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3MB Reproduction (My version) > Ovarian Cancer > Flashcards

Ovarian Cancer Flashcards

1
Q

Ovarian cysts usually resolve on their own. True/False?

A

True

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2
Q

List some common sites of endometriosis

A 
Ovary (chocolate cysts)
Pouch of Douglas
Peritoneum
Cervix, vulva, vagina
Bladder
Bowel
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3
Q

What is the typical appearance of endometriosis in the ovary? (buzzword)

A

Chocolate cysts

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4
Q

List the main epithelial ovarian tumours

A 
Serous
Mucinous
Endometrioid
Clear cell
Brenner
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5
Q

What is the precursor for high-grade serous carcinoma of the ovary?

A

Serous tubal intraepithelial carcinoma (STIC)

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6
Q

Which ovarian cancers are associated with endometriosis?

A

Endometrioid

Clear cell carcinoma

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7
Q

Most endometrioid cancer is low-grade. True/False?

A

True

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8
Q

What syndrome is associated with endometrioid cancer?

A

Lynch syndrome

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9
Q

What is Brenner tumour?

A

Transitional cell epithelium tumour that is usually benign

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10
Q

List the main germ cell tumours that can occur the ovary?

A

Teratoma
Dysgerminomas
Yolk sac tumour
Choriocarcinoma

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11
Q

What is the most common malignant germ cell tumour? Who does it typically affect?

A

Dysgerminomas

Children and young woman

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12
Q

List the main sex cord/stromal tumours

A

Fibroma/thecoma
Granulosa cell tumour
Sertoli-Leydig cell tumours

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13
Q

What are the commonest sites that metastasise to the ovary?

A

Stomach
Colon
Breast
Pancreas

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14
Q

Describe FIGO stage I of ovarian cancer

A

IA: one ovary
IB: both ovaries
IC: ovary with rupture/spill

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15
Q

Describe FIGO stage II of ovarian cancer

A

IIA: extension to uterus/fallopian tube
IIB: extension to other pelvic intraperitoneal structure

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16
Q

Describe FIGO stage III of ovarian cancer

A

IIIA: retroperitoneal lymph node metastasis
IIIB: peritoneal metastasis beyond pelvis up to 2cm
IIIC: peritoneal metastasis beyond pelvic over 2cm

17
Q

Describe FIGO stage IV of ovarian cancer

A

IV: distant metastasis

18
Q

A smear test can pick up ovarian cancer. True/False?

A

False

1 in 3 believe it does though

19
Q

Which BRCA mutation (1 or 2) is more associated with ovarian cancer?

A

BRCA1 (40%)

BRCA2 (18%)

20
Q

Ovarian cancer often presents early with red flag symptoms. True/False?

A

False

Prevents late with non-specific symptoms

21
Q

List some non-specific clinical features of ovarian cancer

A 
Ascites/bloating
Pelvic mass
Bladder dysfunction
Pleural effusion
Breathlessness
22
Q

Ovarian cancer can commonly be asymptomatic. True/False?

A

False

Rarely asymptomatic with almost always abdominal bloating/distention

23
Q

What is the BEAT acronym to help raise awareness for ovarian cancer?

A

Bloating
Eating less, feeling full
Abdominal pain
Tell GP!

24
Q

How is ovarian cancer screened for?

A

It isn’t!

High-risk women are identified and investigated, though

25
Q

What should we offer women with BRCA mutations?

A

Prophylactic oophorectomy and removal of fallopian tubes

26
Q

What marker is used in the diagnosis of ovarian cancer?

A

CA 125

27
Q

Raised CA 125 alone is enough to diagnose ovarian cancer. True/False?

A

False

Can be raised in other things (e.g. endometriosis) so need ultrasound or other investigations

28
Q

What is the gold standard investigation for diagnosing ovarian cancer?

A

Pathology specimen from CT-guided biopsy or laparoscopic biopsy

29
Q

State the calculation for “risk of malignancy index” for ovarian cancer

A

Ultrasound score x menopausal score x CA125 level

30
Q

How many points on the “risk of malignancy index” for ovarian cancer is enough to refer to secondary care?

A

Score greater than 200

31
Q

What are the ultrasound features looked out for in ovarian cancer that are involved in the “risk of malignancy index”?

A 
Multilocular cysts
Solid areas
Bilateral lesions
Ascites
Intra-abdominal mass
32
Q

What are the main methods of metastases of ovarian cancer?

A

Transcoelomic spread (peritoneal)
Haematogenous
Lymphatic

33
Q

List the main treatment options for ovarian cancer

A

Surgery

Chemotherapy + surgery

34
Q

In women with low-grade ovarian cancer, optimal surgical staging should be done by doing what?

A

Biopsies of peritoneal lesions
Infracolic omentectomy
Iliac, para-aortic lymph node sampling

35
Q

In advanced ovarian cancer, what should be given prior to surgery?

A

Neoadjuvant chemotherapy

36
Q

What are the main chemotherapy agents used for ovarian cancer?

A

Carboplatin (1st line)

Paclitaxel (more side-effects)

37
Q

What chemotherapy should be offered in those with relapsing platinum-sensitive ovarian cancer?

A

Platinum-based combination with paclitaxel, PLDH or gemcitabine

38
Q

What therapy can be used for platinum-resistant ovarian cancer?

A

Hormonal therapy (tamoxifen, letrozole)

39
Q

In the absence of symptoms, should CA125 levels be measured during followup for ovarian cancer?

A

Not routinely monitored as won’t benefit with early chemotherapy

3MB Reproduction (My version) (32 decks)

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