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Withrow > Female Reproductive System Tumors > Flashcards

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
Q

This biomarker has been used in human medicine to aid in the diagnosis oif epithelial ovarian tumors and may have similar value in dogs.

A

Hector Battifora mesothelial epitope (HBME-1)

26
Q

Which tumor type is the second most common ovarian tumor (after epithelial)?

A

sex cord stromal tumors (granulosa-theca cell)

27
Q

What are other sex cord stromal tumors besides granulosa-theca cell?

A

sertoli leydig, thecoma, luteoma

28
Q

What tissue do sex cord stromal tumors arise from?

A

estrogen and progesterone producing gonadal stroma of the ovary

29
Q

What is the metastatic rate of granulosa-theca cell tumors? Where?

A

~20%; SLLN, pancreas, lungs, +/- peritoneal carcinomatosis

30
Q

What are the histologic patterns of granulosa-theca cell tumors?

A
  1. Solid
  2. Nest
  3. Cord
  4. Palisade
  5. Cystic
  6. Spindle

A mixture of these can occur in a single tumor

31
Q

What biomarkers are typically expressed in granulosa-theca cell tumors?

A
  1. vimentin
  2. S-100
  3. INH-a
32
Q

Moderate to strong ET-1 immunoreactivity has been detected in what percent of granulosa-theca cell tumors?

33
Q

What are the tumors in the germ cell tumor group?

A
  1. dysgerminoma
  2. teratoma
  3. malignant teratoma/teratocarcinoma
34
Q

What is the most common germ cell tumor of the ovary? What tissue do they arise from?

A

dysgerminoma/ovarian seminomas; undifferentiated germ cells

35
Q

What is the metastatic rate of dysgerminoma of the ovary? Where?

A

10-30%; LN, liver, kidney, omentum, pancreas, adrenal glands

36
Q

What cells compose a teratoma?

A

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
Q

What is the rate of metastasis of malignant teratoma?

38
Q

What biomarker is typically expressed in germ cell tumors?

39
Q

What mesenchymal tumors have been reported in the canine ovary?

A
  1. HSA
  2. hemangioma
  3. leiomyoma
40
Q

What type of ovarian tumor is most common in cats?

A

sex cord stromal tumor (>50% of cases)

41
Q

In cats, which type of sex cord stromal tumor is most common?

A

granulosa theca cell tumor

42
Q

What percent of granulosa theca cell tumor are malignant in cats?

43
Q

Although rare, which type of germ cell tumor is the most common in cats?

A

dysgerminoma

44
Q

What percent of dysgerminomas in cats metastasize?

45
Q

Which group of ovarian tumors is the least common in cats?

A

epithelial

46
Q

The most common tumor of the vulva in dogs and cats?

A

leiomyoma: middle-age to older intact female dogs
leiomyoma: older intact queens

47
Q

The most common malignant vaginal tumor?

A

leiomyosarcoma

48
Q

Tell me more about canine clitoral carcinoma (CCC)

A

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

Withrow (12 decks)

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