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OBGYN Clerkship > Ovarian Cancer > Flashcards

Ovarian Cancer Flashcards

1
Q

What are the 4 types of ovarian cancers

A

epithelial (90%)
germ cell
sex cord stromal
metastatic

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2
Q

Smx of ovarian CA

A

asmx in early stages

vague and pain, bloating, distension, early satiey in later stages

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3
Q

what is the etiology of ovarian CA

A

chronic, uninterrupted ovulation –> inc cellualr repair –> inc opportunities for gene deletion/mutation

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4
Q

what is the ovarian tumor marker used for testing tx response and recurrance but not for screening or dx

A

CA-125

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5
Q

risk factors for ovarian cancer

A

family history (#1)

familial ovarian cancer syndrome (BRCA, HNPCC/Lynch II)

uninterrupted ovulation (nulliparity, infertility, early menarch, late menopause)

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6
Q

protective factors against ovarian cancers

A

OCPs
multiparity
breastfeeding
chroninc anovulation

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7
Q

suspect ovarian cancer, next steps?

A

pelvic US –> staging

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8
Q

differentiate between stages:

Ia
Ib
Ic
IIa
IIb
IIc
IIIa
IIIb
IIIc
IV
A

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

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9
Q

Treatemt specific for

  • epithelial ovarian cancer
  • germ cell
  • sex cord stromal
A
  • epithelial ovarian cancer: surgery (TAHBSO, omentectomy, pelvic/paraaortic LNectomy, carboplatin/pacltaxel)
  • germ cell : USO + BEP (bleomycin, etopside, cisplatin)
  • sex cord stromal : USO only
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10
Q

what is carcinomatous ileus

A

*complication of ovarian cancer

intraperitoneal tumor spread –> ascities and bowel encasement –> intermittent bowel obstruction

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11
Q

what is a sister-mary-joseph nodeule

A

ovarian cancer met to umbillicus

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12
Q

what is pseudomyxoma peritonei

A

*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.

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13
Q

What is Meigs syndrome?

A

*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.

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14
Q

What is latzko triad?

A

pain, profuse watery d/c, pelvic mass, assc with fallopian tube adenocarconoma

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15
Q

What type of ovarian tumor can cause precocious puberty

A

granulosa cell tumor

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16
Q

at what stage is epithelial ovarian cancer found?

A

III+ (bc is it asmx)

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17
Q

MC type of epithelial cancer

A

serous cystadenocarcinoma

18
Q

bilateral ovarian tumor lined with fallopian tube like epithelium

A

serous cystadenoma

type of epithelial tumor

19
Q

bilateral ovarian tumor with psamomma bodies on histologyuy

A

serous (papillary) cystadenocarcinoma

type of epithelial tumor

20
Q

multilocular cyst lined w/ mucous secreting epithelium

A

mucinous cystadenoma

type of epithelial tumor

21
Q

pseudomyxoma peritonei is assc with what type of ovarian tumor

A

mucinous adenocarcinoma

type of epithelial tumor

22
Q

type of ovarian tumor that resembles endometrial cancer and had good px

A

endometrioid carcinoma

type of epithelial tumor

23
Q

ovarian tumor with masses of glycogen-filled clear cells

A

clear cell carcinoma

**good prognosis

24
Q

benign, ovarian tumor that resembles bladder (transitional epithelium)

A

Brenner tumor

type of epithelial tumor

25
Q

type of ovarian tumor that grows rapidly in women < 20 yo (found at earlier stages)

A

germ cell tumor

26
Q

WHat is the MC type of germ cell tumor

A

mature teratoma (aka dermoid cyst) = MC benign

dysgerminomas = MC malignant

27
Q

what is a teratoma?

A

tumor of totipotent fetal tissue

28
Q

how is a mature and immature teratoma distinguised

A

mature = benign and contains hair/teeth/calcification

immature = aggresively malignat, contains neural tissue

29
Q

WHat is stuma ovarii?

A

monodermal, contains thyroid tissue

type of germ cell ovarian tumor

30
Q

ovarian tumor assc with elevated LDH, assc w/ tumor syndrome (45, XO), good prognosis due to radiosensitivity

A

dysgerminoma

type of germ cell ovarian tumor

31
Q

ovarian tumor assc with elevated AFP, biopsy shows schiller-duval bodies that resemble primitive glomeruli

A

endodermal sinus (yolk sac) tumor

type of germ cell ovarian tumor

32
Q

ovarian tumor assc with elevated b-hCG, is also a malignant type of GTD

A

choriocarcinoma

type of germ cell ovarian tumor

33
Q

slow growing steroid-secreting tumors

A

sex-cord stromal tumors

34
Q

MC type of sex-cord stromal tumors

A

granulosa cell tumors

35
Q

ovarian tumor that secretes estrogen –> inc risk of endometrial hyperplasia, histo shows call-exner bodies

A

granulosa cell tumor

type of germ cell ovarian tumor

36
Q

ovarian tumor that presents with pulling sensation in groin and shows histology with bundles od spindle shaped fibroblasts

A

Fibroma

type of germ cell ovarian tumor

37
Q

ovarian tumor with andoblastoma, secretes testosterone and causes virilization

A

Sertoli-Leydig cell tumor

type of germ cell ovarian tumor

38
Q

Metastatic stomach cancer, Dx mucin containing signet ring cells

A

Krukenberg tumor

39
Q

very rare cancer (0.5%), 15% present with Latxio’s triad (pain, profuse watery d/c (hydrops tubae profluens), pelvic mass)

A

falopian tube cancer

40
Q

management for fallopian tube cancer

A

pelvic US, same as epithelial ovarian cancers

OBGYN Clerkship (31 decks)

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