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GYNE > Ovarian and Fallopian Tubr Tumors > Flashcards

Ovarian and Fallopian Tubr Tumors Flashcards

1
Q

MCC of gynecologic DEATH

A

Ovarian carcinoma

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2
Q

65% of all ovarian tumors and 95 % of all ovarian cancers are

A

EPITHELIAL TUMORS

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3
Q

5% to 10% of ovarian cancer is metastatic from other primary tumors in the body

A

GIT - Krukenberg tumor
breast
endometrium

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4
Q

WHO Classification - Ovarian Cancer

EPITHELIAL (65%)

A 
Serous
Mucinous
Endometrioid
Clear cell (Mesonephroid)
Brenner)
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5
Q

WHO Classification - Ovarian Cancer

SEX CORD < 0.01

A

Granulosa cell
Thecoma-fibroma
Sertoli-Leydig

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6
Q

WHO Classification - Ovarian Cancer

GERM CELL (6%)

A

Primitive (Dysgerminoma, Yolk Sac)

Teratoma

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7
Q

WHO Classification - Ovarian Cancer

GERM CELL SEX CORD (<0.01)

A

Gonadoblastoma

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8
Q

WHO Classification - Ovarian Cancer

MISCELLANEOUS

A

Tumors of rete ovarii
Small cell ca
Large cell ca
Wilms tumor

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9
Q

Risk Factors for Ovarian Cancer

A 
Familial ovarian ca
Family hx of breast and/or ovarian ca
Personal hx of breast ca
Increasing age
Early menarche (<12)
Infertility
Nulliparity
Late onset menopause (> 50)
Obesity (BMI > 30)
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10
Q

Protective Factors for Ovarian Cancer

A 
Use of OCPs (> 5 years)
Multiparity
Breastfeeding
Tubal ligation
Hysterectomy
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11
Q

Symptoms of Ovarian Cancer

A

bloating, early satiety, dyspepsia, abdominal pain, pelvic pain

back pain, urinary frequency/urgency
constipation, fatigue, dyspareunia, menstrual changes

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12
Q

The PRIMARY DIAGNOSTIC TOOL for investigating an adnexal mass

A

Pelvic Ultrasound

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13
Q

The MC MALIGNANT epithelial cell tumors

The MC type of epithelial ovarian cancer

A

Serous Cystadenocarcinomas

large, cystic, bilateral

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14
Q

Elevated in 80% of epithelial cell cancers

Useful in tracking the effect of treatment and recurrence of epithelial ovarian ca

A

CA 125

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15
Q

Mainstay of treatment of epithelial cell tumors

A 
SURGERY
TAHBSO
omentectomy
cytoreduction or debulking
bilateral pelvic and paraaortic lymph node sampling
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16
Q

Treatment AFTER surgery of epithelial ovarian cancer

A

COMBINATION CHEMOTHERAPY

IV Carboplatin, Paclitacel or Docetaxel

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17
Q

The most commonly used to evaluate the success of treatment to diagnose recurrent disease

A

CA 125 and CT scan

18
Q

Treatment for recurrent or persistent cancer

A

Chemotherapy

19
Q

Overall 5 year survival rate of ovarian cancer

A

20%

Stage I - 80-95%
Stage II - 40-70%
Stage III - 30%
Stage IV - <10%

20
Q

Transitional cell tumor

“coffee bean” appearing nucleus

Solid mass or nests of epithelial cells and a surrounding fibrous stroma

A

Brenner Tumor

21
Q

Dermoid cysts/Mature teratoma

80% occur in reproductive life

MC neoplasm in prepubertal female

A

Benign Cystic Teratoma

22
Q

MC BENIGN solid tumor of the ovary

Extremely slow growing and unilateral

Whorled pattern

A

Fibroma

MEIG’S SYNDROME

  • ovarian fibroma
  • ascites
  • hydrothorax
23
Q

Epithelial cells filled with mucin

Resembles endocervix/GIT

A

Mucinous tumor

24
Q

Contains cell with abundant glycogen (HOBNAIL CELLS)

Associated with DES exposure

A

Clear Cell

25
Q

MC malignancy in women < 30 years old

Grow RAPIDLY, usually UNILATERAL, stage Ia at diagnosis

A

Germ Cell Tumors

26
Q

MC type of germ cell tumor

A

Benign cystic mature teratoma (Dermoid cysts) - 95%

*mature adult tissue - skin, hair, teeth mixed with sebaceous material

27
Q

Definitive diagnosis of mature teratoma

A

Cystectomy

28
Q

MC MALIGNANT germ cell tumor

A

Dysgerminomas - 50%
Immature teratomas - 20%
Endodermal sinus (yolk sac) tumor - 20%

29
Q

Germ cells stroma infiltrated woth LYMPHOCYTES

Analogous to SEMINOMA of the tested

10% bilateral

A

DYSGERMINOMA - LDH

30
Q

Schiller Duval bodies - numerous hyaline droplets

A

ENDODERMAL SINUS TUMOR YOLK SAC TUMOR - AFP

31
Q

Hemorrhagic

Highly malignant cytotrophoblast and syncytiotrophoblast

A

b-hCG

32
Q

Consists of immature embryonic structures admixed with mature elements

A

IMMATURE TERATOMA - AFP

33
Q

Clinical Manifestations of Germ Cell Tumor

A

pelvic pain d.t. rapid growth, hemorrhage and necrosis

pressure symptoms on the bladder or rectum

85% - abdominal pain and pelvic mass

34
Q

Management for benign teratoma

A

Ovarian cystectomy or Oophorectomy

35
Q

Management for malignant Germ Cell Tumor

A

if fertility is desired - UNILATERAL SALPINGO-OOPHORECTOMY

no desire for fertility - TAHBSO

36
Q

Overall 5 year survival rate for germ cell tumor

A

dysgerminoma - 85%
immature teratomas - 70-80%
endodermal sinus tumors - 60-70%

37
Q

(+) grooved coffee bean nuclei arranged in small clusters around a central cavity (CALL EXNER BODIES)

functionally ESTROGENIC

produce estradiol and inhibin A/B

A

Granulosa Theca Cell Tumor

cause feminization, precocious puberty, menstrual irregularities, secondary amenorrhea or postmenopausal bleeding

38
Q

Resemble fetal TESTES

functionally TESTOSTEROGENIC

A

Sertoli Leydig Cell Tumor

masculinization
breast atrophy
hirsutism
temporal recession
deeper voice
acne
clitoromegaly
39
Q

Treatment for Sex Cord Tumor

A

Young women - UNILATERAL SALPINGOOHORECTOMY

Postmenopausal - TAHBSO

40
Q

The 5 year survival rate for patients with sex cord stromal carcinomas

A

70-90%

41
Q

Pathognomonic for fallopian tube carcinoma

A

LATZKO TRIAD

  • profuse watery discharge
  • pelvic pain
  • pelvic mass
42
Q

Pathognomonic for fallopian tube carcinoma but rarely seen

Colicky low abdominal pain d.t. intermittent hydrosalpinx

A

Hydrops Tubae Profluens

GYNE (16 decks)

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