Ovarian cancer

Question 1

What is the most common germ cell tumor?

Answer 1

1) Dysgerminoma (35-45%)
2) Immature teratoma (20-30%)
3) Endodermal sinus/yolk sac tumor (14.5%)

Question 2

What are the important points on endodermal sinus tumors?

Answer 2

-75-80% are stage 1 at diagnosis.
-10-15% are bilateral.
-30% have LN involvement.
-can biopsy an abnormal ovary because extremely chemosensitive tumor.

Question 3

What is the most frequent malignancy occurring in a mature teratoma?

Answer 3

SCC
* note no specific tumor markers for mature teratoma.

Question 4

What are the important points of Sertoli Leydig tumors?

Answer 4

-LN assessment not required at surgery bcs rarely metstasize to LN.

-Crystalloids of Renke are histological feature.

Question 5

What are the important cytotoxic side effects of BEP?

Answer 5

1) AML can occur secondary to etopiside.
2) Bleomycin causes pulmonary fibrosis (doses > 400 U can be fatal).

Question 6

What are the chemotherapy rules for immature teratomas?

Answer 6

-Stage A1, G1 can be be observed.
- > Stage 1A, G1 requires 3-4 cycles of BEP.

Question 7

What is the lifetime risk of ovarian cancer with BRCA and Lynch mutations?

Answer 7

1) BRCA1 = 40%
2) BRCA2= 16-18%.
3) Lynch - 12%.

Question 8

What causes the hypersensitivity reaction with Taxol?

Answer 8

Cremaphor (castor oil) - treated with steroids.