Ovarian Cancer and Cysts

Question 1

what can ovarian cancer arise from?

Answer 1

any of the 3 cell types
- sex-cord stroma
germ cells
epithelium

Question 2

most common ovarian cancer

Answer 2

epithelial

Question 3

what is a benign teratoma

Answer 3

dermoid cyst

Question 4

presentation of ovarian cancer

Answer 4

mass
pressure symptoms
abnormal bleeding
pain bloating, early satiety (IBS overlap)

Question 5

tumour makers

Answer 5

Ca125
CEA
AFP (embryonal)
HCG (choriocarcinoma)
LDH (dysgerminoma)

Question 6

B features of USS

Answer 6

fluid-filled, unilocular, no blood flow

Question 7

M features of USS

Answer 7

irregular solid areas, associated ascites, papillary projections, irregular areas and increased blood flow.

Question 8

diagnosis of ovarian cancer

Answer 8

MRI if premenopause

CT if postmenopause

Question 9

RMI

Answer 9

Ca125 x USS x menopause score

Question 10

what is Meig’s syndrome?

Answer 10

benign ovarian tumour + ascites + pleural effusion

Question 11

common mets to the ovary

Answer 11

breast
pancreas
stomach
GI track (Kruckenberg tumour= signet ring sign)

Question 12

lymphatic spread of ovarian cancer

Answer 12

para-aortic

Question 13

types of ovarian cysts

Answer 13

follicular 
luteal
endometriotic
epithelial
mesothelial

Question 14

cysts accidents

Answer 14

rupture
torsion
haeorrhage

Question 15

management of benign ovarian masses

Answer 15

GnRH agonists
OCP
surgery

Question 16

what is endometriosis?

Answer 16

presence of endometrial glands and stroma outside the uterine body
common on ovaries and peritoneum

Question 17

presentation of endometriosis

Answer 17

pain during or after sex
painful periods/ cyclical pain
tenderness
chocolate cysts
rupture can present as acute abdomen

Question 18

diagnosis of endometriosis

Answer 18

TVUS
diagnostic laparoscopy
MRI

Question 19

management of endometriosis

Answer 19

analgesia
OCP
danazol
GnRH
surgery