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Reproduction SB > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

ovarian cysts can arise from any element of the ovary - what are these elements

A 
Follicular 
Luteal
Endometriotic
Epithelial
Mesothelial
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2
Q

what is the most common type of ovarian cyst

A

Follicular

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3
Q

when can follicular cysts form

A

when ovulation doesn’t occur
(polycystic ovaries)
> follicle doesn’t rupture and grows until it becomes a cyst

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4
Q

what are the composition of follicular cyst

A

thin walled

lined by granulosa cells

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5
Q

Mx of follicular cyst

A

usually resolve over a few months

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6
Q

what is the staging of ovarian cancer

A

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

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7
Q

what are the two main splits of ovarian cancer

A

> 90% epithelial cell tumours of ovary

<10% germ cell, granulosa cell

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8
Q

what is the second most common type of ovarian cyst

A

luteal cysts

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9
Q

what are the risk factors for ovarian cancer

A 
> 50 y/o
nulliparity 
early menarche 
\+ve family history 
BRCA1 and BRCA2 mutation
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10
Q

what is the tumour markers of ovarian cancer

A

CA 125 = raised in 80% but normal level does not exclude cancer

CEA = moderately elevated esp in mucinous tumours

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11
Q

Sx of ovarian cancer

A

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

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12
Q

Ix of ovarian cancer

A

1st line = USS either transvaginal or abdominal

2nd line = CT [also used for staging]

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13
Q

Tx of ovarian cancer

A

Surgery [= hysterectomy, bilateral salpingo-oophorectomy] + Chemotherapy [= Carboplatin]

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14
Q

what is the most common epithelial cell ovarian tumour

A

serous carcinoma

- usually just in one ovary

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15
Q

how can serous carcinomas be split

A

high grade

low grade

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16
Q

what are the precursors for high grade and low grade serous carcinomas

A

High grade precursor = serous tubal intraepithelial carcinoma (STIC)

Low grade precursor = serous borderline tumour

17
Q

what are mucinous epithelial cells characterised by

A

mucin-filled cyst lined by columnar glandular cells

may be associated with tumours of the appendix

18
Q

what epithelial type of tumour are associated with uterine carcinomas in 20% of cases

A

endometrioid carcinomas

19
Q

what epithelial type of tumour are associated with ovarian endometriosis

A

clear-cell carcinomas

20
Q

what is a brenner tumour

A

tumour of transitional type epithelium in ovary

21
Q

what are teratomas

A

benign tumours developed from a dermoid cyst

22
Q

what can be contained in a dermoid cyst

A

hair, skin, gut, fat, ectoderm/mesoderm/endoderm

23
Q

how are teratomas discovered

A

as an incidental finding

24
Q

Tx of teratomas

A

excised from ovary

25
Q

what classification of tumour is a teratoma

A

germ cell tumour

26
Q

what are examples of germ cell tumours

A 
immature or mature teratoma
dysgenminoma
yolks sac tumour 
choriocarcinoma 
mixed germ cell tumour
27
Q

what is the most common malignant germ cell tumour

A

dysgenminoma

28
Q

why is teratoma NOT the most common malignant germ cell tumour

A

they are 90% of the time benign

29
Q

what may a teratoma produce

A

human chorionic gonadotrophin, alpha-fetoprotein or thyroxine

30
Q

what is the most common germ cell tumour in children

A

yolk sac tumours

31
Q

what are the stromal/sex cord tumours

A

fibroma/thecoma
granulosa cell tumour
Sertoli-Leydig Cell Tumourq

32
Q

what are features of fibroma/thecoma

A

benign

may produce oestrogen causing uterine bleeding

33
Q

what is a granulosa cell tumour characterised by

A

Call Exner bodies

34
Q

what do granulosa cell tumour secrete

A

oestrogen

35
Q

what do Sertoli-Leydig Cell Tumour secrete

A

androgens

36
Q

how might a Sertoli-Leydig Cell Tumour present

A

Sx and signs of androgen excess = Hirsutism, acne, obesity, amenorrhea, alopecia, insulin resistance&raquo_space; T2DM, anxiety, depression

Reproduction SB (30 decks)

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