Malignant Ovarian Tumours Flashcards

1
Q

Serous epithelial Tumours

A

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)

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2
Q

How to differentiate between bg and mg serous ovarian Tumours (cystadenoma vs cystadenocarcinoma)

A

mg shows:
Cellular atypia

Invasion of local ovarian stroma

Psammoma body presence

Benign shows:

Borderline= atypia w/o invasion

Capsule

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3
Q

Mucinous epithelial ovarian Tumours

A

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
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4
Q

What is pseudomyxoma peritonei

A

Condition where a cancerous lesions w/ mucin cells release Abnormally large amounts of mucous causing GELATINOUS ASCITES

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5
Q

Endometriod epithelial ovarian Tumours

A

Solid tumour w/ endonmetial like tissues
BILATERAL
Assoc w/ endometrial cancer !! And endometriosis

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6
Q

Germ cell Tumours (pluripotent germ cell prolif)

A

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
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7
Q

Describe ovarian teratomas

A

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
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8
Q

Describe DYSGERMINOMA

A

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

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9
Q

Describe yolk sac tumors

A

Most common germ cell tumour in children
Very aggressive progression

Assoc w/ increased Alphafetoprotein

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10
Q

Describe choriocarcinoma

A

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

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11
Q

Describe sex cord Tumours

A

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

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12
Q

Oestrogen producing tumors /

Granulosa/theca cell tumors

A

Most common sec cord tumour
usually Affects
middle aged women
post menopausal women

Causes increased production of ESTRADIOL(causes sx:

  1. Early menarche
  2. Uterine bleeding
  3. Tender breasts

Histology

  • small eosinophilic follicles
  • CALL-EXNER bodies (granulosa cells arranged in clusters surrounding a central cavity with eosinophilic secretions, resembling primordial follicles)
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13
Q

Androgen producing SERTOLI leydig tumors

A

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

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14
Q

Describe ovarian fibroma

A

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

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15
Q

Sites of origin of metastatic ovarian tumors

A

Breast and GIT are most common sites of origin of primary tumour

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16
Q

What is a KRUKENBURG tumor

A

Bilateral ovarian metastasis from primary gastric malignancy

Types
Mucin secreting carcinoma

Signet ring cell carcinoma

17
Q

Which is Assoc w/ turners syndrome

A

Dysgerminoma