OnlineMedEd: Gynecology - "Ovarian Cancer" Flashcards
List the three types of ovarian cancer cell origins.
- Epithelial (from cells surrounding the ovary)
- Germ cells
- Stromal
What are the four types of ovarian cancer that arise from germ cells?
- Dysgerminoma
- Choriocarcinoma
- Endometrial sinus tumor
- Teratoma
What kind of ovarian cancer is most common in teenage girls?
Germ cell tumors (dysgerminoma, endometrial sinus tumor, chorciocarcinoma, and teratoma)
___________ tumors are generally nonmalignant.
Germ cell tumors
How are germ cell tumors treated?
Unilateral salpingo-oophorectomy (to preserve fertility)
Why does nulliparity increase the risk of epithelial ovarian cancer?
Ovulation breaks the epithelium around the ovary. As such, repeated ovulation leads to increased trauma and thus increased repair. The repetitive need to regrow tissue leads to increased risk of malignant transformation.
Why do ovarian cancers often present late stage?
Two reasons:
•They are asymptomatic for a long time.
• They seed the peritoneum directly.
Ovarian neoplasms often present with what complications?
- Renal failure
- Small bowel obstruction
- Ascites without liver failure
How is epithelial ovarian cancer treated?
BSO and paclitaxel
There is one exception to the “ovarian cancer is not a diagnosis we screen for” rule. Explain.
Women with BRCA 1/2 mutations get screened with TVUs yearly.
List the four types of epithelial ovarian cancer.
- Brenners
- Endometrioid
- Serous
- Mucinar
The last three are cystic.
What are the two stromal cell ovarian cancers?
- Granulosa-theca cell tumor (which will present with high estrogen)
- Sertoli-Leydig cell tumor (which will present with high testosterone)
TVUs are used to diagnose adnexal masses. Explain the presentation of simple cysts versus complex cysts.
- Simple cyst: TVU will show a small, smooth, round, homogeneous mass without septations
- Complex cyst: TVU will show a large, irregular, loculated cyst with septations
How can you use patient characteristics to narrow down the likelihood of what a complex cyst is?
- If the patient is young and asymptomatic, then the complex cyst is likely a teratoma. Treat with unilateral SO.
- If the patient is older and has symptoms (RF, ascites, SBO), then the complex cyst is likely epithelial ovarian cancer. Treat with TAH + BSO and paclitaxel.
