Ovarian Cancer Flashcards
What is the most common type of ovarian cysts?
Follicular cysts
What are theca lutein cysts stimulated by?
Abnormal B-hCG (twins, molar pregnancy)
What are the components of ovarian tumours?
Surface epithelium, ovarian germ cells, ovarian stroma
What is a Krukenberg tumour?
GI carcinomas that metastasise to the ovary (poor prognosis)
What are the risk factors for ovarian cancers?
- Incessant ovulation
- Genetic predisposition (e.g. BRCA)
What are the clinical features of ovarian cancer?
Vague lower abdo pain
Abdo distention
Early saiety, dyspepsia
SOB (pleural effusion)
Dyspareunia
What are the exam findings of late stage ovarian cancer?
Solid, fixed, irregular mass
Ascites
How is ovarian cancer diagnosed?
Pelvic ultrasound
CT/MRI
Tumour markers (CA-125, AFP, LDH, hCG)
What is the staging of ovarian cancer?
I limited to the ovaries
II extension to the pelvis
III extension to the abdominal cavity
IV distant metastasis
How are benign ovarian tumours managed?
Reproductive age - cystectomy, unilateral salpingo-oophorectomy
Post-menopausal - hysterectomy + bilateral salpingo-oophorectomy
How are malignant ovarian tumours managed?
Surgical staging (peritoneal wash and exploration)
Total abdominal hysterectomy
Bilateral salpingo-oophorectomy
Omentectomy
Sampling of lymph nodes
What is the differential for raised CA-125?
- Menstruation
- Endometriosis
- Adenomyosis
- Pregnancy
- PID
What is the prognosis of epithelial ovarian cancer?
Poor prognosis (75% of patients present with stage III or IV)
How is epithelial ovarian cancer managed?
Total abdominal hysterectomy + bilateral salpingo-oophorectomy
Omentectomy
Debulking
Node sampling
Combination chemo
What are the types of sex cord stromal tumours?
Functional tumours (granulosa theca cell, sertoli leydig cell)
Non-functional tumours (ovarian fibroma)
