Gynaecology - Ovarian Cancers Flashcards
Ovarian Tumours?
Epithelial
Sex Cord
Germ Cell
Metastatic
- Epithelial - Serous Mucinous/ Brenner Endometroid
- Sex Cord - Granulosa Cell/ Sertoli Leydig cell
- Germ Cell - Dysgerminoma yolk sac/Choriocarcinoma Teratoma
- Metastatic - Krukenberg
What is an ‘Adnexal Mass’?
An adnexal mass:
- is a lump in tissue of the adnexa of uterus (structures closely related structurally and functionally to the uterus such as the ovaries, fallopian tubes, or any of the surrounding connective tissue).
- Adnexal masses can be benign or cancerous, and they can be categorized as simple or complex.
What is the ligament that contains
the vessels going to the ovary?
- The supensory ligament of the ovary (infundibulopelvic ligament)
- Ovarian mass can cause torsion
Epithelial Tumours?
Serous/Mucinous?
WHO?
- Post menopausal or BRCA1
- Lynch syndrome
- multiparity
HISTOLOGY?
- Epithelium (can from gland like structures) secreting a clear mucinous liquid
- Benign (cyst adenoma) vs Malignant (adenocarcinoma) - ‘shaggy’ papilliary projections
- Serous=Psammoma
Tumour Markers:
- CA-125 Not diagnostic - used to follow tumour burden
Psammoma bodies?
Psammoma bodies (PBs)
- are concentric lamellated calcified structures, observed most commonly in:
- papillary thyroid carcinoma (PTC),
- meningioma,
- papillary serous cystadenocarcinoma of ovary
- mesothelioma
Other Epithelial Tumours?
Brenner/Endometrioid
Brenner Tumours - Transitional epithelium as seen in bladder
Endometrioid - Appears like endometrioid like tissue, will be lesions in the uterus
What are the epithelial tumours most common in postmenopausal females?
- (1) Serous- An epithelial lined cyst of clear fluid with psammoma bodies
- (2) Mucinous - An epithelial lined cyst of mucous
- (3) Brenner - A cyst lined with bladder epithelium
- (4) Endometroid - Endometrial like tissue in the ovary with an additional tumour in the uterus
What are the main GERM CELL tumours?
Yolk Sac - Schiller Duval bodies
Dysgerminoma - Fried egg appearance
Teratoma - Multiple cell types
Choriocarcinoma - Cyto-/syncytiotrophoblast
Germ Cell Tumours - Histology
Yolk Sac/Dysgerminoma/Teratoma/Choriocarcinoma/Embryonal
- Yolk Sac - Schiller Duval Bodies
- Dysgerminoma - Fried egg appearance
- Teratoma - Multiple cell types
- Choriocarcinoma - Cyto/Syncytiotrophoblast
Germ Cell Tumours
Dysgerminoma?
(Fried Egg)
Who - Peak in premenopausal women
Histology - ‘Fried eggs’ Large cells with clear cytoplasm and large nuclei
Tumour markers - PLAP, bhCG, LDH
Germ Cell Tumours
Yolk Sac (Endodermal Sinus)
Who -
- Peak in premenopausal women (but will commonly be children in question stems)
Histology -
- Endodermal sinuses=Schiller Duval Bodies (resemble primitive glomeruli)/
- Eosinophillic cytoplasmic globules
Tumour Markers -
- Alpha fetoproteins
A 55 year old woman comes to the Doctor due to pelvic pan
