Ovarian Cancers

Question 1

<p>

| Granulosa Cell Tumor</p>

Answer 1

<p>
	Most common sex cord stromal tumor; grows locally/indolently</p>
<p>
	Secretes inhibin and estrogen</p>
<p>
	Cal-Exner bodies (small round spaces filled with eosinophilic material surrounding granulosa cells)</p>
<p>
	50% Risk concurrent endometrial hyperplasia, 3-27% risk of concurrent endometrial cancer</p>
<p>
	Avg time to recurrence: 6 years</p>
<p>
	10-year Survival  Stage I 90%</p>
<p>
	Advanced Disease 29-49%</p>
<p>
	Workup: USO; consider D&amp;C for postmenopausal women</p>

Question 2

<p>

| Fibroma</p>

Answer 2

<p>
Most common sex cord stromal tumor 4% of all neoplasms</p>

<p>
- Meigs&#39; syndrome: ascites (10-15%, large mass, 1% hydrothorax) (related to VEGF)</p>

<p>
- Gorlin&#39;s syndrome: inherited predisposition to fibromas and basal-cfell nevi</p>

<p>
Tx:</p>

<p>
USO. May consider ovarian cystectomy</p>

Question 4

GERM CELL Tumors

Answer 4

DEEP CT G
Dysgerminoma - LDH, plac alk phos
Endodermal sinus tumor - AFP
Embryoma
Polembryonal
Choriocarcinoma (nongestational)
Teratoma
Gonadoblastoma

Question 5

Sex Cord Stromal Tumors

Answer 5

Granulosa - Estrogen, Inhibig
Leydig - Testosterone
SErtoli - MIS
Thecoma - Progesterone
Fibroma - Meigs syndrome

Question 6

Epithelial Ovarian Cancer

Answer 6

Serous (fallopian tube)     CA 125
Mucinous (cervix)     CA 19-9
Clear (Vagina)    endometriosis
Endometrioid (Uterus)   endometriosis
Transitional/Brenner (Bladder)
Carcinosarcoma/MMMT

Question 7

Tumor Markers

Answer 7

CA 125 > Epithelial ovarian cancer
AFP > Germ Cell (Endodermal Sinus)
CA 19-9 > GI malignancy
Inhibin > Granulosa Cell Tumor
CEA > GI

Question 8

Pap returns AGC

Answer 8

Colpo and ECC
EMB
CKC
TVUS