Ovarian cysts Flashcards

1
Q

What is the most common type of ovarian cyst?

A

Follicular cyst

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2
Q

What is a follicular cyst?

A

Cyst that occurs due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle

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3
Q

What is a corpus luteum cyst?

A

If the corpus luteum does not break down at the end of the menstrual cycle then it may fill with blood/fluid and form a cyst

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4
Q

What is the most common benign ovarian tumour in women <30 years?

A

Dermoid cyst

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5
Q

What is a dermoid cyst?

A
  • Also called mature cystic teratoma

- Usually lined with epithelial tissue - may contain skin appendages, hair, and teeth

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6
Q

How often are dermoid cysts bilateral?

A

10-20% of cases

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7
Q

What is the most common type of benign epithelial tumour?

A

Serous cystadenoma

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8
Q

What is the second most common type of benign epithelial tumour?

A

Mucinous cystadenoma

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9
Q

Which ovarian mass(es) may cause pseudomyxoma peritonei?

A

Mucinous cystadenoma

Mucinous cystadenocarcinoma

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10
Q

List the types of ovarian tumours from most to least common.

A
  1. Surface derived (epithelial) tumours (65%)
  2. Germ cell tumours (15-20%)
  3. Metastatic tumours (Krukenberg - 5%)
  4. Sex-cord stromal tumours (3-5%)
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11
Q

Describe serous cystadenocarcinomas.

A
  • Malignant epithelial tumour
  • Often bilateral
  • Psammoma bodies seen (collection of calcium)
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12
Q

Describe mucinous cystadenocarcinomas.

A
  • Malignant epithelial tumour
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13
Q

Describe Brenner tumours.

A
  • Benign epithelial tumour
  • Contain Walthard cell rests (benign clusters of epithelial cells)
  • Typically have ‘coffee bean’ nuclei
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14
Q

Describe dysgerminomas.

A
  • Most common malignant germ cell tumours

- Similar histological appearance to testicular seminomas

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15
Q

Which condition are dysgerminomas associated with?

A

Turner’s

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16
Q

Which hormones are secreted by dysgerminomas?

A

hCG and LDH

17
Q

Describe yolk sac tumours.

A

Malignant germ cell tumour

18
Q

Which hormone is secreted by yolk sac tumours?

A

AFP

19
Q

Describe granulosa cell tumours.

A

The only malignant sex-cord stromal tumour of the ovaries

20
Q

Which hormone is secreted by granulosa cell tumours? What effect does this have?

A
  • Oestrogen
  • Precocious puberty in children
  • Endometrial hyperplasia in adults
21
Q

Describe Sertoli-Leydig cell tumours.

A

Benign sex cord stromal tumour

22
Q

Which hormone is secreted by Sertoli-Leydig cell tumours? What effect does this have?

A
  • Testosterone

- Has masculinising effects

23
Q

Which condition is associated with Sertoli-Leydig cell tumours?

A

Peutz-Jegher syndrome

24
Q

Describe fibromas of the ovaries.

A

Benign sex cord stromal tumour

25
Q

Which condition is associated with fibromas of the ovaries?

A

Meigs’ syndrome –> ascites, pleural effusion

26
Q

How do fibromas of the ovaries usually present?

A

Menopausal women presenting with a ‘pulling’ sensation in the pelvis

27
Q

Describe Krukenberg tumours.

A
  • Metastatic tumour

- Metastases from a GI tumour resulting in a mucin-secreting signet-ring cell adenocarcinoma

28
Q

What are the risk factors for ovarian cancer?

A
  • BRCA1, BRCA2
  • Early menarche
  • Late menopause
  • Nulliparity
29
Q

What are the clinical features of ovarian cancer?

A
  • Abdominal distension and bloating
  • Abdominal and pelvic pain
  • Urinary symptoms (urgency)
  • Early satiety
  • Diarrhoea
30
Q

What investigations should be performed if ovarian cancer is suspected?

A
  • TVUS

- CA125

31
Q

What factors make up the risk of malignancy index (RMI)?

A

USS score * menopausal status * CA-125

32
Q

Describe stage 1 of ovarian cancer (FIGO staging).

A

Stage 1 - Disease macroscopically confined to the ovaries

1a - One ovary is affected, capsule is intact

1b - Both ovaries are affected, capsule is intact

1c - 1a or b with tumour on the surface, ruptured capsule, cytologically +ve ascites, or +ve peritoneal washings

33
Q

Describe stage 2 of ovarian cancer (FIGO staging).

A

Disease extending to the pelvis (uterus, fallopian tubes, other pelvic tissues)

34
Q

Describe stage 3 of ovarian cancer (FIGO staging).

A

Abdominal disease and/or affected lymph nodes

The omentum, small bowel and peritoneum are frequently involved

35
Q

Describe stage 4 of ovarian cancer (FIGO staging).

A

Metastasis - Disease is beyond the abdomen (lungs or liver parenchyma)

36
Q

What is the management of ovarian cancer?

A

Surgery + platinum-based chemotherapy