Ovarian Pathology Flashcards
ovarian cysts can arise from any element of the ovary - what are these elements
Follicular Luteal Endometriotic Epithelial Mesothelial
what is the most common type of ovarian cyst
Follicular
when can follicular cysts form
when ovulation doesn’t occur
(polycystic ovaries)
> follicle doesn’t rupture and grows until it becomes a cyst
what are the composition of follicular cyst
thin walled
lined by granulosa cells
Mx of follicular cyst
usually resolve over a few months
what is the staging of ovarian cancer
I- confined to 1 or both ovaries
II-spread to other pelvic organs eg uterus, fallopian tubes
III- spread beyond the pelvis within the abdomen
IV- spread into other organs eg liver, lungs
what are the two main splits of ovarian cancer
> 90% epithelial cell tumours of ovary
<10% germ cell, granulosa cell
what is the second most common type of ovarian cyst
luteal cysts
what are the risk factors for ovarian cancer
> 50 y/o nulliparity early menarche \+ve family history BRCA1 and BRCA2 mutation
what is the tumour markers of ovarian cancer
CA 125 = raised in 80% but normal level does not exclude cancer
CEA = moderately elevated esp in mucinous tumours
Sx of ovarian cancer
persistent ‘bloating’/abdominal distension
early satiety [eating less and feeling fuller]
loss of appetite + weight loss
change in bowel habit
fatigue
urinary frequency or urgency
abdominal or pelvic pain
Ix of ovarian cancer
1st line = USS either transvaginal or abdominal
2nd line = CT [also used for staging]
Tx of ovarian cancer
Surgery [= hysterectomy, bilateral salpingo-oophorectomy] + Chemotherapy [= Carboplatin]
what is the most common epithelial cell ovarian tumour
serous carcinoma
- usually just in one ovary
how can serous carcinomas be split
high grade
low grade
what are the precursors for high grade and low grade serous carcinomas
High grade precursor = serous tubal intraepithelial carcinoma (STIC)
Low grade precursor = serous borderline tumour
what are mucinous epithelial cells characterised by
mucin-filled cyst lined by columnar glandular cells
may be associated with tumours of the appendix
what epithelial type of tumour are associated with uterine carcinomas in 20% of cases
endometrioid carcinomas
what epithelial type of tumour are associated with ovarian endometriosis
clear-cell carcinomas
what is a brenner tumour
tumour of transitional type epithelium in ovary
what are teratomas
benign tumours developed from a dermoid cyst
what can be contained in a dermoid cyst
hair, skin, gut, fat, ectoderm/mesoderm/endoderm
how are teratomas discovered
as an incidental finding
Tx of teratomas
excised from ovary
what classification of tumour is a teratoma
germ cell tumour
what are examples of germ cell tumours
immature or mature teratoma dysgenminoma yolks sac tumour choriocarcinoma mixed germ cell tumour
what is the most common malignant germ cell tumour
dysgenminoma
why is teratoma NOT the most common malignant germ cell tumour
they are 90% of the time benign
what may a teratoma produce
human chorionic gonadotrophin, alpha-fetoprotein or thyroxine
what is the most common germ cell tumour in children
yolk sac tumours
what are the stromal/sex cord tumours
fibroma/thecoma
granulosa cell tumour
Sertoli-Leydig Cell Tumourq
what are features of fibroma/thecoma
benign
may produce oestrogen causing uterine bleeding
what is a granulosa cell tumour characterised by
Call Exner bodies
what do granulosa cell tumour secrete
oestrogen
what do Sertoli-Leydig Cell Tumour secrete
androgens
how might a Sertoli-Leydig Cell Tumour present
Sx and signs of androgen excess = Hirsutism, acne, obesity, amenorrhea, alopecia, insulin resistance»_space; T2DM, anxiety, depression
