagnosis oif epithelial ovarian tumors and may have similar value in dogs.
Hector Battifora mesothelial epitope (HBME-1)
26
Which tumor type is the second most common ovarian tumor (after epithelial)?
sex cord stromal tumors (granulosa-theca cell)
27
What are other sex cord stromal tumors besides granulosa-theca cell?
sertoli leydig, thecoma, luteoma
28
What tissue do sex cord stromal tumors arise from?
estrogen and progesterone producing gonadal stroma of the ovary
29
What is the metastatic rate of granulosa-theca cell tumors? Where?
~20%; SLLN, pancreas, lungs, +/- peritoneal carcinomatosis
30
What are the histologic patterns of granulosa-theca cell tumors?
1. Solid 2. Nest 3. Cord 4. Palisade 5. Cystic 6. Spindle A mixture of these can occur in a single tumor
31
What biomarkers are typically expressed in granulosa-theca cell tumors?
1. vimentin 2. S-100 3. INH-a
32
Moderate to strong ET-1 immunoreactivity has been detected in what percent of granulosa-theca cell tumors?
88%
33
What are the tumors in the germ cell tumor group?
1. dysgerminoma 2. teratoma 3. malignant teratoma/teratocarcinoma
34
What is the most common germ cell tumor of the ovary? What tissue do they arise from?
dysgerminoma/ovarian seminomas; undifferentiated germ cells
35
What is the metastatic rate of dysgerminoma of the ovary? Where?
10-30%; LN, liver, kidney, omentum, pancreas, adrenal glands
36
What cells compose a teratoma?
germ cells that have undergone differentiation into at least two germinal cell layers. Any combination of tissues can be seen and are usually well differentiated.
37
What is the rate of metastasis of malignant teratoma?
up to 50%
38
What biomarker is typically expressed in germ cell tumors?
Vimentin
39
What mesenchymal tumors have been reported in the canine ovary?
1. HSA 2. hemangioma 3. leiomyoma
40
What type of ovarian tumor is most common in cats?
sex cord stromal tumor (>50% of cases)
41
In cats, which type of sex cord stromal tumor is most common?
granulosa theca cell tumor
42
What percent of granulosa theca cell tumor are malignant in cats?
50%
43
Although rare, which type of germ cell tumor is the most common in cats?
dysgerminoma
44
What percent of dysgerminomas in cats metastasize?
20-33%
45
Which group of ovarian tumors is the least common in cats?
epithelial
46
The most common tumor of the vulva in dogs and cats?
leiomyoma: middle-age to older intact female dogs leiomyoma: older intact queens
47
The most common malignant vaginal tumor?
leiomyosarcoma
48
Tell me more about canine clitoral carcinoma (CCC)
looks like AGASACA cytologically like AGASACA can have hyperCa consistently express CK AE1/AE3, but expression of neuroendocrine markers are more variable. locoregional nodal metastasis is common
49
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