Ovarian Cancer Flashcards
What are the 4 types of ovarian cancers
epithelial (90%)
germ cell
sex cord stromal
metastatic
Smx of ovarian CA
asmx in early stages
vague and pain, bloating, distension, early satiey in later stages
what is the etiology of ovarian CA
chronic, uninterrupted ovulation –> inc cellualr repair –> inc opportunities for gene deletion/mutation
what is the ovarian tumor marker used for testing tx response and recurrance but not for screening or dx
CA-125
risk factors for ovarian cancer
family history (#1)
familial ovarian cancer syndrome (BRCA, HNPCC/Lynch II)
uninterrupted ovulation (nulliparity, infertility, early menarch, late menopause)
protective factors against ovarian cancers
OCPs
multiparity
breastfeeding
chroninc anovulation
suspect ovarian cancer, next steps?
pelvic US –> staging
differentiate between stages:
Ia Ib Ic IIa IIb IIc IIIa IIIb IIIc IV
Ia : one ovary
Ib : 2 ovaries
Ic : + ovarian surface tumor, ruptures capsule, malignant ascities, peritoneal cytology +
IIa : invades FT or uterus
IIb : invaides other pelvic tissue
IIc : + ovarian surface tumor, ruptures capsule, malignant ascities, peritoneal cytology +
IIIa : abd peritoneal met+, < 2cm
IIIb : abd peritoneal met+, > 2cm
IIIc : pelvic/paraaortic/inguinal LN+
IV : distal mets
Treatemt specific for
- epithelial ovarian cancer
- germ cell
- sex cord stromal
- epithelial ovarian cancer: surgery (TAHBSO, omentectomy, pelvic/paraaortic LNectomy, carboplatin/pacltaxel)
- germ cell : USO + BEP (bleomycin, etopside, cisplatin)
- sex cord stromal : USO only
what is carcinomatous ileus
*complication of ovarian cancer
intraperitoneal tumor spread –> ascities and bowel encasement –> intermittent bowel obstruction
what is a sister-mary-joseph nodeule
ovarian cancer met to umbillicus
what is pseudomyxoma peritonei
*complication of ovarian cancer
“jelly belly” assc with appendiceal carcinoma and mucinous cystadenocarcinoma
caused by cancerous cells (mucinous adenocarcinoma) that produce abundant mucin or gelatinous ascites.[1] The tumors cause fibrosis of tissues and impede digestion or organ function, and if left untreated, the tumors and mucin they produce will fill the abdominal cavity. This will result in compression of organs and will destroy the function of colon, small intestine, stomach, or other organs. Prognosis with treatment in many cases optimistic,[2] but the disease is lethal if untreated, with death by cachexia, bowel obstruction, or other types of complications.
What is Meigs syndrome?
*complication of ovarian cancer
triad of ascites, pleural effusion and benign ovarian tumor (fibroma, Brenner tumour and occasionally granulosa cell tumour). It resolves after the resection of the tumor.
What is latzko triad?
pain, profuse watery d/c, pelvic mass, assc with fallopian tube adenocarconoma
What type of ovarian tumor can cause precocious puberty
granulosa cell tumor
at what stage is epithelial ovarian cancer found?
III+ (bc is it asmx)
MC type of epithelial cancer
serous cystadenocarcinoma
bilateral ovarian tumor lined with fallopian tube like epithelium
serous cystadenoma
type of epithelial tumor
bilateral ovarian tumor with psamomma bodies on histologyuy
serous (papillary) cystadenocarcinoma
type of epithelial tumor
multilocular cyst lined w/ mucous secreting epithelium
mucinous cystadenoma
type of epithelial tumor
pseudomyxoma peritonei is assc with what type of ovarian tumor
mucinous adenocarcinoma
type of epithelial tumor
type of ovarian tumor that resembles endometrial cancer and had good px
endometrioid carcinoma
type of epithelial tumor
ovarian tumor with masses of glycogen-filled clear cells
clear cell carcinoma
**good prognosis
benign, ovarian tumor that resembles bladder (transitional epithelium)
Brenner tumor
type of epithelial tumor
type of ovarian tumor that grows rapidly in women < 20 yo (found at earlier stages)
germ cell tumor
WHat is the MC type of germ cell tumor
mature teratoma (aka dermoid cyst) = MC benign
dysgerminomas = MC malignant
what is a teratoma?
tumor of totipotent fetal tissue
how is a mature and immature teratoma distinguised
mature = benign and contains hair/teeth/calcification
immature = aggresively malignat, contains neural tissue
WHat is stuma ovarii?
monodermal, contains thyroid tissue
type of germ cell ovarian tumor
ovarian tumor assc with elevated LDH, assc w/ tumor syndrome (45, XO), good prognosis due to radiosensitivity
dysgerminoma
type of germ cell ovarian tumor
ovarian tumor assc with elevated AFP, biopsy shows schiller-duval bodies that resemble primitive glomeruli
endodermal sinus (yolk sac) tumor
type of germ cell ovarian tumor
ovarian tumor assc with elevated b-hCG, is also a malignant type of GTD
choriocarcinoma
type of germ cell ovarian tumor
slow growing steroid-secreting tumors
sex-cord stromal tumors
MC type of sex-cord stromal tumors
granulosa cell tumors
ovarian tumor that secretes estrogen –> inc risk of endometrial hyperplasia, histo shows call-exner bodies
granulosa cell tumor
type of germ cell ovarian tumor
ovarian tumor that presents with pulling sensation in groin and shows histology with bundles od spindle shaped fibroblasts
Fibroma
type of germ cell ovarian tumor
ovarian tumor with andoblastoma, secretes testosterone and causes virilization
Sertoli-Leydig cell tumor
type of germ cell ovarian tumor
Metastatic stomach cancer, Dx mucin containing signet ring cells
Krukenberg tumor
very rare cancer (0.5%), 15% present with Latxio’s triad (pain, profuse watery d/c (hydrops tubae profluens), pelvic mass)
falopian tube cancer
management for fallopian tube cancer
pelvic US, same as epithelial ovarian cancers
