GONADS Flashcards
What’s the functional unit if an ovary
A follicle
What’s an ovary
It’s an oocyte surrounded by granulosa and theca cells
What causes theca cells to produce androgens
LH - Luteinising hormone
What causes granulosa to take androgen
FSH- follicle stimulating hormone
What does the granulosa convert the androgen to
Estrogen
What does the eastrogen produced by the granulosa do
It hits the oocyte and causes it to mature as well as it causes the endometrium to enter the proliferative phase
What happens to residual follicles after ovulation
Becomes the corpus luteum
What does the corpus loteum do
Primarily secretes progesterone, preparing endometrium for maintenance of a possible pregnancy
What can hemorrhage in the corpus loteum do
It can result in hemorrahic luteal cyst
What happens when there is degranulation of follicle
follicular cysts
Usually females have 1-2/3 follicular cysts
- multiple follicular cysts in ovary due to hormonal imbalance
- characterised by increased Luteinizing hormone and decreased follicular stimulating hormone hormone
Polycystic ovarian disease (PCOD)
What happens in Polycystic ovarian disease (PCOD)
Due to high levels of LH -
The theca cells will secrete a shit ton of androgens and when it goes into blood -> it causes hirstrism(hair growth on face and arms etc) - the androgens will also go in to periphery in to adipose tissue and it will get converted in to estrons.
What is an estron
Estrogen produced by adipose tissue
What does estron do in the body
It will go feed in to the anterior pituitary and decrease production of FSH, hence granulosa cells won’t be able to convert the androgen-> leading to degeneration of follicle ( decrease in estrogen to maintain the follicle) and that all results in cyctic formation
Presents with Obese young women with infertility, oligomenorrhea and hirsutism
- some patients have insulin resistance
- high circulating estrone levels -> increase risk of emdometrial carcinoma decreased
Polycystic ovarian disease
What are the 3 layers of the ovary
Surface epithelium
Her cell
Sex cord stroma
Where can a tumor arise from in the ovary
All three layers of the ovary
Surface epithelium
Her cell
Sex cord stroma
What’s the most common type of ovarian tumors
Surface epithelial tumours
What are surface epithelial tumors derived from
Coelomic epithelium that lines the ovary( coelomic epithelium can produce different types of epithelium)
What are the 2 most common Types of epithelial tumours
Serous and mucinous and both are usual cystic—> can be benign or malignant or border line tumours
- benign tumour of epithelium of the ovary
- can be mucinous or serous
- composed of single cyst with simple flat lining
- most commonly arises in premenopausal women(30-40 years old)
Cyst adenoma
Malignant tumour of the epithelium layer of the ovary can by mucinous or serous
- composed of complex cyst with thick shaggy lining
- most commonly arises in post menopausal women 60-70 years old
Cyst adenocarcinoma
- tumour features in between benign and malignant tumours
- better prognosis than clearly malignant tumours but still carry metastatic potential
Borderline tumours
BRCA 1 Mutation carriers
Have increased risk for SEROUS carcinoma of the ovary and Fallopian tube
What are other types of surface epithelial tumours
Endometroid and Brenner tumour
- usually a malignant tumour of the surface epithelium
- associated with endometriosis of the ovary (chocolate cyst)
Endometrioid tumour of the ovary
-15% of people with endometrial carcinoma of the ovary will have separate endometriod carcinoma of the endometrium
Tumour of the surface of the ovary that contains urothelium in the ovary
Brenner tumour
Surface tumours present late —>
- Vague abdominal symptoms (pain, fullness)
- signs of compression
- poor prognosis
- epithelial carcinomas tend to spread locally especially to the peritoneum (shows omental caking)
Which tumour marker does surface epithelial tumours release
CA-125 —> useful serum marker to monitor treatment response and screen recurrence
What is the second most common ovarian tumour
Germ cell tumours (15%)
- usually occur in women of reproductive age (15-30 yes)
- tumour subtypes mimics tissues normally produced by germ cells.
Germ cell tumours
Types of tumours of feral tissue
Cystic teratoma or emberyonal carcinoma
Type of tumors in the yolk sac
Yolk sac tumour
Type of tumours of germ cells
Dysgenioma
Type of tumours of placenta
Choriocarcinoma
What is the most common germ cell tumour in females
Cystic teratoma
- A tumour composed of fetal tissue derived from 2-3 embryologic layers, bilateral 10% of the cases.
- Tumour is composed of (Bone, hair, teeth, gut …..)
- benign (MATURE TERATOMA) but if there is immature tissue (neural ectoderm) it indicates malignancy or also somatic malignancy —> making it IMMATURE TERATOMA
Cystic teratoma
- Cystic teratoma composed primarily of thyroid tissue
- can also present with hyperthyroidism and mass in the ovary or
Monodermal teratoma (struma ovarian)
- a mass of a bunch egg like cells
- composed of large cells with clear cytoplasm and central nuclei
- most common malignant germ cell tumour
- testicular counterpart is called seminoma
- good prognosis responds to radiotherapy
- serum LDH is elevated
Dysgerminoma
- malignant tumour that mimics yolk sac
- most common germ cell tumour in children (a girl who’s 5years old)
- serum AFP is elevated
- schiller-duval bodies (glomeriliod-like structures)are seen on histology
Endoderm all sinus tumour
-tumour composed of trophoblasts and syncytiotrophoblasts (villi are absent)
- high B-HCG (Human chorionic gonadotropin )
- small hemorrhagic tumour with early hematogenous spread (poor prognosis)
(Happens because trophoblasts are programmed from the beginning to invade)
Choriocarcinoma
- resembles granulosa cells theca cells, fibrous tissue and rarely sertoli/leydig cells
Sex cord stromal tumours
- neoplasm of granulosa and theca cells
- often produces estrogen
- presents with signs of estrogen excess (symptoms vary with age)
Granulosa theca cell tumour
- Sertoli cells from tubules
- leydig cells contain a characteristic REINKE CRYSTALS.
- may produce androgens, associated with hirsutism or virilization
Sertoli leydig tumour
Benign tumour of fibroblasts
Associated with pleural effusions and ascites (meigs syndrome)
Fibroma
Diffuse gastric carcinoma with finger shaped cells involved both ovaries primary involves only one
Kuckenberg tumour
Metastasis means the cancer will be
Mucinous carcinoma
A lot of mucus in peritoneum usually due to mucinous carcinoma of the appendix
Pseudomyxoma peritonei
The implantation of a fertilised ovum in any other site than the uterus (90% of these cases is in the oviductal tubal pregnancy)
Ectopic pregnancy
- inflammation of the Fallopian tube with pus occurs as a part of PID.
- scarring of the tube and increased risk of ectopic pregnancy
Supportive salpingitis
- most common benign Fallopian tube tumour
- mesothelial in origin
Adenomatoid tumour
- benign cysts arising from mullerian vestiges, below the Fallopian tube near fimbriae
- no significance until it’s torted -> leleading to infarction
Hydatids of morgani
