Malignant Ovarian Tumours Flashcards
Serous epithelial Tumours
Most common ovarian Tumour
Histo:
Cystic lesion
tall columnar epithelium w/ Serous fluid
Cystadeboma (bg) -encapsulated -BILATERAL Cystic/fibrous/ cystic-fibroid Can become MG
Cystadenocarcinoma
Most aggressive MG ovarian tumour
usually metastasised to OMENTUM causing ACITES
-Psammoma bodies typical (Intracellular Ca2+ collection)
How to differentiate between bg and mg serous ovarian Tumours (cystadenoma vs cystadenocarcinoma)
mg shows:
Cellular atypia
Invasion of local ovarian stroma
Psammoma body presence
Benign shows:
Borderline= atypia w/o invasion
Capsule
Mucinous epithelial ovarian Tumours
2nd most common ovarian Tunmour
75% are benign
Affects females at reproductive ages
UNILATERAL
Present w/ PSEUDOMYXOMA PERITONEI
Histology
- cystic lesion
- lined by mucous producing cells
Histo
- sponge like
- cavitations
- mucous cells w/ mucous
What is pseudomyxoma peritonei
Condition where a cancerous lesions w/ mucin cells release Abnormally large amounts of mucous causing GELATINOUS ASCITES
Endometriod epithelial ovarian Tumours
Solid tumour w/ endonmetial like tissues
BILATERAL
Assoc w/ endometrial cancer !! And endometriosis
Germ cell Tumours (pluripotent germ cell prolif)
Usually affect women below 20-30
(EXCEPT CYSTIC TERATOMA
@ reproductive age)
D/2 abnormal proliferation of pluripotent germ cell precursors remaining in ovaries(and testes)
Tumour markers TERATOMA-no specific DYSGERMINOMA -increased LDH Choriocarcinoma- increases beta HCG YOLK SAC-increased AF1P
Describe ovarian teratomas
Aka monster cells developing from all 3 embryologic layers
MATURE (differentiated & benign rarely turns mg)
1) dermoid cyst (usually bg)
* most common of all germ cell tumors (90% of cases)
* Can contain any type of tissue(hair, teeth, and sebaceous glands)
2) struma ovarii
* teratoma w/ endodermal diff into thyroid tissue
* Very rare: malignant transformation into a thyroid carcinoma
* thyroxine and cause hyperthyroidism symptoms
IMMATURE (Rare, undifferentiated high risk of mg)
- common in prepubertal women
- originate from NEUROECTODERM CELLS
- quick metastasis
Describe DYSGERMINOMA
Equivalent to Male seminoma in women
germ cells are encapsulated at birth within the primordial follicle. If they somehow escape encapsulation, cell death usually occurs. If the germ cells survive, rapid growth ensues, owing to the lack of normal contact inhibition, hence germ cell tumor (GCT) formation. All dysgerminomas are considered malignant, but only one third of dysgerminomas behave aggressively
RADIOSENSITIVE responds well to therapy
Assoc w/ turners syndrome
Describe yolk sac tumors
Most common germ cell tumour in children
Very aggressive progression
Assoc w/ increased Alphafetoprotein
Describe choriocarcinoma
Very rare
Very malignant w/ metastasis
Increased beta HCG
Germ cells originate from the syncytiotrophoblast cells of the placenta when ch release HCG
Can cause hyperthyroidism
Describe sex cord Tumours
Affect all age groups
Granulosa/theca cell tumour
Serrtoli leydig
Ovarian fibroma
LH stims theca cells to convert androgens into oestrogen by aromatase
FSH stims granulosa cells to make androepiasterone
Overall increase of oestrogen over stims ovulation
Oocyte exits ovary and causes damages to the epithelial surface stimulating fibroblasts healing
Causes collagen deposition and increases damage
Cycle of increased damage stim cell division and fibroblasts increases risk of oncogenesis every ovulation
Oestrogen producing tumors /
Granulosa/theca cell tumors
Most common sec cord tumour
usually Affects
middle aged women
post menopausal women
Causes increased production of ESTRADIOL(causes sx:
- Early menarche
- Uterine bleeding
- Tender breasts
Histology
- small eosinophilic follicles
- CALL-EXNER bodies (granulosa cells arranged in clusters surrounding a central cavity with eosinophilic secretions, resembling primordial follicles)
Androgen producing SERTOLI leydig tumors
Very rare
Affects mid age women (30-40)
Sx related to androgen release mimicking testosterone causing VIRILLIZATION
- hirsuitism
- Male pattern balding
- deep voice
- clitoromegaly
Histological features
- bright pink REINKE CRYSTALS
Describe ovarian fibroma
Benign Tumor of the fibroblasts cells
Presents w/ MEIG’s syndrome (O. A. P.)
1) ovarian fibroma
2) ascites
3) pleural effusion
Tumors mass can compress the round ligament of the uterus
Sites of origin of metastatic ovarian tumors
Breast and GIT are most common sites of origin of primary tumour
