Ovarian Pathology

Question 1

what are the elements that ovarian cysts can arise from

Answer 1

Follicular e.g. polycystic ovaries 
Luteal 
Endometriotic 
Epithelial
Mesothelial

Question 2

most common type of ovarian cyst

Answer 2

follicular

Question 3

when can follicular cysts form

Answer 3

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

Question 4

what cells line follicular cysts

Answer 4

granulosa cells

Question 5

Management of follicular cysts

Answer 5

usually resolve after a few months

Question 6

what is endometriosis

Answer 6

endometrial glands + stroma outside the uterine body

Question 7

classic appearance of endometriosis cysts

Answer 7

chocolate cysts

Question 8

effects of endometriosis

Answer 8

Pelvic inflammation, infertility, pain, malignancy

Question 9

Staging of ovarian cancer

Answer 9

1- confined to 1 or both ovaries
2- spread to other local organs e.g. uterus, Fallopian tube
3- spread beyond the pelvis within the abdomen
4- spread into other organs.e.g liver, lung

Question 10

two main types of ovarian cancer

Answer 10

> 90% epithelial cell

<10% germ cell, granulosa cell

Question 11

second most common type of ovarian cyst

Answer 11

luteal cyst

Question 12

ovarian cancer risk factors

Answer 12

>50 years old
nulliparity (never had kids)
early menarche
\+ve family history 
BRCA1/BRCA2 mutation

Question 13

what marker is raised in 80% of ovarian cancers

Answer 13

CA 125

Question 14

Symptoms of ovarian cancer

Answer 14

persistent 'bloating'
abdo distension
early satiety 
weight loss
change in bowel habit 
fatigue 
abdo pain

Question 15

1st line investigation for ovarian cancer

Answer 15

transvaginal USS

Question 16

2nd line investigation for ovarian cancer

Answer 16

CT

Question 17

Treatment of ovarian cancer

Answer 17

surgery= hysterectomy, bilateral saplingo-oophorectomy + chemotherapy

Question 18

most common epithelial cell ovarian tumour

Answer 18

serous carcinoma

Question 19

how can ovarian serous carcinomas be split

Answer 19

high grade

low grade

Question 20

precursor for high grade serous carcinoma

Answer 20

Serous tubal intraepithelial carcinoma

Question 21

precursor for low grade serous carcinoma

Answer 21

serous borderline tumour

Question 22

what are mucinous epithelial cells characterised by

Answer 22

mucin filled cyst lined by columnar glandular cells

Question 23

what tumour is associated with ovarian endometriosis

Answer 23

clear cell carcinomas

Question 24

what is a Brenner tumour

Answer 24

tumour of transitional type epithelium in the ovary

Question 25

what are teratomas

Answer 25

benign tumours developed from a dermoid cyst

Question 26

what can be contained in a dermoid cyst

Answer 26

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

Question 27

how are teratomas discovered

Answer 27

incidental finding

Question 28

treatment of teratoma

Answer 28

excised from ovary

Question 29

most common malignant germ cell tumour

Answer 29

dysgenminoma

Question 30

why is teratoma not the most common germ cell tumour

Answer 30

they are benign 90% of the time

Question 31

what might a teratoma produce

Answer 31

AFP

HCG

Question 32

most common germ cell tumour in kids

Answer 32

yolk sac tumour

Question 33

what are the sex cord tumours

Answer 33

Fibroma/thecoma
granulosa cell tumour
sertoli-leydig cell tumours

Question 34

features of a fibroma/thecoma

Answer 34

benign

may produce oestrogen- uterine bleeding

Question 35

what is a granulosa cell tumour characterised by

Answer 35

Call Exner bodies

Question 36

what do granulosa cell tumours secrete

Answer 36

oestrogen

Question 37

what do sertoli-leydig cell tumours secrete

Answer 37

androgens

Question 38

presentation of sertoli-leydig tumour

Answer 38

Hirsutism, acne, obesity, amenorrhea, anxiety, alopecia