Ovarian Pathology

Question 1

A follicular cyst is (Painful/Painless)?

Answer 1

Painful

Question 2

What hormone is highest in the female reproductive cycle after ovulation and is produced by the corpus luteum?

Answer 2

Progesterone

Question 3

22 year old female patient presents to your office complaining of excruciating pain in her abdominopelvic region. An ultrasound of the area shows a large solitary structure present on the right ovary. The mass is hypoechoic and appears to be fluid filled. What is the likely diagnosis?

Answer 3

Follicular cyst

Question 4

25 year old female patient presents to your office complaining of menstrual irregularity. The patient has not had a period in almost four months. The patient does not appear to be in any pain and reports no outstanding symptoms. An ultrasound is performed and reveals a hypoechoic mass that appears to be the remnant of an unresolved corpus luteum. A blood test shows high levels of progesterone to confirm this suspicion. What is the likely diagnosis?

Answer 4

Corpus luteal cyst

Question 5

What is ovarian hyperstimulation syndrome? What does this result in?

Answer 5

(Theca lutein cysts)
- associated w/ ^gonadotropin (as in pregnancy, hydatidiform mole, choriocarcinoma or exog. hormone therapy)
- presents as edema & foci of luteinized stromal cells (maturing of too many follicles)

Question 6

36 year old female patient presents to your office complaining of infertility. She has been on exogenous hormone for months and still has been unable to get pregnant. Recently she notes that she has gained considerable weight and has been feeling hot. The patients blood pressure is 145/95. A blood test shows high levels of progesterone. An ultrasound shows multiple cysts bilaterally in the ovaries of the patient. What is the likely diagnosis?

Answer 6

Theca lutein cysts caused by ovarian hyperstimulation syndrome

Question 7

What is a hydatidiform mole?

Answer 7

Molar pregnancy involving growth with no embryo due to no presence of maternal nuclei

Question 8

How does a hydatidiform mole present clinically?

Answer 8

Painless vaginal bleeding with grape-like vesicles on ultrasound

Question 9

What is the ultrasound finding common in a patient with a hydatidiform mole?

Answer 9

Grape-like vesicles

Question 10

32 year old female patient presents to your office complaining of vaginal bleeding. She is in no pain. A pregnancy test is positive as the patient has heightened levels of HCG. An ultrasound shows a collection of dark “grape-like” vesicles. What is the likely diagnosis?

Answer 10

Hydatidiform mole

Question 11

What is a choriocarcinoma?

Answer 11

Placental cancer that may occur in the ovaries and contains paternal DNA

Question 12

What are risk factors for developing choriocarcinoma?

Answer 12

Hydatidiform mole, ectopic pregnancy, spontaneous abortion

Question 13

34 year old male patient presents to your office complaining of vaginal bleeding and dyspnea. The patient reports having an unremarkable birth of her baby boy about four months ago.. The patient takes a blood test and she still possesses heightened levels of HCG. A radiograph is performed on the patient and you notice multiple small masses in the patients lungs. What is the likely diagnosis?

Answer 13

Choriocarcinoma with Mets to the lungs

Question 14

What is Stein-Leventhal syndrome?

Answer 14

Polcystic ovarian syndrome

Question 15

What are the primary symptoms in polycystic ovarian syndrome?

Answer 15

Amenorrhea, hirsutism, obesity, and type II diabetes mellitus

Question 16

25 year old female patient presents to your office complaining of weight gain and lack of menstruation. Upon physical examination you notice that the patient has an abnormal amount of facial hair as well as hair on the arms. A blood test shows hyperglycemia. An ultrasound is performed on the abdominopelvic region for the menstrual complaint. Ultrasound shows 9 separate lesions present on the ovaries. What is the likely diagnosis?

Answer 16

Polycystic ovarian syndrome (Stein-Leventhal Syndrome)

Question 17

What is a chocolate cyst?

Answer 17

Endometriosis to the ovaries leading to a brown discoloration

Question 18

27 year old female patient presents to your office complaining of abdominopelvic pain that is worse during her menstrual cycle. The patient has a history of endometriosis. When inquiring about any other symptoms, the patient is hesitant to admit that she has been having pain during intercourse as well. An ultrasound shows a hypoechoic mass in the ovary. The mass is excised and has a brown discoloration to it. What is the likely diagnosis?

Answer 18

Chocolate cyst

Question 19

What is a dermoid cyst or teratoma?

Answer 19

Tumor of mixed histogenetic origin including hair, skin, teeth, and nails

Question 20

90% of ovarian cancers are ______________ in origin?

Answer 20

Epithelial

Question 21

What is the age and gender of onset for ovarian carcinoma?

Answer 21

Women 40-60

Question 22

What is the most common subtype of ovarian carcinoma?

Answer 22

Serous cell carcinoma

Question 23

What tumor marker is a sign that may indicate ovarian carcinoma?

Answer 23

CA-125

Question 24

52 year old female patient presents to your office complaining of pain and a feeling of fullness in the abdomen and pelvis. The patient has a history of the CA-125 gene marker in her family. A mass is shown on MRI in the right ovary. A biopsy of the tissue shows epithelial cells that are poorly organized and anaplastic. What is the likely diagnosis?

Answer 24

Ovarian carcinoma

Question 25

What is a Krukenberg tumor?

Answer 25

Metastasis of a diffuse gastric adenocarcinoma to the ovaries bilaterally

Question 26

59 year old female patient presents to your office complaining of bilateral abdominopelvic pain. She is currently being co-treated for a diffuse gastric adenocarcinoma. An ultrasound of the region shows masses on both ovaries. A biopsy of the tissues shows glandular epithelium resembling the stomach. What is the likely diagnosis?

Answer 26

Krukenberg tumor