Ovarian cancer

Question 1

Types
1. […] ovarian tumours - around […]%, […] common OC
- lines the […] of the fallopian tubes or the ovaries
- may contain […]
- metastasises into […] cavity

2.[…] cell tumours features
- typically grow […] and spread predominantly via the[…] route
- more common in […] women (atypical for most cases of ovarian cancer)
- tumour markers include […]-[…] and sometimes beta human chorionic gonadotrophin (B-HCG).

3. Sex cord stromal tumours (rare)
   - originate from […] tissue
   - less agressive

Answer 1

Epithelial, 90, most
fimbriae
cysts
peritoneal

Germ
rapidly, lymphatic
young
alpha-fetoprotein

connective

Question 2

Krukenberg tumour
- “[…] […]” sub-type of tumour, typically […] in origin, metastasised to ovary

Answer 2

signet ring, gastrointestinal

Question 3

Risk factors
- Older age
- Smoking
- Greater number of […] (early menarche, late menopause)
-[…]
- Hormone replacement therapy (HRT)
- […] 1 and 2 genes

Answer 3

ovulations
Obesity
BRCA

Question 4

Protective factors
- Parity
- Breastfeeding
- Early […]
- […]

Answer 4

menopause
COCP

Question 5

Clinical features
- […] presentation and often non-specific e.g. abdominal discomfort, […], […] satiety, urinary frequency or change in bowel habits

• […] in late disease - increased production of vascular growth factors cause leaky vessels
• Other symptoms of late disease include pelvic, back and abdominal pain

There may be a palpable […] where the cancer is growing.

Answer 5

late, bloating, early
ascites
mass

Question 6

2ww
- Any age with […] + unexplained abdominal […]
- >50yo with
* Abdominal distension
* Early […]
- […]/abdominal pain
- Urinary frequency/urgency

Answer 6

ascites, mass
satiety
Pelvic

Question 7

2ww
- Any age with […] + unexplained abdominal […]
- >50yo with
* Abdominal distension
* Early […]
- […]/abdominal pain
- Urinary frequency/urgency

Answer 7

ascites, mass
satiety
Pelvic

Question 8

INVX
- […]
- Pelvic and abdominal […]

*AFP and beta-hCG for younger women who may have germ cell cancers

Answer 8

CA-125
ultrasound

Question 9

Risk of Malignancy Index (RMI)
1. How is calculated
2. The ultrasound score is a score from […]-[…] depending on the number of abnormalities identified. For the menopausal score, it values at 1 for[…], and 3 for […].

Answer 9

1. ultrasound score x menopausal score x Ca-125 level
2. 0-3, premenopausal, postmenopausal

Question 10

Mx
1. Surgery
- If early - removal of the uterus, ovaries, Fallopian tubes and […] omentectomy
- advanced - add on […] surgery
2. Chemo

Answer 10

infracolic
debulking