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DM 2 - Gynecology > Ovarian Cancer > Flashcards

Ovarian Cancer Flashcards

1
Q

Incidence of ovarian cancer with genetic predisposition

A

10%

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2
Q

How do you reduce the risk of cancer in patients with high risk?

A

Risk reducing salpingoopherectomy

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3
Q

What is the primary imaging modality for Investigating suspected ovarian cancer

A

Ultrasound

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4
Q

Ultrasound features inkeeping with malignancy?
M RULES (5)

A
  • irregular solid tumor
  • ascites
  • atleast 4 papillary structures
  • irregular multilocular solid tumor >10cm
  • increased vascularity
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5
Q

Other reported ultrasound features of malignancy (elearning)
(5)

A
  • thickened septum (>3mm)
  • multilocularity
  • solid components/ papillary projections
  • bilateral lesions
  • ascites or metastatic lesions
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6
Q

ORADS 5 (USA) high risk features (5)

A
  • unilocular cyst with >4 papillary projections
  • multilocular cyst with solid component , mod- strong blood flow
  • solid (>80%) with smooth contour , very strong flow
  • solid with irregular contour
  • ascites +/- peritoneal nodules
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7
Q

Stage 1 A

A

Limited to one ovary with serosa intact. Negative washing

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8
Q

Stage 1B

A

Both ovaries, capsule intact, negative washing

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9
Q

Stage 1C1

A

1A or 1B with intraoperative capsule breech

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10
Q

Stage 1C2

A

Stage 1A or B with Preoperative capsule rupture

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11
Q

1C3

A

Either 1A or 1B with positive peritoneal washings

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12
Q

Stage 2A

A

One or both ovaries

Extension or implant on uterus +/- fallopian tubes

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13
Q

Stage 2B

A

Extension to other pelvic intrapertitoneal tissue

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14
Q

Stage 3A1i

A

Retroperitoneal nodes <10mm

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15
Q

Stage 3A2

A

Microscopic extrapelvic Mets +/- retroperitoneal nodes

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16
Q

Stage 3A1ii

A

Retroperitoneal nodes >10mm

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17
Q

Stage 3B

A

Macroscopic extrapelvic <2cm +/- retroperitoneal nodes

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18
Q

Stage 3C

A

Extrapelvic nodes >2cm +/- retroperitoneal nodes

Includes extension to capsule of liver/spleen without parenchymal involvement

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19
Q

Stage 4A

A

Pleural effusion + cytology

20
Q

Stage 4B

A

Hepatic/ spleen parenchyma

Extra abdominal lymph nodes eg inguinal

21
Q

Associated symptoms (5)

A
  • persistent abdominal bloating
  • early satiety
  • loss of appetite
  • pelvic or abdominal pain
  • increased Urinary frequency or urgency
22
Q

Sensitivity and specificity of ultrasound in postmenopausal ovarian cyst

A

Sensitivity 89%
Specificity 73%

23
Q

Risk of ovarian ca with lynch syndrome

A

12%

24
Q

Risk of cancer if RMI 25-250

A

20%

25
Q

Risk of cancer if RMI >250

A

> 75%

26
Q

Germ cell tumors make up what percentage of ovarian tumors

A

10%

27
Q

What tumor markers are increased for dysgerminomas (3)

A

LDH

Alkaline phosphates

Occasionally hcg

28
Q

What tumor markers is related to endodermal sinus tumor

A

Alpha feto protein

29
Q

What tumor markers are associated with embryonic carcinoma (3)

A

Alpha feto protein

Hcg

Estrogen occasionally

30
Q

What is the most common germ cell tumor

A

Dysgerminoma

(Seminoma in males)

31
Q

What age group is dysgerminoa prevalent in

A

Young women

60% seen in women <20years

32
Q

What is the hallmark histological finding of dysgerminomas

A

Lymphocytic infiltration of the stroma

33
Q

What is the inheritance pattern if lynch syndrome

A

Autosomal dominant

34
Q

What cancers are linked to LYNCH(7)

A
  • colorectal
  • endometrial
  • ovarian
  • gastric
  • Urinary tract
  • brain
  • hepatobiliary
35
Q

LYNCH
Lifetime risk of colorectal cancer

A

50-80%

36
Q

LYNCH
lifetime risk of endometrial ca

A

40-60%

37
Q

LYNCH
life time risk if ovarian ca

A

10-12%

38
Q

What gene carries an especially high risk of endometrial ca in LYNCH syndrome

A

MSH 6

39
Q

What is the risk reduction of BSO in brca positive women

A

80-96%

40
Q

What is the risk reduction of mastectomy in BRCA 1 positive

A

56%

41
Q

What is the risk reduction with mastectomy in BRCA 2

A

46%

42
Q

What is the risk of primary peritoneal cancer

A

1-6%

43
Q

When should risk reduction surgery be done for BRCA 1 positive patients

A

Age 35-40

44
Q

When should risk reduction be offered for BRCA 2

A

40 Years

45
Q

What percentage of patients with granulosa cell tumor have endometrial hyperplasia

A

1:3

33%

46
Q

What is the incidence of granulosa cell tumors

A

10-25%

70% secrete estrogen

DM 2 - Gynecology (22 decks)

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