ovarian pathology Flashcards
functional cyst types
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)
when are ovarian cysts most common
reproductive years! if occur post-menopausal, usually malignant bc these cysts are related to ovulation
complications of ovarian cysts
ovarian torsion, hemorrhage, rupture, bloating, urination issues, defecation issues
most common ovarian tumor type
epithelial
signs of malignancy in epithelial ovarian tumor
multiocular, solid, hypervascularity, fluid production, older patients
should I biopsy an ovarian tumor?
NO - could rupture
types of epithelial ovarian tumors
serous (most common)
mucinous
endometriod
clear cell
what are the types of sex-cord stromal tumors
granulosa cell
sertoli-leydig
fibroma
granulosa cell tumor
secretes estrogen! leads to heavy bleeding, breast tenderness, early puberty
most common sex-stromal cell
sertoli-leydig
androgenic tumor–> virilization
fibroma sex-stromal cell
benign, can lead to Meig’s syndrome: ascites + pleural effusion
germ cell tumors
common in young women, mostly benign and unilateral
mature teratoma
also called dermoid cyst, benign
dysgerminoma
tumor marker: LDH
mimics germ cells
yolk sac tumor
mimics yolk sac
AFP tumor marker
Schiller-Duval bodies
choriocarcinoma
mimics placenta - highly malignant
signs of ovarian cancer
bloating, pelvic pain, abdominal distension, constipation, urinary frequency, early satiety, weight change
adnexal/pelvic mass
tumor marker for epithelial tumors
CA125 - NOT SPECIFIC
increased risk for ovarian cancer?
post-menopausal endometriosis, PCOS nullparity BRCA1, 2 Lynch Syndrome
how do you stage ovarian cancer?
scraping underside of right diaphragm removal of para-aortic lymph nodes removal of pelvic lymph nodes removal of omentum peritoneal washing
CEA
mucinous tumor (subtype of epithelial)
AFP
yolk sac tumor (germ cell subtype)
LDH
dysgerminoma (germ cell subtype)
bhCG
germ cell tumor
inhibin B
sex cord stromal tumor
