malignant disease of ovary Flashcards
Classification of ovarian cancer
Primary
epithelial - high grade serous, endometrioid, clear cell, mucinous
sex-cord stromal - granulosa, sertoli-leydig
germ cell - dysgerminoma, endodermal sinus
Secondary
colon, breast, stomach
Features of high grade serous
most common epithelial ovarian cancer
Characterised by psammoma bodies
Features of mucinous
very large cell bodies
features of endometrioid
associatede with endometrial cancer and endometriosis
features of clear cell
least common
can also be associated with endometriosis
What is the precursor lesion for high grade serous cancer
serous tubular intraepithelial carcinoma
RF for ovarian cancer
Nulliparity HRT IUD Obesity endometriosis cigarette smoking (mucinous only) Diabetes
decreased risk of ovarian cancer
Multiparity
COCP
tubal ligation
Salpingo-hysterectomy
What is the risk of malignant index
A way of triaging pelvic masses
Calculated using menopausal status, pelvic US features and CA125
What staging is used in ovarian cancer
FIGO
1 - 4
What is the general surgical management of ovarian cancer
surgery with platinum based chemo
What are some chemo drugs for ovarian Ca
platinum (calculate dose based on GFR)
paclitaxel (give pre-emptive steroids to prevent hypersensitivity reaction)
bevacizumab (monoclonal Ab against VEGF)
What are the clinical features of sex cord stromal tumours
all come from excess hormone production
irregular bleeding
PMB
precocious puberty
features of granulosa tumour
large and so may tort
may produce inhibin (use to survey)
These often reccur
features of sertoli leydig
signs of virilisation
can produce renin which leads to HTN
