Ovarian Pathology Flashcards
sonographic findings of brenner tumor
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
sono findings of dysgerminoma
multilobulated solid mass, size variable
may be bilateral 15%
most common germ cell tumor accounting for 95%, usually found in women of active reproductive years?
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
percentage of ovarian neoplasms that are bengin and malignant mucinous tumors
benign: 20-25%
malignant: 5-10%
result from overstimulation by hCG associated with gestational trophoblastic disease or hCG administrationduring infertility treatment?
theca lutein cysts
multilocular and bilateral
may persist for days or weeks
generally involute without surgery
typically bilateral ovarian cancer that arises from a GI tract carcinoma, possible ascites, predominantly solid and hypoechoic
krukenberg tumor
what are sex cord stromal tumors
arise from sex cords of the embryonic gonad or from ovarian stroma
fibroma, thecoma, sertoli-leydig, granulosa
sertoli-leydig tumor is rare (0.5%) are unilateral and occur 30 yrs old. Androgen producing and symptoms of masculinization. what are sono findings?
20% malignant
5-15cm
sold echogenic mass
similar appearance of granulosa cell tumor
estrogen producing tumors most commonly occuring in postmenopausal women, accounting for 1% of ovarian tumors?
thecoma
commonly unilateral
rarely malignant
5-10cm in diameter
solid hypoechoic mass with posterior shadowing
abnormally thick endo secondary to hormonal stimulation
serous tumors account for 25-30% of neoplasms, what percentage are bengin and what percent are malignant?
benign: 50-70%
malignant: 40-50%
most common cause of ovarian enlargement in young women
functional cysts: follicular, corpus luteal, theca lutein
sonographic findings of benign mucinous tumors
30-50 yrs old
rarely bilateral
multiloculated with thicker and more numerous septations
fine echoes
up to 50 cm in diameter
endocrinologic disorder associated with chronic anovulation in young women in late teens and early twenties?
stein-leventhal syndrome (PCOS)
pseudomyxoma peritoneal is associated with what?
benign or malignant mucinous tumor capsule penetration or rupture filling peritoneal cavity with gelatinous material
80% of endometroid tumors are malignant, what percentage accounts for all ovarian carcinomas?
20-25%
histologically are identical to endometrial carcinoma
30% of patients associated with endometrial adenocarcinoma
mixed cystic and solid mass
the five epithelial tumors that account for 65-75% of all ovarian neoplasms and 90% of ovarian malignancies?
serous
mucinous
endometroid
clear cell
transitional cell (brenner)
malignant germ cell tumor from the primordial germ cells of ovary, 3-5% of ovariam malignancies
dyserminoma
under 30 yrs old
more commonly unilateral
highly radiosensitive
homologous to testicular seminomas
what is there to know about metastatic tumors?
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
fibromas are benign and occur at all ages but more likely in 40s and 50s. sono findings?
homogeneous hypoechoic mass with posterior shadowing
associated with ascites and pleural effusion (Meigs syndrome)
patient 20-30 years old with increased serum AFP most likely has what?
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
sonographic findings of serous cystadenocarcinomas
50% are bilateral
commonly occur peri- and postmenopausal
typically smaller than mucinous
multilocular
projections and septations
ascites
tumor that can be adult or juvenile, commonly produce estrogen?
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
germ cell tumors account for 20% of all ovarian neoplasms and most are benign, what are the three?
benign cystic teratoma
dysgerminoma
endodermal sinus tumor
account for 1-2% of primary ovarian tumors and are almost always benign occuring in women 40-80 yrs old?
Transitional cell (Brenner) tumor
which ovary is more likely to torse?
right
sonographic findings of benign serous tumors?
40-50 yrs old
12-20% bilateral
sharply marginated
anechoic
large and typically unilocular
possible thin-walled septations
overstimulation of follicle that fails to rupture, unilocular, 3 to 8 cm?
follicular cysts
sonographic findings of malignant mucinous tumors
40-70 yrs old
multiloculated cystic lesions measuring 15-30 cm in diameter
contain echogenic material and papillary excrescences
clear cells tumors are nearly always malignant, what are the findings?
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
What is a biological tumor marker that is elevated in women with ovarian cancer?
CA-125
when suspicious mass is present, should evaluate peritoneum for ascites and metastases, lymph nodes, liver , and pleural space
rarely exceed 4 cm, normally persist during pregnancy and usually resolve by 16 weeks?
corpus luteal cysts
