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Ob/Gyne 2 > Module 2 : Ovarian Pathology > Flashcards

Module 2 : Ovarian Pathology Flashcards

1
Q

two main categories for cystic ovarian masses

A
  • simple

- bilateral and multiple

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2
Q

5 types of simple cystic ovarian masses

A
  • follicular
  • corpus lute
  • paraovarian
  • omental
  • urachal
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3
Q

3 types of bilateral and multiple cystic ovarian masses

A
  • theca lutean
  • polycystic ovaries
  • ovarian torsion
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4
Q

follicular cysts characteristics

A
  • LH and FSH stimulates the ovary to mature the oocyte
  • follicle grows a lot in 10 days
  • normal
  • evolve into corpus luteum after rupture
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5
Q

corpus luteum cysts characteristics

A
  • term after ovulation
  • odd shape
  • 1 - 10 cm
  • often debris within
  • if large resolve in 8 weeks without pregnancy
  • resolve 12-15 weeks with pregnancy
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6
Q

perisitent cysts

A
  • follicular or corpus luteum
  • may grow quite large before rupture
  • may cause pain
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7
Q

paraovarian cysts characteristics

A
  • remnants of embryonic ducts
  • aka cysts of morgangi, para tubular, surosa cysts
  • thin walls arising form mullerian wall
  • NEVER SURROUNDED BY OVARIAN TISSUE
  • do not change with cycle 1-4cm
  • asymptomatic
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8
Q

urachal cyst characteristics

A
  • located midline anterior and wall between umbilicus and bladder
  • remnant of development of bladder
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9
Q

omental cysts characteristics

A
  • located in higher pelvis or abdomen

- along the omentum

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10
Q

theca lutean cysts characteritics

A
  • multiple bilateral cysts
  • can be very large
  • might undergo hemorrhage, rupture to torsion
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11
Q

4 other pathology associated with theca lutean cysts

A
  • multiple gestation
  • molar pregnancy
  • choriocarcinoma
  • hyperstimulation syndrome
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12
Q

which hormone causes theca lutean cyst to occur

A
  • excessive amounts of HCG
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13
Q

polycystic ovarian syndrom PCOS

A
  • steiqn-levinthal syndrome
  • 20-30 years
  • unopposed estrogen with no surge of LH
  • increased androgen secretion from stroma
  • many small immature follicles
  • ovulation does not occur
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14
Q

PCOS symptoms

A
  • obesity
  • hirsutism
    + increased androgens
  • infrequent menses
    + oligomenorrhea
  • infertility
  • pre cursor to type 2 diabetes
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15
Q

what other disease is PCOS associatied with

A
  • endometrial cancer
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16
Q

what is the most extreme form of PCOS called

A
  • hyperthecosis or thesis
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17
Q

PCOS diagnosis

A
  • blood work

+ increased testosterone

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18
Q

PCOS sonographic appearance

A
  • slightly enlarged ovaries with multiple SMALL cysts around periphery
  • string of pearls
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19
Q

ovarian torsion symptoms

A
  • acute sharp pain

- associate with ovarian masses

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20
Q

incomplete ovarian torsion

A
  • large edematous ovaries

- multiple cysts

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21
Q

complete ovarian torsion

A
  • increased or decreased echo texture due to infarct or hemorrhage
22
Q

ovarian torsion ultrasound

A
  • evaluate with color and spectral doppler

- early diagnosis could save ovary

23
Q

3 types of neoplastic tumors

A
  • epithelial tumors
  • germ cell tumors
  • connective tissue (stromal) tumors
24
Q

7 types of epithelial tumors

A
  • serous cystadenoma
  • serous cystadenocarcinoma
  • mucinous cystadenoma
  • mucinous cystadenocarcinoma
  • endometroid
  • clear cell carcinoma
  • brenners tumor
25
Q

serous cystadenoma

A
  • simple cystic tumor
  • menstrauting age group
  • common and BENIGN
  • thin walls
  • variable size
  • may have septation
  • serous means serum producing = thin fluid
26
Q

serous cystadenocarcinoma

A
  • may be cystic with irregular texture and walls
  • ASCITES
  • large >10cm
  • look for paraaortic nodes
  • MOST COMMON MALIGNANT OVARIAN CANCER
27
Q

mucinous cystadenoma

A
  • BENIGN
  • unilateral cystic mass with low level echoes or complex
  • very large
  • may rupture
  • comprised mostly of mucin producing cells
28
Q

mucinous cystadenocarcinoma

A
  • rare compared to benign
  • MALIGNANT
  • complex with AASCITES
  • greater chance of rupture
  • risk of PSEUDOMYXOMA PERITONEI
    + massive adhesions from mucin in the ascites
29
Q

endometroid carcinoma

A
  • usually MALIGNANT
  • menopausal age
  • large
  • complex or solid
  • associated with endometrial cancer
30
Q

clear cell carcinoma

A
  • aka mesonephroid, mullerian duct origin
  • COMPLEX MASS
  • MALIGNANT
  • variant of endometroid carcinoma
31
Q

brenners tumor

A
  • akak transitional cell tumor
  • rare
  • BENIGN
  • SOLID
  • unilateral
32
Q

4 types of germ cell tumors

A
  • cystic teratoma (dermoid)
  • solid teratoma
  • dysgerminoma
  • endodermal sinus tumor (yolk sac tumor)
33
Q

cystic teratoma

A
  • aka mature teratoma or dermoid
  • usually BENIGN (can become malignant)
  • predominantly complex with fat/fluid levels, calcifications (teeth or hair)
  • tip of the ice berg appearance
  • all ages
  • may undergo torsion
  • NO COLOR FLOW
34
Q

rokitansky nodule

A
  • very hyperechoic discrete rounded protuberance within the dermoid
35
Q

solid teratoma

A
  • aka immature teratoma
  • increased risk of becoming malignant
  • benign to HIGHLY MALIGNANT
  • solid mass with complex internal echoes
36
Q

dysgerminoma

A
  • rare
  • found in young women
  • solid
  • MALIGNANT AND RADIOSENSITVE
  • male counterpart is seminoma
  • associated with choriocarcinoma
  • ## INCREASED HCG
37
Q

endodermal sinus tumor

A
  • also called yolk sac tumor
  • MALIGNANT
  • rapid growth
  • solid
  • poo prognosis with high recurrence
  • INCREASED AFP
38
Q

4 types connective cell tumors

A
  • aka sex cord or stromal tumors
  • granulosa cell tumor
    + theca luteal cell tumor
    + thecoma
  • sertoli-leydig cell
    + androblastoma or arrenoblastoma
  • fibroma and fibrosarcoma
39
Q

granulosa cell tumor

A
  • solid
  • usually BENIGN
  • produces ESTROGEN
  • precocious (early) puberty in children
  • irregular cycle in adults
  • increased risk of endo cancer
40
Q

sertoli - leydig tumor

A
  • aka androblastoma
  • adolesence
  • produces ANDROGENS - masculine
  • solid and unilateral
  • small amount become MALIGNANT usually BENIGN
41
Q

fibroma and fibrosarcoma

A
  • BENIGN = fibroma MALIGNANT = fibrosarcoma
  • unilateral
  • postmenopausal
  • solid like fibroud
  • ASSOCIATED WITH MEIGS SYNDROME
42
Q

meigs syndrome

A
  • hydrothorax and ascites with an ovarian mass but once mass is removed syndrome resolves
43
Q

secondary ovarian tumors

A
  • primary carcinoma of different organ with mets to ovary
  • common
  • ## usually from GI or breast
44
Q

krukenberg tumor

A
  • bilateral metastatic ovarian tumors that produce mucin

- large complex masses

45
Q

ovarian cancer facts

A
  • 4th leading cause of death
  • silent killer
  • older age gourps
  • increase when nulliparous or low parity
  • delayed child bearing
  • early onset of meses
  • late menopause
  • HRT
  • family history
  • direct relation to number of year and epithileal ovarian cancer
46
Q

ovarian cancer and breast cancer

A
  • strong association with each other
47
Q

BRCA 1 and BRCA 2

A
  • mutation of these genes increase risk of ovarian and breast cancer
48
Q

MSH 2 and MLH1

A
  • associated with colon cancer
49
Q

ultrasound role with cancer

A
  • if any pelvic abnormality seen you should to EV
  • look for irregular walls, thick speciation, size (>5cm worrisome), ascites, distal mets
  • check is mass is fixed or invading other organes
  • doppler
50
Q

blood work of cancer

A
  • Ca125 antibody used to detect ovarian cancer
  • helpful for detecting recurrance
  • most sensitive are nonmucinous tumors
51
Q

CHEETAH

A 
- acronym for masses that look similar
C - cystadenoma
H - hemorrhagic cyst
E - ectopic 
E - endometrioma
T - teratoma
A - abscess 
H - hydrosalpinx

Ob/Gyne 2 (19 decks)

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