Ovarian Cancer Flashcards
Most comm cyst in the ovary
Functional ovarian cyst
Most common cyst are
Follicular cyst
Theca lutein cyst
Due to increased hcg
Seen in molar pregnancy
Twin pregnancy and
Infertility treatment
Investigation of choice of adenexal mass
Tvs
Malignancy mass occur in the
Extremities of age
Prepubertal / menopausal
Laterality im the benign and malignant
Benign unilateral
Malignant. Bilateral
Cystic consistency is seen in the
Benign mass
Tenderness in benign and Mali
Benin present
Malignant absent
Ultra sound features of benign mass
Unilateral
Anechoic
No solid component
Ultrasound of malignant adenexal mass
s>10cm
Bilateral variable consistency
Solid components
Thick septa
Papillary out growing
High vascularity
Evidence of ascites
Lymph nodes
Matted bowel loops
A cyst in the reproductive age group of size 3-5 cm what is the managem
Wait and watch
A cyst in the reproductive age group of size 5-7cm what is the managem
Follow up and usg
A cyst in the reproductive age group of size >7cm what is the managem
Surgery
Because of high chances of rupture and torsion
What is the management of the post menopausal women who is presenting with the cyst
We have suspect the malignancy even the usg shows no signs of it so we have to d0
CA125> 35 iu
Surgery after investigation
What is the management of the pre pubertal women who is presenting with the cyst
Check for alpha feto protein
Hcg
Ldh
Percentage of ovarian mass to undergo malignant transformation post menopausal women
30
Percentage of ovarian mass to undergo malignant transformation in pre menopausal women
7
Most cool beningn cyst or tumour in the reproductive age group and pregnancy
Dermoid cyst
Most common time for torsion
End of 1 st trimister or perpuerium
Most common ovarian cancer during pregnancy
Dysgerminoma
Symptomatic cyst in the pregnancy management
Removal of cyst irrespective of gestational age
Asymptomatic cyst management
Asymptomatic cyst 1 st trimester wait and watch because mostly it will be theca lutein cyst which on removal causes abortiom
2 nd trimester usg showing features of malignancy >10 cm surgery
Risk factors related to ovarian cancer
🤩excessive Estrogen
Early menarache
Late menopause
Obesity
Endometriosis
Nulliparity
Pcos
Hrt
Infertility
Ovulation inducing drugs
🤩genetic syndrome
Lynch.brca1 brca2
Carcinogen related to ovarian cancer
Asbestos
Controversial
Talc
Smoking
Protection against ovarian cancer
Physical exercise
Aneuploidy
Multiparity
Ocp
Breast feedi
Hysterectomy
Tubal ligation
Salpingectomy
Smoking causes
Mucinous adenicarcinoma
Genetic syndrome
Lynch syndrome
Mlh1/msh2
Colorectal cancer >endometrial cancer
Brca1 40%
Brca2 15%
Herigpdietary ovarian cancers occurs by what age
50 yrs
Sporadic ovarian cancers occur
by60 -70 yrs
What is the best method of prevention for the Brca 1 mutation
Trans abdominal hysterectomy
Bilateral salpingoooopherectemy
After completing the family 35 -40
1 degree relative 50 yrs
Tvs ands ca125
35 -40 yrs
Types of ovarian cancer
Epithelial ovarian cancer 90%
Germ cell tumours 2nd common 5-8%
Sexcord tumors 3 mc 3-5%
Metastatic tumots
Most common ovarian tumour
Serous cystadenoma
Most common ovarian tumours in reproductive age grp
Mature cystic Tera to a dermoid cyst
Most common ovarian cancer
60-70 yrs
serous cyst Adenocarcinoma
Epithelial tumours types
Serous most common
Mucinous type
Brenners tumour
Endometrium tumour
Clear cell tumour
Most common age 60 yrs
Benign and malignant variants of epithelial tumour of ovary
Serous cyst adeno a benign
Serous cyst Adenocarcinoma is the malignant tyle
Histopatholigical finding of epithelial cell tumour
Psamomma body
Non specific features of epithelial tun
Nausea
Vomiting
Irritable bowel syndrome
Weigh loss
Difference between serous and malignant
Serous mostly bilateral
Mucinous mostly unilateral
Benign cases of epithelial cell tumour
60% in serous
80% in the Mucinous
Genetic involvement In the epithelial tun
Brca1
Brca2
P53
Mucinous genetic involvement
K ras
Tumour markers for serous cyst Adenocarcinoma
Ca125
Tumour markers for Mucinous cyst Adenocarcinoma
Cea ca19-9
Gross findings of serous cyst Adenocarcinoma
Uniloculated cyst filled
With clear and serous fluid
Gross findin of Mucinous cyst adeno
Multiloculated cyst filled with Mucinous material
Honey comb appearance
Lining of epithelial tumours resemble
Lining of fallopian tubes
Lining of Mucinous cyst Adenocarcinoma resemble
Endocervical linimg
Pseudomyxoma perotini
Peritoneum is covered by Mucinous material
Most commonly caused by appendix cancer
Brenner tumour
Walthard cell nest coffe 🫘 bean
Benign
Unilateral
Solid
Transitional epithelium
Coffee ☕️ bean nuclei present in
Brenners tumour
Granulosa cell tumour
Endometriosis tumours
Histological lh resemble endometrial glands
Associated with endometriosis
Associated with endometrial cancer
Most common ovarian cancer associated with endometriosis
Clear cell tumour 1st
Endometroid 2 nd best
Hpe finding of clear cells
Hob nail cells
Most commonly ovarian tumours associated with endometrial cancer
Endometroid cancer
Granulosa cell tumour
Utero di ethyl sterlbestrol exposure
Clear cell tumou
Malignant
Germ cells tumours
Teratoma
Mature teratoma beningn
Immature teratoma is malignant
Monoclonal type struama ovari
Dysgerminoma
Yolksac
Embryonic carcinoma
Choriocarcinoma
Mixed type
Common feature of germ cell tumour
Young girls 10 to 30
Unilateral
Better prognosis
Tumour markers are absent in the
Teratoma
Hcg tumour seen in all except
Yolksac
Alpha feto protein
Choriocarcinoma and
Dysgerminoma
Lh is seen in all except
Choriocarcinoma and embryonal tumours
Tumour markers of Dysgerminoma
Lh mainly
Plap
Hcg
Yolk sac tumour markers
Alpha feto protein
Lh appha 1anti trypsin
Embryonal carcinoma
AFP, hcg
Most common germ cell tumour
Dermoid cyst
Most common germ cell cancer
Immature teratoma
2 nd most common germ cell tumour
Dysgerminoma
Got with best prognosis
Dysgerminoma
Got with worse prognosis
Yolksac tumour
Ovarian tumours radiosensitive
Dysgerminoma
Got 100%unilateral
Yolk sac
Usg findings of Dermoid tumours is
Tip of ice berg appearance
Dot dash appearance
Prognosis descending order is
Sex cord stromal tumours > get>epithelial
Signet ring cells are seen in
Krukenberg tumour
