Ovarian Neoplasms

Question 1

What are risk factors for ovarian cancer?

Answer 1

nulliparity, family history, early menarche and late menopause, white race, increasing age and residence in North America and Northern Europe; oral contraceptive use is protective against ovarian cancer due to anovulation; five years cumulative use decreases lifetime risk by one half

Question 2

How do you assess someones risk for BRCA when mother has breast cancer and grandmother has ovarian?

Answer 2

affected individual(proband) should be tested; because breast cancers are part of the BRCA mutation, affected mother should be tested

Question 3

what is an endometrioma?

Answer 3

isolated collection of endometriosis involving an ovary

Question 4

What are serous cystadenomas?

Answer 4

generally larger than functional cysts and patients may present with increasing abdominal girth

Question 5

What are mucinous cystadenomas?

Answer 5

tend to be mutlilocular and quite large on ultrasound

Question 6

what are dermoid tumors?

Answer 6

usually have solid components or appear echogenic on ultrasound, as they may contain teeth, cartilage, bone, fat and hair

Question 7

What are granulosa cell tumors(sex cord stromal tumor)?

Answer 7

functional tumors that secrete high levels of estrogen, which can ultimately stimulate the endometrium to undergo hyperplastic changes and even lead to endometrial cancer. Approximately 25-50% of women with GCT will have endometrial hyperplasia on biopsy and 5-10% will have endometrial cancer; GCTs represent 70% of sex cord stromal tumors and typically affect women i their 50s

Question 8

What are the three main histologic sub types of ovarian cancer?

Answer 8

epithelial tumors(90%), germ cell tumors(5%), sex cord stromal tumors(1-2%)

Question 9

What population do germ cell tumors mostly affect?

Answer 9

typically affect women of younger age groups(age 10 to 30), comprise 20-25% of ovarian neoplasms overall(benign and malignant) and account for 70% of tumors in this age group

Question 10

what type of cysts are common etiologies in young women with ovarian torsion?

Answer 10

torsion usually occurs in setting of an enlarged ovary, with dermoid cyst being common etiology in young women; these cysts often contain oily contents that are less dense than surrounding tissue, rising to more anterior position and creating instability of the infundibulopelvic ligament

Question 11

what characteristics make cancer more likely?

Answer 11

complexity with solid components, size greater than 10cm, mural nodules or excrescences, presence of ascites and bilaterality

Question 12

what type of ovarian neoplasm are most common in women <30 and women >30?

Answer 12

germ cell tumors most common in women <30; epithelial cell tumors are most common in >30