Ovarian Tumours

Question 1

What are the 4 types of ovarian tumours?

Answer 1

surface derived tumours
germ cell tumours
sex cord-stromal tumours
metastasis

Question 2

What are the 5 types of surface derived tumours?

Answer 2

Serous cystadenoma
Serous cystadenocarcinoma
Mucinous cystadenoma
Mucinous cystadenocarcinoma
Brenner tumour

Question 3

What is serous cystadenoma?

Answer 3

Most common benign ovarian tumour, often bilateral
Cyst lined by ciliated cells (similar to Fallopian tube)

Question 4

What is serous cystadenocarcinoma?

Answer 4

Malignant tumour
Often bilateral
Psammoma bodies seen (collection of calcium)

Question 5

What is mucinous cystadenoma?

Answer 5

Benign tumour
Cyst lined by mucous-secreting epithelium (similar to endocervix)

Question 6

What is mucinous cystadenocarcinoma?

Answer 6

Malignant tumour
May be associated with pseudomyxoma peritonei (although mucinous tumour of appendix is the more common cause)

Question 7

What is Brenner tumour?

Answer 7

Contain Walthard cell rests (benign cluster of epithelial cells), similar to transitional cell epithelium. Typically have ‘coffee bean’ nuclei.

Question 8

Who are germ cell tumours seen in?

Answer 8

More common in adolescent girls and are account for 15-20% of tumours. Similar cancer types to those seen in the testicle.

Question 9

What are the 4 types of germ cell tumours?

Answer 9

Teratoma, dysgerminoma, yolk sac tumour and choriocarcinoma

Question 10

What is a teratoma?

Answer 10

Most commonly benign (mature teratoma/dermoid cyst)
Immature teratoma is malignant
Account for 90% of germ cell tumours
Contain a combination of ectodermal (e.g. hair), mesodermal (e.g. bone) and endodermal tissue

Question 11

What is a dysgerminoma?

Answer 11

Most common malignant germ cell tumour
Histological appearance similar to that of testicular seminoma
Associated with Turner’s syndrome
Typically secrete hCG and LDH

Question 12

What is a yolk sac tumour?

Answer 12

Malignant tumour
Typically secrete AFP
Schiller-Duval bodies on histology are pathognomonic

Question 13

What is a choriocarcinoma?

Answer 13

Malignant tumour
Rare tumour that is part of the spectrum gestational trophoblastic disease
Typically have increased hCG levels
Often characterised by early haematogenous spread to the lungs

Question 14

What are the 3 types of sex-cord stromal tumours?

Answer 14

Granulosa cell tumour
Sertoli-Leydig cell tumour
Fibroma

Question 15

What is a granulosa cell tumour?

Answer 15

Malignant tumour
Produces oestrogen leading to precocious puberty if in children or endometrial hyperplasia in adults.
Contains Call-Exner bodies (small eosinophilic fluid-filled spaces between granulosa cells)

Question 16

What is a Sertoli-Leydig cell tumour?

Answer 16

Benign tumour
Produces androgens → masculinizing effects
Associated with Peutz-Jegher syndrome

Question 17

What is a fibroma?

Answer 17

Benign tumour
Associated with Meigs’ syndrome (ascites, pleural effusion)
Solid tumour consisting of bundles of spindle-shaped fibroblasts
Typically occur around the menopause, classically causing a pulling sensation in the pelvis

Question 18

What is a Krukenberg tumour?

Answer 18

Malignant tumour
Metastases from a gastrointestinal tumour resulting in a mucin-secreting signet-ring cell adenocarcinoma