Module 2: Ovarian Pathology Flashcards

1
Q

What is a follicular cyst?

A

Normal functional simple cyst due to LH and FSH stimulating ovary to mature occyte.

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2
Q

How large are follicular cysts?

A

Grows 3mm-24mm in 10 days

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3
Q

What is a corpus luteum cyst?

A

A normal functional cyst with debris that occurs after the follicle ruptures during ovulation.

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4
Q

How large are corpus luteum cysts?

A

1-10 cm

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5
Q

How fast do corpus luteum cysts resolve?

A

No pregnancy = 8 weeks

Pregnancy = 12-15 weeks

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6
Q

What is a persistent cyst?

A

A follicular or corpus luteum that grows large before rupturing and causing pain.

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7
Q

What is a paraovarian cyst?

A

A thin walled, asymptomatic cyst that grows from the remnants of embryonic ducts

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8
Q

Are paraovarian cysts surrounded by ovarian tissue?

A

No

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9
Q

How large are paraovatian cysts?

A

1-4cm, not affected by cycle.

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10
Q

What is a urachal cyst?

A

A cyst that grows from a remnant in development of the bladder.

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11
Q

Where are urachal cysts located?

A

Midline, anterior abdominal wall between umbilicus and bladder.

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12
Q

What is a omental cyst?

A

Cyst located higher in the pelvis/abdomen along the omentum.

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13
Q

What are theca lutean cysts?

A

Mulitple, bilateral cysts that are caused by excessive amounts of hCG.

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14
Q

How large are theca lutean cysts?

A

Several cm

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15
Q

What are theca lutean cysts associated with?

A
  1. Multi pregnancies
  2. Molar pregnancy
  3. Choriocarcinoma
  4. Hyper-stimulation syndrome
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16
Q

What can happen to a theca lutean cyst?

A

Hemorrhage, rupture, torsion

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17
Q

What is hyper stimulation?

A

A life threatening condition due to pergonal over stimulation.

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18
Q

What is PCOS and what is it?

A

Polycyctic ovarian syndrome is when the ovary has many immature follicles that never mature or rupture (no ovulation).

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19
Q

Why does PCOS occure?

A

Increased androgen secretion from the ovarian stroma (imbalanced) results in no surge of LH.

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20
Q

What is another name for Polycystic Ovarian Syndrome?

A

Stein-Leventhal syndrome

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21
Q

Who is affected by PCOS?

A

Women 20-30 years old.

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22
Q

What are the symptoms of PCOS? (5)

A
  • Obesity
  • Hirsutism
  • Infrequent menses (oligomenorrhea)
  • Ogliomenorrhea
  • Infertility
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23
Q

What is Hirsutism?

A

Male pattern hair growth in females.

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24
Q

What is PCOS associated with?

A

Endometrial cancer

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25
Q

What is the most extreme form of PCOS?

A

Hyperthecosis, or thecosis

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26
Q

How is PCOS diagnosed?

A

Blood is tested for increased testosterone

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27
Q

How does PCOS appear on US?

A

Slightly enlarged ovaries with multiple, small cysts around the periphery (“string of pearls”).

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28
Q

What is incomplete ovarian torsion?

A

Large, edematous ovaries with multiple cysts (fluid retention due to congestion).

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29
Q

What is complete ovarian torsion?

A

Increased or decreased echotexture due to infarct or hemorrhage.

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30
Q

How do you evaluate torsion?

A

With colour and spectral doppler.

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31
Q

What is serous cystadenoma?

A
  • Epithelial
  • Simple cystic
  • Benign
  • Menstruating
  • May have septations
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32
Q

What is Serous Cystadenocarcinoma?

A
  • Epithelial
  • Complex
  • Malignant
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33
Q

What is the most common malignant ovarian cancer?

A

Serous cystadenocarcinoma (60%)

34
Q

How large is Serous cystadenocarcinoma?

A

Large, Greater than 10 cm

35
Q

What is Mucinous Cystadenoma?

A
  • Epithelial
  • Complex w/ debris (mucin)
  • Benign
36
Q

How large is Mucinous Cystadenoma?

A

Very large, 15 -30 cm at risk to rupture because of size.

37
Q

What is Mucinous Cystadenocarcinoma

A
  • Epithelial
  • Complex
  • Malignant
  • Rare
38
Q

What is Mucinous Cystadenoma at risk of?

A
  1. Rupture

2. Pseudomyxoma Peritonei

39
Q

What is Pseudomyxoma Peritonei?

A

Massive adhesions from the mucin in the acites

40
Q

What is Endometrioid Carcinoma?

A
  • Epithelial
  • Complex/solid
  • Usually malignant
  • Menopausal
41
Q

How large are Endometrioid Carcinoma?

A

Large, 10 - 15 cm

42
Q

What is Endometrioid Carcinoma associated with?

A

Endometrial cancer

43
Q

What is Clear Cell Carcinoma?

A
  • Epithelial
  • Complex
  • Malignant
44
Q

What are other names for clear cell carcinoma?

A

Mesonephroid (mullerian duct origin)

45
Q

What is clear cell carcinoma a variant of?

A

Endometrioid carcinoma

46
Q

What is Brenner’s Tumors?

A
  • Epithelial
  • Solid
  • Benign
  • Unilateral
47
Q

What is Brenner’s Tumor also known as?

A

Transitional Cell Tumor

48
Q

What are the germ cell layers?

A
  1. Endoderm
  2. Mesoderm
  3. Ectoderm
49
Q

What is a Cystic Teratoma?

A
  • Germ Cell
  • Complex (calcifications/teeth/hair)
  • Benign (2% malignant)
  • all ages
  • Tip of the iceberg
50
Q

What accounts for 25 % of all ovarian neoplasms?

A

Cystic Teratoma

51
Q

What is Cystic Teratoma also known as?

A

Mature teratoma or dermoid

52
Q

What is a solid teratoma?

A
  • Germ cell
  • Solid (complex internal echoes)
  • Benign to highly malignant
  • Young children and women
53
Q

What is another name for solid Teratoma?

A

Immature teratoma

54
Q

What is Dysgerminoma?

A
  • Germ cell
  • Solid (areas of necrosis)
  • Malignant (radiosensitive)
  • Young women
55
Q

What is Dysgerminoma associated with?

A

Choriocarcinoma (elavated hCG)

56
Q

What is the male counterpart to dysgerminoma?

A

Seminoma

57
Q

What is Endodermal Sinus Tumor?

A
  • Germ cell
  • Solid
  • Malignant (rapid growth)
58
Q

What is Endodermal Sinus Tumor also known as?

A

Yolk Sac tumor

59
Q

What increases with the Endodermal Sinus Tumor?

A

AFP

60
Q

What are sex cord (stromal tumors)?

A

Connective cell tumors

61
Q

What is Granulosa Cell Tumor

A
  • Connective tissue
  • Usuall Benign
  • solid
62
Q

What do granulosa cell tumours cause? (4)

A
  • Estrogen production
  • Precocious puperty in cheldren
  • Irregular cycle (wonky hormones)
  • Increased risk of endo CA
63
Q

What is Sertoli-Leydig Cell Tumor?

A
  • Connective tissue
  • Solid (necrosis)
  • 10 - 20 % become maignant (usually benign)
  • Adolesence
64
Q

What does Sertoli-Leydig Cell Tumor produce?

A

Androgens (masculinization)

65
Q

What are the other names for Sertoli-Leydig Cell Tumors?

A

Androblastoma and Arrenoblastoma

66
Q

What is a fibroma?

A
  • Connective tissue
  • Solid (fibroid like)
  • Unilateral
67
Q

What are fibromas associated with?

A

Meig’s Syndrome

68
Q

What is Meigs syndrome?

A

Hydrothorax and ascites with an ovarian mass but

once the mass is removed the Meigs’ Syndrome resolves.

69
Q

What is Krukenberg’s Tumor?

A

Bilateral metastatic ovarian tumours that produce mucin (thick acites

70
Q

What are secondary ovarian tumors?

A

Cancer that spreads to ovaries from somewhere else (GI or breast) large complex masses

71
Q

Mutation of what genes may increase breast and ovarian cancer?

A

BRCA 1 and BRCA 2

72
Q

What cancer does MSH 2 and MLH1 associate with?

A

Colon

73
Q

What is an antibody used to detect ovarian cancer?

A

Ca 125

74
Q

What ovarian masses have similar appearances? CHEETAH

A
Cystadenoma / ca
Hemorrhagic cyst
Ectopic
Endometrioma
Teratoma
Abscess
Hydrosalpinx
75
Q

What are Granulosa Cell Tumors also known as?

A
  1. Theca - Luteal Cell Tumor

2. Thecoma

76
Q

What is the 4th leading cause of death due to cancer in women?

A

Ovarian cancer

77
Q

What % of women present with advanced ovarian cancer and ascites?

A

75%

78
Q

How does childbirth affect the risk of ovarian cancer?

A

Increased risk in nulliparous or low parity women.

79
Q

What is the peak age for ovarian cancer?

A

60-70 years

80
Q

How often does sporadic ovarian cancer occur in women over 50?

A

90%

81
Q

What other type of cancer is ovarian cancer strongly linked to?

A

Breast Ca