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Urogenital 2 > Genital Cancers - Ovary / Tube / Vulval > Flashcards

Genital Cancers - Ovary / Tube / Vulval Flashcards

1
Q

Explain the roll of germ cells in the ovary.

A

The germ cells are totipotent cells forming oocytes.

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2
Q

What is the roll of stromal cells of the ovary.

A

The stromal cells support the germ cells and are hormone secreting.

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3
Q

Epithelial cancers of the ovary are what type of tumour?

A

Adenocarcinomas

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4
Q

What are the four types of adenocarcinomas of the epithelial cells of the ovary?

A

Serous
Mucinous
Endometrioid
Transitional

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5
Q

What gene mutation is associated with serous adenocarcinomas of the ovary?

A

BRCA

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6
Q

How do adenocarcinomas of the ovary present?

A

Abdominal swelling
Pressure symptoms e.g incontinence
Discomfort
GI disturbance

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7
Q

What investigation are carried out for suspected germ cell cancers?

A

Ca125
Ultrasound
CT of the abdo/pelvis

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8
Q

How do stromal cancers of the ovary present?

A 
Abdominal swelling
Pain 
Hormonal effects (increased oestrogen / testosterone secretion).
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9
Q

What are the main types of stromal cell cancer?

A

Granulosa cell tumours (malignant)
Thecomas (benign)
Sertoli-Leydig cell tumours (malignant)

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10
Q

What investigations are carried out in cases of suspected stromal cell cancers?

A

Ca125
Inhibin levels
Ultrasound of pelvis
CT abdo/pelvis

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11
Q

Ca125 is a marker of what?

A

Peritoneal irritation

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12
Q

What causes elevated levels of Ca125?

A

Menstruation, pregnancy, endometriosis, heart failure, pneumonia, peritoneal malignancy.

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13
Q

Endometriosis

A

Painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus (the endometrium) grows outside your uterus.

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14
Q

What are BRCA1 and BRCA2?

A

BRCA’s are DNA repair genes - increased risk of cancer if dmaged.

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15
Q

Tubal cancer is what type of cancer?

A

Serous ovarian cancer

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16
Q

What is the origin of most high grade serous ovarian cancer?

A

Tubal origin

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17
Q

What is the most common form of vulval cancer?

A

Squamous cell carcinoma

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18
Q

What is the most common cause of vulval squamous cell carcinoma?

A

HPV16

Lichen sclerosis

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19
Q

How does vulval cancer present?

A

With a vulval lump/ulcer

Usually painful

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20
Q

What investigations are carried out for suspected vulval cancer?

A

Biopsy from the edge of the lesion

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21
Q

Cancer of what cell is the most common form of ovarian cancer?

A

Epithelial cell

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22
Q

Benign tumour

A

Does not invade nearby tissue or spread to other parts of the body.

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23
Q

Serous cystadenoma

A

Benign serous epithelial tumours that are fluid filled cysts.

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24
Q

Mucinous cystadenoma

A

Benign mucinous epithelial cell tumours that for large mucus filled cysts.

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25
Q

Cystadenocarcinoma indicates what type of tumour?

A

Malignant

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26
Q

What is characteristic of Mucinous and Serous cystadenocarcinoma’s?

A

Inflamed/Swollen lining

Common in post menopausal women

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27
Q

Endometrioid tumours

A

Ectopic cysts filled with dark blood.

28
Q

If endometrioid tumours are malignant where do they commonly spread to?

A

Fallopian tubes and the peritoneal cavity

29
Q

Transitional tumours aka

A

Brenner tumours

30
Q

What type of cells make up transitional tumours?

A

Transitional cells normally found lining the bladder, usually solid.

31
Q

What increases the risk of ovarian cancer?

A

Increased risk with conditions such as endometriosis and PCOS.
BRCA1/BRCA2 mutations
Lynch syndrome
Increased risk with cumulative time spent in ovulation.

32
Q

What are the diagnostic methods used for ovarian cancer?

A

Tumour markers e.g B-hcg
Transvaginal ultrasound
Biopsy - determine benign/malignant
CT or MRI scan

33
Q

When is surgery an ideal treatment for ovarian cancer?

A

When the tumour is confined to the ovary

34
Q

When is chemotherapy an ideal treatment for ovarian cancer?

A

When it has spread

35
Q

Ca125 stands for…

A

Carbohydrate antigen 125

36
Q

What is Ca125 produced by?

A

Produced by ovarian tumours therefore it’s level is tracked in the blood.

37
Q

What results in decreased risk of ovarian cancer?

A

Pregnancy / Breastfeeding / Oral contraceptives

~ decreases number of ovulations

38
Q

Germs cells are totipotent, multipotent or pluripotent?

A

Pluripotent

39
Q

What are the different types of germ cell ovarian cancer?

A

Tertomas
Yolk sac tumour
Choriocarcinoma
Dysgerminoma

40
Q

What are the two types of teratoma?

A

Mature cystic teratoma

Immature teratoma

41
Q

Outline mature cystic teratomas

A

Most common ovarian tumour in young women and are formed from tissue that comes from any of the three germ layers.

42
Q

Immature teratomas are derived from what?

A

Neuro-ectoderm cells

Tend to be malignant and metastasise quickly.

43
Q

Yolk sac tumours are also known as…

A

Endodermal sinus tumours

44
Q

Schiller-duval bodies are formed by what type of ovarian cancer?

A

Yolk sac tumour

45
Q

What are schiller-duval bodies?

A

Rings of cells around a central blood vessel

46
Q

Choriocarcinomas are germ cells formed from what cells?

A

Syncytiotrophoblast cells

47
Q

What are characteristics of choriocarcinomas?

A

Bleed easily and spread

48
Q

Choriocarcinomas produce what hormones and what can this lead to?

A

B-hcg excess production can lead to the formation of ovarian cysts

49
Q

Dysgerminomas

A

Oocytes grow uncontrollably

50
Q

Sex cord-stromal ovarian cancer

A

Cancer of the follicular cells of the ovary or the stromal connective tissue.

51
Q

What are the most common malignant stromal tumours?

A

Granulosa-theca cell tumours

52
Q

Stromal tumours leads to an excess production of…

A

Estradiol

53
Q

What symptoms are seen as a result of estradiol overproduction in stromal tumours?

A

Uterine bleeding
Breast tenderness
Early puberty in young girls

54
Q

Fibromas are made up of what cells?

A

Fibroblasts (Benign)

55
Q

What are the three types of stromal ovarian tumour?

A

Fibromas
Granulosa-theca cell tumours
Sertoli-Leydig cell tumours

56
Q

Sertoli-leydig cell tumours are made up of what?

~ what is the significance of this?

A

Primative gonadal stroma

~ the cells can secrete androgens e.g testosterone

57
Q

What are the main symptoms of ovarian cancer?

A 
Abdominal distension
Bloating
Abdominal / pelvic pain (due to ovarian torsion)
Ascites
Abdominal masses
Bowel obstruction
Dyspareunia 
Sister mary joseph nodule
58
Q

Sister Mary Joseph nodule

A

When a cancer metastasises to the umbilicus.

59
Q

Outline standard vaginal cancers

A

Typically Squamous carcinoma’s associated with HPV infection

16 and 18

60
Q

What is clear cell adenocarcinoma?

A

A form of vaginal cancer developing from the glandular cells of the vagina.

61
Q

What are the symptoms of vaginal cancer?

A 
Usually asymptomatic
Abnormal vaginal bleeding (postmenopausal/postcoital)
Watery blood tinged vaginal discharge
Pelvic pain
Urinary frequency
Constipation
62
Q

How is vaginal cancer diagnosed?

A

Vaginal colposcopy

Biopsy

63
Q

What is the most common type of ovarian cancer for young women?

A

Germ cell ovarian cancers

64
Q

Teratomas aka

A

Ovarian dermoid cysts

65
Q

Ascites

A

Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen.

66
Q

RMI

A

Risk of Malignancy index

67
Q

RMI =

A

RMI = Ultrasound score x Menopausal score x Ca125

Urogenital 2 (22 decks)

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