Ovarian Pathology

Question 1

what families are at high risk of ovarian cancer?

Answer 1

> HNPCC
BRAC 1/2
lynch type 2 familial cancer

Question 2

ovarian cysts can give rise to high or low grade ovarian cancer?

Answer 2

low grade

Question 3

what are the symptoms of ovarian cancer?

Answer 3

> pelvic mass (pressure symptoms/asymptomatic)
> weight gain
> bloating
> altered bowel habit
> early satiety
> pain
> indigestion

Question 4

how is ovarian cancer diagnosed?

Answer 4

> ultrasound scan of the abdomen or pelvis
CT scan
CA125 (glycoprotein antigen)

Question 5

what malignancies is CA125 (cancer associated antigen) seen in?

Answer 5

> breast cancer
pancreatic cancer
colon cancer
ovarian cancer

Question 6

what benign conditions if CA125 seen in?

Answer 6

> liver disease
> menstruation
> endometriosis
> pelvic inflammatory disease
> recent surgery

Question 7

how is the risk of malignancy calculated in ovarian cancer?

Answer 7

> ultrasound features
 - ascites
 - bilateral
 - solid areas
 - multi locular
> menopausal status
> CA125 levels

Question 8

describe stage one ovarian cancer

Answer 8

limited to the ovaries with the capsule intact

Question 9

describe stage 2 ovarian cancer

Answer 9

in one or two of the ovaries with pelvic expansion

Question 10

describe stage 3 ovarian cancer

Answer 10

1/2 ovaries with peritoneal implants outside the pelvis plus nodes

Question 11

what is stage 4 ovarian cancer?

Answer 11

distant metastasis

Question 12

what is the management for ovarian cancer?

Answer 12

> laparotomy
 - staging and tissue diagnosis
 - disease clearance
 - debulking
> chemotherapy
 - platinum +taxane
 - within 8 weeks of surgery

Question 13

what is the prognosis of stage 1 ovarian cancer?

Answer 13

88%

Question 14

what is the prognosis of stage 2 ovarian cancer?

Answer 14

47%

Question 15

what is the prognosis of stage 3 ovarian cancer?

Answer 15

15%

Question 16

what is the prognosis of stage 4 ovarian cancer?

Answer 16

10%

Question 17

what women are screened for ovarian cancer?

Answer 17

high risk women
> mutations
> prophylactic oophorectomy
> 2 or more relatives have the disease

Question 18

what screening test is available for ovarian cancer?

Answer 18

> pelvic exam
ultrasound of the ovaries
CA 125

Question 19

true or false

benign ovarian cysts are unilocalaur with and intact smooth surface

Answer 19

true

Question 20

what is the pathology of borderline ovarian cysts?

Answer 20

> serous cyst adenoma (papillary cysts cause ascites)

Question 21

what is the management of borderline ovarian cysts?

Answer 21

resection (but malignancy can recur)