Gynecologic Pathology III Flashcards
T/F cystadenomas are benign
T
Ovarian tumor sources
surface epithelial, germ cell, sex-cord stromal, metastatic
What is the source of borderline tumors?
surface epithelia
Most common source of benign, malignant, and borderline ovarian tumors?
surface epithelia
Epithelial tumors arise form the surface epithelium of the ovary and from _____
epithelial inclusion cysts
Inclusion cyst formation
after ovulation, invagination of surface epithelium can form a cyst
Classification of surface epithelial tumors
serous, mucinous | malignant, borderline, benign
______ are lined by a single layer of bland epithelial cells.
benign cystadenomas
Ovarian masses that are ______ are most suspicious for malignancy
solid and cystic
Completely cystic masses are mostly benign/malignant
benign
T/F Completely solid masses may be benign or malignant
T
Typical spread of ovarian cancer
peritoneal surfaces, omentum
T/F most early stage ovarian cancers come without signs and symptoms
T
Stage I ovarian cancer
a = one ovary, b = both ovaries, c = surface/rupture of ovary
Stage 2 ovarian cancer
spread to tubes, uterus, other pelvic organs
Stage 3 ovarian cancer
lymph node metastasis, spread out of pelvis or to omentum
Stage 4 ovarian cancer
distant metastasis
Most common malignant ovarian tumor
ovarian serous carcinoma
Risk factors for ovarian serous carcinoma
nulliparity, family hx, heritable mutations
Which heritable mutations are risk factors for ovarian serous carcinoma
BRCA1 or BRCA2
Which mutations tend to lead to low grade ovarian serous carcinoma (e.g. serous borderline tumors) ?
KRAS or BRAF
Which mutations tend to lead to high grade ovarian serous carcinoma?
p53
Almost all ovarian carcinomas in women with ______ mutations are high grade serous carcinoma and a significant percentage of these arise from _______
BRCA 1/2 and fallopian tube epithelium
T/F Most serous tumors are malignant vs borderline or benign
T
Borderline tumors have high/low malignant potential.
low
Is there invasion in borderline tumors?
No stromal invasion!
Implants
not considered metastases –> extraovarian lesions with borderline tumors
borderline tumors with invasive implants act like ____
low grade carcinomas
Stage I borderline ovarian tumors
confined to ovary; if noninvasive implants –> 100% survival
Metastatic tumors of ovary are hard to distinguish from ___
primary mucionous ovarian tumors
Primary ovarian mucinous tumors are almost always uni/bilateral and large/small
unilateral and large
Metatstatic tumors of the ovary tend to be uni/bilateral and small/large
bilateral and small
Krukenberg tumor
special form of bilateral metastasis to ovary that is solid
Classical Krukenberg histology
signet ring tumor cells –> breast and stomach cancer
Germ cell ovarian tumors are ____ >95% of the time
benign dermoid cyst/cystic teratoma
For 0-30 year old age group, ___ are hte most common malignant tumors.
dysgerminoma (germ cell tumor)
dermoid cyst
benign, common form of germ cell tumor in ovary
malignant transformation of a dermoid cyst is rare/common
rare
Dysgerminoma
uncommon but most common malignant germ cell tumor –> can be bilateral; excellent prognosis
Sex cord stromal tumors arise from ____
granulosa and thecal cells
Most benign granulosa-stromal cell tumors are
thecoma-fibroma
Most of clinically malignant sex-cord stromal tumors are ___
granulosa cell tumors –> all have malignant potential
Granulosa cell tumors can produce estrogens and cause _____
endometrial hyperplasia/carcinoma
granulosa cells in tumors form follicles called ___
call-exner bodies
coffee bean nuclei with grooves
granulosa cell tumor
____ tumors have a lot of lipid
thecoma
____ tumors have no hormone production and are associated with two rare syndromes
ovarian fibroma
two syndromes associated with ovarian fibroma
meigs, gorlins
meigs’ syndrome
ascities and pleural effusion
gorlins’ syndrome
nevoid basal cell carcinoma syndrome –> multiple fibromas
bundles of spindle cells are what kind of tumor?
ovarian fibroma
