Ovarian cancer Flashcards
types of ovarian cysts
follicular eg. polycystic ovaries luteal endometriotic epithelial mesothelial
follicular cysts are what when do they form size describe them tx
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
what can endometriosis cause in terms of symptoms
pelvic inflammation which can result in scarring of the fallopian tubes and lead to infertility
pain
sites of endometriosis
ovary pouch of douglas peritoneal surfaces cervix/vulva/vgaina bladder, bowel etc in abdomen on CSec scar
pathogens of endometriosis
regurgitation
metaplasia
vascular or lymphatic dissemination
macroscopic ovarian endometriosis
peritoneal spots or nodules
fibrous adhesions
choc cysts
microscopic endometriosis
endometrial glands and stroma
haemorrhage, inflammation, fibrosis
cx of endometriosis
pain cyst formation infertility ectopic preg malignancy
ovarian tumours classification
epithelial germ cell sex cord/stromal mets other
epithelial ovarian tumours
serous mucinous endometrioid clear cell brenner
benign epithelial ovarian tumours
no cytological abnormalities, proliferative activity absent or scant, no stromal invasion
borderline epithelial ovarian tumours
cytological abnormalities, proliferative
no stromal invasion
malignant epithelial ovarian tumours
stormal invasion
high grade serous carcinoma
more common
serous tubal intraepithelial carcinoma
most cases are tubal in origin
low grade serous carcinoma
serous borderline tumour
what has a strong association with endometriosis of the ovary
endometrioid and clear cell
what is brenner tumour
tumour of transitional type epithelium, usually benign
what percentage of ovarian tumours are germ cell tumours
15-20%
what are dermoid cysts
mature benign cystic teratomas
95% of germ cell tumours
skin, resp epithelium, gut, fat, sebum, hair
other kinds of germ cell tumours
immature teratoma - rare dysgerminoma yolk sac tumour choriocarcinoma mixed germ cell tumour
what is dysgerminoma
who
most common malignant primitive germ cell tumour
children and young women av age 22
stromal tumours types
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
figo staging of ovarian cancer 1A 1B 1C 2A 2B 3A 3B 3C 4
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
fallopian tubes can have what
inflammation - salpingitis cysts and tumours serous tubal intraepithelial carcinomas endometriosis ectopic preg
difference between chronic and acute salpingitis
chronic has lymphocytes
who should a dx of ectopic preg be considered in
female of reproductive age with amenorrhea and acute hypotension or an acute abdomen
