Ovarian Cancer

Question 1

What percentage of patients present after the ovarian Cancer has spread beyond the Pelvis?

Answer 1

70%

Question 2

What is Endometriosis?

Answer 2

Endometriosis refers to ectopic endometrial tissue outside the uterus (Glands and Stroma). A lump of Endometrial tissue outside the uterus is described as an Endometrioma.

Question 3

What are endometriomas in the ovaries often referred to as?

Answer 3

“Chocolate cyst”

Question 4

What are the different classifications of Ovarian Tumours? (Cell types)

Answer 4

• Epithelial
• Germ cell
• Sex-cord / Stromal
• Metastatic

Question 5

What are the different types of Epithelial Ovarian Tumours?

Answer 5

• Serous Tumours (most common)
• Mucinous Carcinomas
• Endometroid Carcinomas
• Clear cell Carcinomas
• Undifferentiated Carcinomas

Question 6

How are Epithelial Ovarian Tumours categorised?

Answer 6

Benign
- No cytological abnormalities, Proliferative activity Absent or Scant. No stromal invasion.

Borderline
- Cytological abnormaliities, proliferative. No stromal invasion.

Malignant
- Stromal Invasion.

Question 7

Most common benign ovarian tumour, often bilateral. Cysts lined with ciliated cells (similar to fallopian tube)

Answer 7

Benign Serous Cystadenoma.

Question 8

How can Benign Ovarian masses be catagorised?

Answer 8

• Physiological cysts,
• Benign Germ cell tumours,
• Benign epithelial tumours
• Benign Sex cord stromal tumours.

Question 9

Physiological Cysts include?

Answer 9

Follicular cysts
- Commonest type of Ovarian Cyst.
- Due to non-rupture of the dominant follicle or failure of atresia in non-dominant follicle.
- Commonly regress after several menstrual cycles.

Corpus Luteum Cyst.
- During the menstrual cycle if pregnancy doesn’t occur the corpus luteum usually breaks down and disappears. If this doesn’t occur the corpus luteum may fill with blood or fluid and form a corpus luteal cyst.
- More likely to present with intraperitoneal bleeding than follicular cysts.

Question 10

Benign germ cell tumours include?

Answer 10

Mature cystic Teratomas (Dermoid Cysts)
- Usually lined with epithelial tissue and hence contain skin appendages, hair and teeth.
- Most common benign ovarian tumour in women under the age of 30.
- Bilateral in 10-20%
- Usually asymptomatic. Torsion is more likely than with other ovarian tumours.
(small chance of Malignancy, Bad prognosis)

Question 11

Benign Epithelial Cystic Tumours Include?

Answer 11

Serous Cystadenoma. (Typically arise in pancreas)

Mucinous Cystadenoma. (Typically arise in Ovaries)
- Second most common benign epithelial tumour.
- They are typically large and may become massive,, Cause compression problems/torsion.
- If ruptures may cause pseudomyxoma peritonei.

Question 12

What is the general treatment for an Ovarian Cancer?

Answer 12

Depends on the staging of the cancer and the patients fitness for treatment.

Surgery in early disease.
- Removal of affected structures.
- Debulking if disease is more advanced.

Chemotherapy can be used in adjunct to surgery.