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Ovarian Disease Flashcards

1
Q

What are the two most common types of pathologies of the ovaries?

A

Cysts and tumors

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2
Q

How, generally, do ovary diseases present?

A
  • Adnexal masses
  • Abdo pain/enlargement
  • Abnormal uterine bleeding
  • Bowel/bladder s/sx
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3
Q

What is the order of incidence for cancer of the Gyn in the US? (3)

A
  1. Endometrial
  2. Ovarian
  3. Cervical
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4
Q

What is the most common gyn cancer worldwide?

A

World = cervical

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5
Q

What is the order of prognosis for cancer of the Gyn? (3)

A
  1. Endometrial (best)
  2. Cervical
  3. Ovarian (worst)
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6
Q

What are the three major pathologies of the ovaries?

A
  • Cysts
  • Benign tumors
  • Malignant tumors
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7
Q

What is the most common ovarian mass in young women?

A

Follicular cysts

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8
Q

What are follicular cysts?

A

Distention of an unruptured graafian follicle. Usually regresses spontaneously

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9
Q

What is the significance of follicular cysts?

A

Insignificant unless lining granulosa cells secrete estrogen, causing endometrial hyperplasia

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10
Q

What are corpus luteum (granulosa luteal) cysts?

A

Cystic enlargement of corpus luteum with central hemorrhage.

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11
Q

What is the significance of corpus luteum cysts?

A

If ruptures, causes peritoneal reaction with fibrosis and hemorrhage mimicking endometriosis

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12
Q

True or false: corpus luteum cysts usually regress spontaneously

A

True

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13
Q

Rupture of corpus luteal cysts often mimic the s/sx of what other disease?

A

Endometriosis

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14
Q

What are the gross characteristics of corpus luteum cysts?

A

Central area of hemorrhage/necrosis

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15
Q

What are theca-lutein cysts?

A

Cysts that arise from hCG stimulation from a mole. Presents a risk of hemorrhage.

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16
Q

True or false: theca-lutein cysts are often unilateral and singular

A

False- bilateral and multiple

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17
Q

What disease are theca-lutein cysts associated with? (2)

A

Choriocarcinoma and moles

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18
Q

What are the histological characteristics of theca-lutein cysts?

A

Luteinized cells forming the inner cysts lining with adjacent surrounding theca cells

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19
Q

What are hemorrhagic cysts? Prognosis?

A

Blood vessel rupture in cyst wall, causing cyst growth with blood retention

Usually self resolving

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20
Q

What are dermoid cysts?

A

Mature, benign teratomas of germ cell line (germ cell tumor)

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21
Q

What is the most common ovarian tumor in women 20-30 years old?

A

Dermoid cysts

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22
Q

What are the odd characteristics about dermoid cysts?

A

Contains elements from all three germ layers

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23
Q

What are struma ovarii?

A

Dermoid cysts that has functional thyroid tissue, causing hyperthyroidism

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24
Q

What are the presenting s/sx of dermoid cysts?

A

Pain d/t ovarian enlargement or torsion

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25
What are endometrioid cysts? Characteristics?
Endometriosis within ovary with cyst formation that varies with menstrual cycle
26
What are "chocolate cysts"?
Endometrioid cysts that are filled with dark, reddish-brown blood
27
What percent of ovarian tumors (for women ages 20-45) are benign?
80%
28
Why is there usually poor prognosis with ovarian neoplasms? Where does it fall in terms of cancer deaths?
Usually caught late 5th largest cause of cancer deaths
29
What are the s/sx of ovarian neoplasia?
- Abdominal pain - Distention - GI/GU complaints
30
What are the risk factors for ovarian neoplasms? (3)
- BRCA1 or 2 mutations - Family h/o - Nulliparity
31
Whom does ovarian carcinoma usually affect?
Women 45-65 yo
32
Which increases the risk for ovarian cancer: nulliparity or multiparity?
Nulliparity
33
What are ovarian neoplasms classified on?
Cell origin
34
What is the most common ovarian neoplasm origin?
Surface epithelium (70%)
35
What are serous cystadenomas?
Benign adenomas of the ovary.
36
What is the most common ovarian tumor?
Serous cystadenomas
37
In whom do cystadenomas usually occur?
20-50 years
38
What is the malignant form of cystadenomas?
Cystadenocarcinomas
39
What are the characteristics of serous cystadenomas?
Single, Thin walled cystic masses with serous fluid
40
What is the epithelium that lines cystadenomas?
Fallopian like epithelium (tall, ciliated secretory columnar)
41
True or false: cystadenomas are commonly unilateral
False-bilateral
42
What is the type of epithelium of fallopian tubes?
Tall, ciliated secretory columnar
43
Are mucinous cystadenomas usually single or multiloculated?
Multiloculated
44
Are mucinous cystadenomas usually unilateral or bilateral? Large or small?
Unilateral | Large
45
What is the epithelial lining of mucinous cystadenomas?
endocervical epithelium (tall, mucus secreting columnar epithelium)
46
Are mucinous cystadenomas or serous cystadenomas more likely to become malignant?
Serous
47
In whom do mucinous cystadenomas usually occur?
30-60 years old
48
What is an endometrioma?
Mass arising from growth of ectopic endometrial tissue
49
What are the presenting s/sx of endometrioma? (3)
Pelvic pain Dysmenorrhea Dyspareunia
50
How do endometriomas usually present on US?
Complex mass
51
What are Brenner tumors?
Uncommon adenofibroma with nodules of transitional type epithelium in a dense fibrous stroma
52
Uncommon adenofibroma with nodules of transitional type epithelium in a dense fibrous stroma = what ovarian tumor?
Brenner tumor
53
What is the epithelium of Brenner tumors?
*Transitional* epithelium in a dense, fibrous stroma
54
What are the gross characteristics of Brenner tumors?
Pale-yellow-tan in color, and appears encapsulated
55
What are the histologic characteristics of Brenner tumors with H and E staining
Transitional epithelium + Coffee bean nuclei
56
Coffee bean nuclei in the thyroid = ?
Papillary thyroid carcinoma
57
Are brenner tumors benign or malignant? Unilateral or bilateral?
Benign | Unilateral
58
What are the histological characteristics of papillary, follicular, medullary, and anaplastic thyroid carcinomas?
- Papillary = Orphan annie eyes, coffee bean, psammoma bodies - Follicular = Follicles - Medullary = sea of amyloid - Anaplastic = anaplastic cells
59
What are ovarian fibromas? Benign of malignant?
Bundles of spindle shaped fibroblasts Benign
60
What are the s/sx of fibromas?
Pulling sensation in the groin
61
What is Meig's syndrome? (3)
Triad of: - ovarian fibroma - Ascites - Hydrothorax
62
What are thecomas?
Like granulosa cell tumors--may produce estrogen
63
What are the usual s/sx of thecomas? Why?
Abnormal uterine bleeding in a postmenopausal woman d/t estrogen production from the tumor
64
What is the most common ovarian *malignancy*?
Serous cystadenocarcinomas
65
Are Serous cystadenocarcinomas usually unilateral or bilateral?
bilateral
66
What are the histological characteristics of Serous cystadenocarcinomas?
Psammoma bodies
67
What are the histological characteristics of Serous cystadenocarcinomas?
Tumor showing *papillary* growth, *hyperchromatic* cells, and psammoma bodies
68
Tumor showing papillary growth, hyperchromatic cells, and psammoma bodies= what tumor?
Serous cystadenocarcinomas
69
What are the histological characteristics of Mucinous cystadenocarcinomas? (3)
- Complex architecture - Nuclear atypia - Stromal invasion
70
What are the differences between mucinous and serous cystadenocarcinoma?
Mucinous has a complex architecture with nuclear atypia
71
What is pseudomyxoma peritonei? What causes this?
Intraperitoneal accumulation of mucinous material from mucinous cystadenocarcinoma ovarian or appendiceal tumor
72
What are immature teratomas?
Rare, aggressive solid tumor consisting or primitive or embryonic elements, often neuroectoderm
73
Are immature teratomas usually aggressive or not?
Aggressive
74
Mature teratomas are more likely to contain what type of endocrine tissue?
Thyroid tissue
75
What are granulosa cell tumors?
Malignant tumors of granulosa cell, which actively produce estrogen
76
What is the most common sex cord stromal tumor? In whom do these usually occur?
Granulosa cell tumor Women in 50s
77
What are the s/sx of granulosa cell tumors? Why?
Abnormal uterine bleeding and breast TTP d/t estrogen/progesterone production
78
What are call-exner bodies? What tumors are these seen in?
Primordial follicles that are small, eosinophilic and fluid filled spaces that are often seen in granulosa cell tumors Often seen in Granulosa cells tumors
79
What are dysgerminomas?
a type of germ cell tumor; it usually is malignant and usually occurs in the ovary
80
In whom are dysgerminomas usually present in?
Adolescents
81
What are the histological characteristics of dysgerminomas?
"Sheets of fried egg cells"
82
What are the tumor markers of dysgerminomas? (2)
hCG | LDH
83
"Sheets of fried egg cells" on histology = what ovarian tumor?
Dysgerminoma
84
What are choriocarcinomas?
malignancy of trophoblastic cells
85
How common are choriocarcinomas?
Rare
86
What is the relation between choriocarcinomas and theca-lutein cysts?
Increases the frequency of the cyst
87
Are chorionic villi present with choriocarcinomas
No
88
What organ do choriocarcinomas usually met to?
Lungs
89
What is the prognosis for choriocarcinomas?
Very responsive to chemo
90
What are yolk sac tumors?
Aggressive tumors of ovaries or testes
91
What is the most common tumor in male infants?
Yolk sac tumors
92
What are the gross characteristics of yolk sac tumors?
Yellow, friable, solid mass
93
What are the histological characteristics of yolk sac tumor?
"Schiller-Duval bodies"
94
What is the tumor marker of yolk sac tumors?
AFP
95
What are Krukenberg tumors?
GI malignancy which mets to the ovaries, causing a mucin-secreting signet cell adenocarcinoma

OB/GYN (33 decks)

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