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Reproductive System > Ovarian Cancer > Flashcards

Ovarian Cancer Flashcards

1
Q

What are the different classes of ovarian neoplasm?

A
  • Epithelial
  • Germ cell
  • Sex rod-stromal
  • Metastatic
  • Miscellaneous
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2
Q

Describe the epidemiology of ovarian cancer (age group)?

A
  • Rare <30 years
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3
Q

What are risk factors for ovarian cancer?

A
  • Family history/genetics
    • HNPCC/Lynch type II familial cancer syndrome
    • BRCA1
    • BRCA2
  • Never having children
  • Hormonal therapy after menopause
  • Fertility medication
  • Obesity
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4
Q

What genes put you more at risk of ovarian cancer?

A
  • HNPCC/Lynch type II familial cancer syndrome
  • BRCA1
  • BRCA2
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5
Q

Describe the pathophysiology of ovarian cancer?

A
  • Most originate from fallopian tube
  • Some derive from pre-existing benign ovarian cysts
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6
Q

Where do most ovarian cancers originate?

A
  • Most originate from fallopian tube
  • Some derive from pre-existing benign ovarian cysts
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7
Q

What is the presentation of ovarian cancer?

A
  • Indigestion/early satiety (early fullness when eating)/poor appetite
  • Altered bowel habit/pain
  • Bloating/discomfort/weight gain
  • Pelvis mass
    • Pressure symptoms
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8
Q

What investigations are done for ovarian cancer?

A
  • Diagnosed by
    • US-guided biopsy
    • Surgical/pathological
    • US scan abdomen and pelvis
    • CT scan
    • Blood test – CA125 (glycol-protein antigen)
      • Indicator of malignancy for ovary (epithelial tumours), colon/pancreas or breast cancer), or benign conditions such as menstruation/endometriosis/PID, liver disease
    • Surgery
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9
Q

What blood test is used to diagnose ovarian cancer?

A
  • Blood test – CA125 (glycol-protein antigen)
    • Indicator of malignancy for ovary (epithelial tumours), colon/pancreas or breast cancer), or benign conditions such as menstruation/endometriosis/PID, liver disease
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10
Q

What is CA 125 an indicator of?

A
  • Indicator of malignancy for ovary (epithelial tumours), colon/pancreas or breast cancer), or benign conditions such as menstruation/endometriosis/PID, liver disease
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11
Q

What are the different stages of ovarian cancer?

A
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12
Q

Describe the management for ovarian cancer?

A
  • Depends on type of tumour, grade and stage, guided by RMI score
    • RMI score is product of US score (multi-locular, solid areas, bilateral, ascites, intra-abdominal), menopausal status and CA 125 level)
  • Surgery
    • Laparotomy (large incision on abdomen)
      • To obtain tissue diagnosis, stage disease, disease clearance, debulk disease
  • Chemotherapy
    • Adjuvant and neo-adjuvant
    • First line is platinum and taxane (taxol)
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13
Q

What does the management of ovarian cancer depend on?

A
  • Depends on type of tumour, grade and stage, guided by RMI score
    • RMI score is product of US score (multi-locular, solid areas, bilateral, ascites, intra-abdominal), menopausal status and CA 125 level)
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14
Q

What is RMI score?

A
  • RMI score is product of US score (multi-locular, solid areas, bilateral, ascites, intra-abdominal), menopausal status and CA 125 level)
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15
Q

Describe the prognosis of ovarian cancer?

A
  • Depends on type of tumour (benign/malignant/borderline), tumour grade and tumour stage
  • Worst prognosis for a cancer of female reproductive tract
  • Cure rates by stage
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16
Q

Who recieves screening for ovarian cancer?

A

Population screening not proven, only done for high risk woman:

  • Cancer gene mutation carriers
  • 2 or more relatives
17
Q

What does screening for ovarian cancer involve?

A
  • Pelvic examination
  • US scanning of ovaries
  • CA 125
18
Q

How is recurrence managed in ovarian cancer?

A
  • Chemotherapy
  • Palliation
    • Symptomatic recurrence
  • Platinum if > 6months
  • Tamoxifen (SERM)
  • Potentially surgery
19
Q

What are the precursors to low grade serous carcinoma (purple)?

A

Ovariun surface epithelium –> cortical inclusion cysts –> serous cystadeoma –> serous borderline tumour –> low grade serous carcinoma (–> high grade serous carcinoma)

Genes: BRAF, KRAS, NRAS, ERBB2

20
Q

What are the precursors to high grade serous carcinoma (green)?

A

Can take purple route OR

Fimbriae of fallopian tube –> serous tubal intraepithelial carcinoma –> high grade serous cell carcinoma

GENES: P53, BRCA1, BRCA2

21
Q

Which cancers can endometriosis progress to?

A

Endometriod carcinoma

Clear cell carcinoma

GENES: ARID1A, PIK3CA, PTEN

22
Q

What are the types of ovarian cancers mention in this lecture?

A

Endometrioid carcinoma

Clear cell carcinoma

Low grade serous carcinoma

High grade serous carcinoma

Most ovarian cancers are epithiliod and all of the above fall into this category. The most common of the epithilioid cancers of the ovary are serous (70%). Clear cell and endometriod account for ~10% each.

23
Q

Apart form epithelial, what other groups of ovarian cancers exist?

A

Sex-cord stromal

Germ cell

Mixed cell types

Reproductive System (31 decks)

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