Ovarian cancer

Question 1

types of ovarian cysts

Answer 1

follicular eg. polycystic ovaries
luteal
endometriotic
epithelial
mesothelial

Question 2

follicular cysts are what 
when do they form 
size
describe them 
tx

Answer 2

very common

can form when ovulation doesn’t occur - follicle doesn’t rupture but grows till it becomes a cyst

can grow up to several cm

thin walled, lined by granulosa cells

usually resolve over a few months

Question 3

what can endometriosis cause in terms of symptoms

Answer 3

pelvic inflammation which can result in scarring of the fallopian tubes and lead to infertility
pain

Question 4

sites of endometriosis

Answer 4

ovary 
pouch of douglas
peritoneal surfaces
cervix/vulva/vgaina
bladder, bowel etc
in abdomen on CSec scar

Question 5

pathogens of endometriosis

Answer 5

regurgitation
metaplasia
vascular or lymphatic dissemination

Question 6

macroscopic ovarian endometriosis

Answer 6

peritoneal spots or nodules
fibrous adhesions
choc cysts

Question 7

microscopic endometriosis

Answer 7

endometrial glands and stroma

haemorrhage, inflammation, fibrosis

Question 8

cx of endometriosis

Answer 8

pain
cyst formation
infertility 
ectopic preg
malignancy

Question 9

ovarian tumours classification

Answer 9

epithelial 
germ cell
sex cord/stromal 
mets
other

Question 10

epithelial ovarian tumours

Answer 10

serous
mucinous
endometrioid
clear cell
brenner

Question 11

benign epithelial ovarian tumours

Answer 11

no cytological abnormalities, proliferative activity absent or scant, no stromal invasion

Question 12

borderline epithelial ovarian tumours

Answer 12

cytological abnormalities, proliferative

no stromal invasion

Question 13

malignant epithelial ovarian tumours

Answer 13

stormal invasion

Question 14

high grade serous carcinoma

Answer 14

more common
serous tubal intraepithelial carcinoma
most cases are tubal in origin

Question 15

low grade serous carcinoma

Answer 15

serous borderline tumour

Question 16

what has a strong association with endometriosis of the ovary

Answer 16

endometrioid and clear cell

Question 17

what is brenner tumour

Answer 17

tumour of transitional type epithelium, usually benign

Question 18

what percentage of ovarian tumours are germ cell tumours

Answer 18

15-20%

Question 19

what are dermoid cysts

Answer 19

mature benign cystic teratomas
95% of germ cell tumours
skin, resp epithelium, gut, fat, sebum, hair

Question 20

other kinds of germ cell tumours

Answer 20

immature teratoma - rare
dysgerminoma
yolk sac tumour
choriocarcinoma
mixed germ cell tumour

Question 21

what is dysgerminoma

who

Answer 21

most common malignant primitive germ cell tumour

children and young women av age 22

Question 22

stromal tumours types

Answer 22

fibroma/thecoma - benign, may produce oestrogen causing bleeding

granulosa cell tumour - all potentially malignant, may be assoc with oestrogen malfestations

sertoli-leydig cell tumours - rare, may produce androgens

Question 23

figo staging of ovarian cancer
1A
1B
1C
2A
2B
3A
3B
3C
4

Answer 23

1A tumour limited to one ovary
1B both ovaries
1C cancer involving ovarian surface/rupture/surgical spill/tumour in washings
2A - extension or implants on uterus/fallopian tube
2B extension to other pelvic intraperitoneal
3A retroperitoneal LN mets or microscopic extra pelvic peritoneal involvement
3B macroscopic peritoneal mets beyond pelvic up to 2cm in dimension
3C macroscopic peritoneal mets >2cm in dimension
4 distant mets

Question 24

fallopian tubes can have what

Answer 24

inflammation - salpingitis
cysts and tumours
serous tubal intraepithelial carcinomas
endometriosis
ectopic preg

Question 25

difference between chronic and acute salpingitis

Answer 25

chronic has lymphocytes

Question 26

who should a dx of ectopic preg be considered in

Answer 26

female of reproductive age with amenorrhea and acute hypotension or an acute abdomen