Mehl. Ovarian neoplasms 03-24 (1)

Question 1

M. Has Fallopian tube-like epithelium. Can occur bilaterally. Benign. Dx?

Answer 1

Serous cystadenoma

Question 2

M. Can have psammoma bodies.
20-30% bilateral at time of diagnosis.
Malignant (i.e., has metastatic potential). I discuss tumor nomenclature in detail in the HY Path PDF. Dx?

Answer 2

Serous cystadenocarcinoma

Question 3

M. Has intestine-like epithelium. Loculated or locular (meaning, has tiny cavities, like honeycomb). Benign. Dx?

Answer 3

Mucinous cystadenoma

Question 4

M. Same as mucinous cystadenoma, but malignant. Can cause pseudomyxoma peritonei, which is accumulation of mucin-producing tumor cells and gelatinous ascites in the peritoneal cavity. Dx?

Answer 4

Mucinous cystadenocarcinoma

Question 5

M. Seminoma equivalent in females. name?

Answer 5

Dysgerminoma

Question 6

M. Large uniform cells with clear cytoplasm (same as seminoma). Highly sensitive to chemo- and radiotherapy (same as seminoma). Dx?

Answer 6

Dysgerminoma

Question 7

M. Can occur idiopathically or in Turner syndrome. LDH is a tumor marker, Dx?

Answer 7

Dysgerminoma

Question 8

M. Dysgerminoma tumor marker?

Answer 8

LDH is a tumor marker.

Question 10

M. Produces androgens. Can cause virilization in females. Dx?

Answer 10

Sertoli-Leydig cell tumor

Question 11

M. Sertoli-Leydig cell tumor - what produces? what can cause in women?

Answer 11

Produces androgens.
Can cause virilization in females.

Question 12

M. Granulosa cell tumor. produces what?

Answer 12

Produces estrogen.

Question 13

M. Granulosa cell tumor. effect on endometrium?

Answer 13

Can cause endometrial hyperplasia and incr.­ risk of endometrial cancer due to unopposed estrogen.

Question 14

M. NBME Q gives female with ovarian neoplasm + incr. thickness of endometrial stripe + vaginal bleeding. answer for ovarian lesion = Dx?

Answer 14

Granulosa cell tumor.

Question 15

M. Yolk sac tumor. Aka?

Answer 15

Aka endodermal sinus tumor.

Question 16

M. Yolk sac tumor. in what kids case this is answer?

Answer 16

the answer on USMLE for ovarian tumor in pediatrics (usually up to age 3).

Question 17

M. Yolk sac tumor. secretes what as tumor marker?

Answer 17

Secretes AFP as tumor marker.

Question 18

M. Secretes AFP as tumor marker. what tumor?

Answer 18

Yolk sac tumor

Question 19

M. LDH is a tumor marker. what tumor?

Answer 19

Dysgerminoma

Question 20

M. Schiller-Duval bodies on histo, which resemble glomeruli. what tumor?

Answer 20

Yolk sac tumor

Question 21

M. Aggressive and rapidly growing. tumor?

Answer 21

Embryonal carcinoma

Undifferentiated/anaplastic cells on histology.

Question 22

M. Secretes both AFP and hCG together as tumor markers. tumor?

Answer 22

Embryonal carcinoma

Question 23

M. Embryonal carcinoma - tumor markers 2?

Answer 23

Secretes both AFP and hCG together as tumor markers.

Question 24

M. Usually occurs in adult men, but can be seen as ovarian tumor also. The key for USMLE is that it’s the answer if AFP and hCG are both high, whereas if only AFP is high, then the answer is yolk sac tumor. You can also remember yolk sac tumor is kids, whereas embryonal cancer is usually adults.

Answer 24

Embryonal carcinoma.

Question 25

M. Benign ovarian tumor that has urothelium (i.e., transitional cells). Can appear tan/yellow. tumor?

Answer 25

Brenner tumor

Question 26

M. Benign ovarian tumor that secretes thyroid hormone. tumor?

Answer 26

Struma ovarii

Question 27

M. Gastric metastases to the ovaries bilaterally. Has mucin-containing signet-ring cells on biopsy. Spread to ovaries from stomach is usually hematogenous. Dx?

Answer 27

Krukenberg tumor