Gyn onc

Question 1

Struma ovarii

Answer 1

OVarian teratoma that produces thyroid hormones, thereby causing thyrotoxicosis.

Question 2

Best screening test for virilizigng neoplasm

Answer 2

Measure serum testosterone and DHEAS which could delineate the site of excess androgen production. Elevated testosterone with normal DHEAS indicate an ovarian source.
Elevated DHEAS with normal testosterone indicate an adrenal source. DHEA is secretied from both ovaries and adrenals, whereas DHEAS, a sulfated form of DHEA, is specifically secreted from the adrenals.

Question 3

What syndrome is associated with phyllodes tumors?

Answer 3

Li-Fraumeni syndrome

Question 4

When should you suspect phyllodes tumor rather than fibroadenoma?

Answer 4

Large tumor size at presentation or rapid growth.

Question 5

Tx of phyllodes tumor

Answer 5

Wide excision. If malignant, consider adjuvant radiation.

Question 6

Typical appearance of a phyllodes tumor on mammography? Ultrasound?

Answer 6

Mammo: smooth, polylobulated mass.
Ultrasound: solid, hypoechoic, well-circumscribed.
The presence of cystic areas within the mass may increase the level of suspicion for phyllodes tumors.