Ovarian Cancer

Question 1

classification of ovarian cancer

Answer 1

1. sex cord-stroma
2. germ cell
3. epithelial

Question 2

most common type of ovarian cancer

Answer 2

epithelial

Question 3

what is a dermoid cyst?

Answer 3

benign teratoma

Question 4

examples of epithelial ovarian cancers

Answer 4

serous
mucinous
endometrioid
clear cell
transitional cell

Question 5

examples of germ cell ovarian cancers

Answer 5

dysgerminoma
yolk sac
embryonal carcinoma
choriocarcinoma
teratoma

Question 6

examples of sex cord stroma ovarian cancers

Answer 6

granulosa cell
thecoma
fibroma
sertoli cell
sertoli-leydig
steroid

Question 7

presentation of ovarian cancer

Answer 7

often asymptomatic- late presentation
mass
pressure symptoms
abnormal bleeding
pain
bloating 
early satiety

Question 8

tumours markers in ovarian cancer

Answer 8

Ca125
CEA
AFP
HCG
LDH

Question 9

when can Ca125 be raised?

Answer 9

ovulation
pregnancy
benign conditions
ovarian cancer

Question 10

when can CEA be raised?

Answer 10

mucinous tumours e.g. colon, breast, ovary, etc.

Question 11

when can AFP be raised?

Answer 11

embryonal carcinoma

Question 12

when can HCG be raised?

Answer 12

choriocarcinoma

Question 13

when can LDH be raised?

Answer 13

dysgerminoma

Question 14

B features on USS

Answer 14

fluid-filled
unilocular
no blood flow

Question 15

M features on USS

Answer 15

irregular solid areas
associated ascites
papillary projections
increased blood flow

Question 16

diagnosis of ovarian cancer

Answer 16

tumour markers
USS
MRI if premenopausal
CT if post-menopausal
RMI

Question 17

how to calculate RMI?

Answer 17

Ca125 x USS score x menopause status score

Question 18

what RMI indicates high risk of ovarian cancer?

Answer 18

> 200

<30 is low chance

Question 19

what is Meig’s syndrome?

Answer 19

benign ovarian tumour (fibroma) with ascites and pleural effusion

Question 20

where do metastases of ovarian cancer go to?

Answer 20

breast
pancreas
stomach
GI tract (Kruckenberg tumour= signet ring sign)
often has peritoneal spread

Question 21

where is lymphatic drainage of the ovaries?

Answer 21

para-aortic (embryological development- posterior abdominal wall)

Question 22

peritoneal spread in ovarian cancer

Answer 22

ascites
omental
peritoneal nodules
sub-diaphragmatic
liver deposits
malignant pleural effusion