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Ovarian Cysts/tumors Flashcards

1
Q

When should ovaries NOT be palpable?

A

Pre-menarchal

Post-menopausal: non-palpable w/in 3 years

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2
Q

What % of reproductive women are the ovaries palpable?

A

50%

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3
Q

What are the size of simple cysts in premenopausal? postmenopausal?

A 
Premonopausal= <3 cm
Postmenopausal= <1 cm
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4
Q

What is this describing?

Hyper echoic nodule with distal acoustic shadowing

A

Benign Teratoma

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5
Q

What is this describing?

Network of linear curvilinear pattern

A

Hemorrhagic Cyst

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6
Q

What is this describing?

Homogenous echos

A

Endometrioma

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7
Q

Describe the appearance of a malignant adnexal mass/cyst

A
  1. Solid
  2. Nodular/papillary
  3. Blood flow
  4. Thick septations= >2 mm
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8
Q

List the Functional Ovarian Cysts

A
  1. Follicular Cyst=MC*
  2. Corpus Luteum Cysts
  3. Theca Lutein Cysts
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9
Q

What is the MC type of functional ovarian cyst?

A

Follicular cyst

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10
Q

What do follicular cyst result from?

A
  1. Failure of mature follicle to rupture

2. Failure of non-dominant follicles to undergo atresia

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11
Q

What do Corpus Luteum Cysts result from? Si/sx?

A

Failure of corps luteum resorption following ovulation= Continues to produce Progesterone=Missed/Delayed period

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12
Q

What is the fluid appearance of Theca Lutein Cysts?

A

Clear, Straw colored

B/L

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13
Q

What do Theca Lutein Cysts result from?

A

Increased chorionic gonadotropin levels:

  1. Hydatidorm mole
  2. Choriocarcinoma
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14
Q

List the Nonfunctional Epithelial Cell Ovarian Tumors

A
  1. Serous
  2. Mucionus
  3. Endometriod
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15
Q

What is the MC Epithelial Cell Tumor? Presenting age?

A

Serous Cystadenoma

30-50 y.o.

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16
Q

Serous Cystadenoma treatment

A

Surgical: Cystectomy vs. Oophorectomy

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17
Q

Mucinous cyst adenoma (epithelial tumor) US findings

A

Multiocular septations

Large

18
Q

Mucinous cyst adenoma (epithelial tumor) treatment

19
Q

What is the presenting age in germ cell tumors, teratoma?

A

Reproductive age=30

20
Q

Teratoma clinical presentation

A
  1. Asx: Incidental findings
  2. Pelvic Pain: occurs secondary to torsion/rupture (rare)
  3. Urinary urgency/frequency
  4. Back pain
21
Q

What would you order if you suspect a teratoma?

A
  1. Transvaginal US: Unilateral, complex cyst

2. CEA, CA-125, AFG, BHCG= Normal

22
Q

Teratoma treatment

23
Q

List the Stromal Cell tumors. What is unique about these tumors?

A
  1. Granulosa Theca Cell Tumors
  2. Sertoli-Leydig Cell tumors

*Malignant Potential

24
Q

What do Granulosa Theca Cell Tumors produce? Along which cell type line?

A

Produce Estrogen

Develop Along Female Cell Type

25
Q

What do Sertoli-Leydig Cell tumors produce? Along which cell type?

A

Produce Androgen

Male gonadal tissue type

26
Q

What is the 2nd MC gynecologic CA?

A

Ovarian CA

27
Q

Ovarian CA RF’s

A
  1. FHx: Ovarian, breast or colorectal CA (BRCA, Lynch Syndrome)
  2. Personal Hx of Breast CA
  3. Increased # of ovulatory cycles
  4. Obesity
  5. Endometriosis
28
Q

What reduces your risk of ovarian cancer?

A
  1. Long term OCP’s
  2. Multiparity, breastfeeding
  3. Low fat diet
  4. B/L Salpingectomy
29
Q

List the 4 types of ovarian cancer

A
  1. Epithelial
  2. Germ Cell
  3. Sex Cord and Stromal
  4. Neoplasma Metastatic to ovary
30
Q

What tumor suppressor gene mutation is associated with epithelial ovarian CA? At what part of the Fallopian tube does the mutation occur?

A

P53

DISTAL Fallopian tube

31
Q

What is the MC epithelial ovarian CA? Where does it arise from?

A

High Grade Serous Carcinoma

Arises from Fallopian tubes

32
Q

Are germ cell ovarian cancers normally unilateral or bilateral?

A

UNILATERAL

33
Q

What is the MC germ cell ovarian cancer?

A

Dysgerminoma

34
Q

Which germ cell ovarian cancer is the ONLY one that is NOT unilateral

A

Endodermal Sinus Tumor=Bilateral

35
Q

Which germ cell ovarian cancer is the ONLY one that does NOT produce AFP tumor marker? What tumor marker does it produce?

A

Dysgerminoma= LDH, +/- hCG

36
Q

What is the MC sex cord and stromal cancer? What age does it present? What does it produce?

A

Granulosa Cell
50’s
Hyperestrogenism: precocious puberty, postmenopausal bleeding

37
Q

Ovarian CA clinical presentation

A
  1. Abd bloating/distention
  2. Abd/pelvic pain
  3. Early satiety
  4. Lethargy
  5. Urinary Urgency
38
Q

Ovarian CA physical exam findings

A
  1. Ascites

2. Pelvic mass

39
Q

What kind of ovarian cancer would show an increase in CA-125

A

Epithelial

40
Q

What kind of ovarian would have increased hCG, AFP, LDH?

41
Q

Ovarian CA treatment

A
  1. Consult Gynecologist Oncologist
  2. Surgical
  3. Chemotherapy: advanced dz

Foundations-Women's Health (8 decks)

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