Ovarian Pathology

Question 1

sonographic findings of brenner tumor

Answer 1

hypoechoic solid mass, may have small cystic spaces

calcifications

may mimic ovarian fibroma

most are smaller than 2 cm, few will exceed 10cm

6-7% bilateral

Question 2

sono findings of dysgerminoma

Answer 2

multilobulated solid mass, size variable

may be bilateral 15%

Question 3

most common germ cell tumor accounting for 95%, usually found in women of active reproductive years?

Answer 3

benign cystic teratoma

three layers: endoderm, mesoderm, and ectoderm

dermoid cyst by definition contains ectoderm only

usually asymptomatic

teratocarcinoma: very rare, malignant, first 20 yrs of life

Question 4

percentage of ovarian neoplasms that are bengin and malignant mucinous tumors

Answer 4

benign: 20-25%
malignant: 5-10%

Question 5

result from overstimulation by hCG associated with gestational trophoblastic disease or hCG administrationduring infertility treatment?

Answer 5

theca lutein cysts

multilocular and bilateral

may persist for days or weeks

generally involute without surgery

Question 6

typically bilateral ovarian cancer that arises from a GI tract carcinoma, possible ascites, predominantly solid and hypoechoic

Answer 6

krukenberg tumor

Question 7

what are sex cord stromal tumors

Answer 7

arise from sex cords of the embryonic gonad or from ovarian stroma

fibroma, thecoma, sertoli-leydig, granulosa

Question 8

sertoli-leydig tumor is rare (0.5%) are unilateral and occur 30 yrs old. Androgen producing and symptoms of masculinization. what are sono findings?

Answer 8

20% malignant

5-15cm

sold echogenic mass

similar appearance of granulosa cell tumor

Question 9

estrogen producing tumors most commonly occuring in postmenopausal women, accounting for 1% of ovarian tumors?

Answer 9

thecoma

commonly unilateral

rarely malignant

5-10cm in diameter

solid hypoechoic mass with posterior shadowing

abnormally thick endo secondary to hormonal stimulation

Question 10

serous tumors account for 25-30% of neoplasms, what percentage are bengin and what percent are malignant?

Answer 10

benign: 50-70%
malignant: 40-50%

Question 11

most common cause of ovarian enlargement in young women

Answer 11

functional cysts: follicular, corpus luteal, theca lutein

Question 12

sonographic findings of benign mucinous tumors

Answer 12

30-50 yrs old

rarely bilateral

multiloculated with thicker and more numerous septations

fine echoes

up to 50 cm in diameter

Question 13

endocrinologic disorder associated with chronic anovulation in young women in late teens and early twenties?

Answer 13

stein-leventhal syndrome (PCOS)

Question 14

pseudomyxoma peritoneal is associated with what?

Answer 14

benign or malignant mucinous tumor capsule penetration or rupture filling peritoneal cavity with gelatinous material

Question 15

80% of endometroid tumors are malignant, what percentage accounts for all ovarian carcinomas?

Answer 15

20-25%

histologically are identical to endometrial carcinoma

30% of patients associated with endometrial adenocarcinoma

mixed cystic and solid mass

Question 16

the five epithelial tumors that account for 65-75% of all ovarian neoplasms and 90% of ovarian malignancies?

Answer 16

serous

mucinous

endometroid

clear cell

transitional cell (brenner)

Question 17

malignant germ cell tumor from the primordial germ cells of ovary, 3-5% of ovariam malignancies

Answer 17

dyserminoma

under 30 yrs old

more commonly unilateral

highly radiosensitive

homologous to testicular seminomas

Question 18

what is there to know about metastatic tumors?

Answer 18

5-10% are metastatic in origin

most common sites are breast and GI tract

spread by direct invasion of uterus or fallopian tubes, peritoneal fluid, blood vessels and lymphatics

Question 19

fibromas are benign and occur at all ages but more likely in 40s and 50s. sono findings?

Answer 19

homogeneous hypoechoic mass with posterior shadowing

associated with ascites and pleural effusion (Meigs syndrome)

Question 20

patient 20-30 years old with increased serum AFP most likely has what?

Answer 20

endodermal sinus tumor (yolk sac tumor)

second most common germ cell malignancy

usually unilateral, vary in size

highly malignant and metastasize

perdominantly solid with necrosis

Question 21

sonographic findings of serous cystadenocarcinomas

Answer 21

50% are bilateral

commonly occur peri- and postmenopausal

typically smaller than mucinous

multilocular

projections and septations

ascites

Question 22

tumor that can be adult or juvenile, commonly produce estrogen?

Answer 22

granulosa tumor

more commonly adult tyoe 50-55 yrs old

juvenile result in precocious puberty

small, mostly solid

large, multiloculated and cystic

abnormally thick endo secondary to hormonal stimulation

Question 23

germ cell tumors account for 20% of all ovarian neoplasms and most are benign, what are the three?

Answer 23

benign cystic teratoma

dysgerminoma

endodermal sinus tumor

Question 24

account for 1-2% of primary ovarian tumors and are almost always benign occuring in women 40-80 yrs old?

Answer 24

Transitional cell (Brenner) tumor

Question 25

which ovary is more likely to torse?

Answer 25

right

Question 26

sonographic findings of benign serous tumors?

Answer 26

40-50 yrs old

12-20% bilateral

sharply marginated

anechoic

large and typically unilocular

possible thin-walled septations

Question 27

overstimulation of follicle that fails to rupture, unilocular, 3 to 8 cm?

Answer 27

follicular cysts

Question 28

sonographic findings of malignant mucinous tumors

Answer 28

40-70 yrs old

multiloculated cystic lesions measuring 15-30 cm in diameter

contain echogenic material and papillary excrescences

Question 29

clear cells tumors are nearly always malignant, what are the findings?

Answer 29

5-10% of epithelial tumors

50-70 yrs old

bilateral 20%

range up to 30cm

histologic variant of endometroid and serous carcinomas

complex predominantly solid mass

Question 30

What is a biological tumor marker that is elevated in women with ovarian cancer?

Answer 30

CA-125

when suspicious mass is present, should evaluate peritoneum for ascites and metastases, lymph nodes, liver , and pleural space

Question 31

rarely exceed 4 cm, normally persist during pregnancy and usually resolve by 16 weeks?

Answer 31

corpus luteal cysts