ovarian pathology

Question 1

functional cyst types

Answer 1

can secrete hormones!

follicular: mature follicle doesn’t rupture (most common) - associated with hyperestrognism + endometrial hyperplasia

corpus luteum: fails to involute and fills with blood - makes progesterone (can delay menses)

Theca Lutein = excess bhCG –> hyperplasia of theca cells (associated with gestational trophoblastic disease + multiple gestations)

Question 2

when are ovarian cysts most common

Answer 2

reproductive years! if occur post-menopausal, usually malignant bc these cysts are related to ovulation

Question 3

complications of ovarian cysts

Answer 3

ovarian torsion, hemorrhage, rupture, bloating, urination issues, defecation issues

Question 4

most common ovarian tumor type

Answer 4

epithelial

Question 5

signs of malignancy in epithelial ovarian tumor

Answer 5

multiocular, solid, hypervascularity, fluid production, older patients

Question 6

should I biopsy an ovarian tumor?

Answer 6

NO - could rupture

Question 7

types of epithelial ovarian tumors

Answer 7

serous (most common)

mucinous

endometriod

clear cell

Question 8

what are the types of sex-cord stromal tumors

Answer 8

granulosa cell

sertoli-leydig

fibroma

Question 9

granulosa cell tumor

Answer 9

secretes estrogen! leads to heavy bleeding, breast tenderness, early puberty

most common sex-stromal cell

Question 10

sertoli-leydig

Answer 10

androgenic tumor–> virilization

Question 11

fibroma sex-stromal cell

Answer 11

benign, can lead to Meig’s syndrome: ascites + pleural effusion

Question 12

germ cell tumors

Answer 12

common in young women, mostly benign and unilateral

Question 13

mature teratoma

Answer 13

also called dermoid cyst, benign

Question 14

dysgerminoma

Answer 14

tumor marker: LDH

mimics germ cells

Question 15

yolk sac tumor

Answer 15

mimics yolk sac

AFP tumor marker

Schiller-Duval bodies

Question 16

choriocarcinoma

Answer 16

mimics placenta - highly malignant

Question 17

signs of ovarian cancer

Answer 17

bloating, pelvic pain, abdominal distension, constipation, urinary frequency, early satiety, weight change

adnexal/pelvic mass

Question 18

tumor marker for epithelial tumors

Answer 18

CA125 - NOT SPECIFIC

Question 19

increased risk for ovarian cancer?

Answer 19

post-menopausal
endometriosis, PCOS
nullparity
BRCA1, 2
Lynch Syndrome

Question 20

how do you stage ovarian cancer?

Answer 20

scraping underside of right diaphragm 
removal of para-aortic lymph nodes
removal of pelvic lymph nodes
removal of omentum
peritoneal washing

Question 21

CEA

Answer 21

mucinous tumor (subtype of epithelial)

Question 22

AFP

Answer 22

yolk sac tumor (germ cell subtype)

Question 23

LDH

Answer 23

dysgerminoma (germ cell subtype)

Question 24

bhCG

Answer 24

germ cell tumor

Question 25

inhibin B

Answer 25

sex cord stromal tumor