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Reproduction SOH > Ovarian tumours > Flashcards

Ovarian tumours Flashcards

1
Q

More common in pre/post menopausal women?

A

Post-menopausal women

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2
Q

Ovarian cancer - Risk factors

A

Increasing age - over 50
Nulliparity
Delayed pregnancy
Family history of ovarian and breast cancer

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3
Q

Ovarian cancer - Genetics

A

BRCA 1 and 2

HNPCC (Lynch syndrome)

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4
Q

Ovarian cancer - clinical features

A 
Gradual symtoms 
Pelvic mass 
Persistent bloating 
Early satiety 
Abdominal pain 
Ascites 
Pressure symptoms (esp in bladder)
Change of bowel habit 
Weight loss 
Pleural effusion
SOB
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5
Q

Ovarian cancer often presents non-gynaecological. True or false?

A

True

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6
Q

Ovarian cancer - name 2 tumour markers

A

CA125

Carcino-embryonic antigen (CEA)

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7
Q

Normal levels of CA125 excludes ovarian cancer - true or false?

A

False

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8
Q

CA125 is raised in ovarian cancer ONLY. True or false?

A

False

- can be raised in other benign conditions such as endometriosis

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9
Q

Ovarian cancer - investigations

A 
Tumour markers 
- CA125
- CEA 
Imaging 
- Transvaginal/abdo US 
- CT
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10
Q

Ovarian cancer - investigations - US findings

A 
Complex mass with SOLID and CYSTIC area 
Multi-loculated 
Thick separations 
Associated ascites 
Bilateral disease
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11
Q

Ovarian cancer - investigations - what is the role of CT

A

Assess disease outwith the ovary

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12
Q

Screening is performed routinely for ovarian cancer. True or false?

A

False

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13
Q

Ovarian cancer - staging

A

FIGO stage

4 stages

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14
Q

Ovarian cancer - stage I

A

Confined to 1 or both ovaries
IA - cancer in one ovary
IB - cancer in both ovaries
IC - cancer in ovary and on the surface of one ovary

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15
Q

Ovarian cancer - stage II

A

Spread to other local pelvic organs e.g. uterus, fallopian tubes

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16
Q

Ovarian cancer - stage III

A

Spread beyond the pelvis within the abdomen

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17
Q

Ovarian cancer - stage IV

A

Spread into other organs e.g. liver, lungs

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18
Q

Ovarian cancer - management of treatable disease

A

Surgery

- bilateral salpino oophrectomy

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19
Q

Ovarian cancer - management of advanced disease

A

Surgery + Chemotherapy

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20
Q

What is the first line chemotherapy treatment of epithelial ovarian cancer?

A

Platinum agent

  • carboplatin
  • paclitaxel
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21
Q

Management of relapsed ovarian cancer in a platinum sensitive patient

A

Platinum based combination with paclitaxel, PLDH or gemcitabine

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22
Q

Management of relapsed ovarian cancer in a platinum resistant patient

A

Hormonal therapy

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23
Q

The OCP is protective against ovarian cancer. True or false?

A

True

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24
Q

If you have genetic testing and carry the BRCA mutation, what should you have removed?

A

Mastectomy
Take out ovaries
Take out fallopian tubes

25
Q

Primary ovarian tumours - where do the majority arise from?

A

Surface epithelium

26
Q

Primary ovarian tumours - Name 3 locations they can arise from?

A

Surface epithelium
Germ cells
Stroma

27
Q

Primary ovarian tumours - Epithelial tumours - subtypes (5)

A 
Serous 
Mucinous 
Endometrioid 
Clear cell
Brenner
28
Q

Primary ovarian tumours - Epithelial tumours - benign form

A

No cytological abnormalities
Proliferative activity absent
No stromal invasion

29
Q

Primary ovarian tumours - Epithelial tumours - brotherliness form

A

Cytological abnormalities
Proliferative activity
No stromal invasion

30
Q

Primary ovarian tumours - Epithelial tumours - malignant form

A

Stromal invasion

31
Q

Primary ovarian tumours - Germ cell tumours - benign

A

Benign cystic teratoma (dermoid cyst)

32
Q

Primary ovarian tumours - Germ cell tumours - malignant

A

Malignant germ cell tumours

33
Q

Primary ovarian tumours - Stromal tumours - if the are i the inner layer (granolas cells) then they are more/less likely to secrete oestrogen?

A

More

34
Q

Primary ovarian tumours - Epithelial tumours - what is the most common type of ovarian cancer?

A

Serous carcinoma

35
Q

Primary ovarian tumours - Epithelial tumours - endometrioid and clear cell

A

Most are low grade and early stage

- usually confined to ovary at presentation

36
Q

Primary ovarian tumours - Epithelial tumours - endometrioid and clear cell - associated conditions

A

Endometriosis of the ovary

Lynch syndrome

37
Q

Primary ovarian tumours - Epithelial tumours - brenner tumour is most commonly benign/malignant?

A

Benign

38
Q

Primary ovarian tumours - Epithelial tumours - brenner tumour - definition

A

Bengin tumour of transitional type epithelium

39
Q

Primary ovarian tumours - germ cell tumours - dermoid cyst

A

Can differentiate into anything

  • teeth
  • hair
  • sebaceous material
40
Q

Primary ovarian tumours - germ cell tumours - malignant germ cell tumours - who gets it ?

A

Young women and children

Very rare

41
Q

Primary ovarian tumours - stromal tumours - granulosa cell tumour - definition

A

May produce oestrogen

42
Q

Primary ovarian tumours - stromal tumours - granulosa cell tumour - clinical features

A

Precocious puberty

Post menopausal bleeding

43
Q

Primary ovarian tumours - stromal tumours - thecal tumour - definition

A

May produce androgens (testosterone)

44
Q

How does ovarian cancer commonly spread ?

A

Transperitoneal spread

  • ascites with protein exudate
  • omental disease/infiltration
  • peritoneal nodules
45
Q

Ovarian cancer - initial diagnosis is made by which imaging?

A

US

46
Q

What is the main risk factor

A

The number of times a woman ovulates

  • nulliparity
  • increased age
  • early menarche / late menopause
47
Q

COCP and ovarian cancer

A

COCP reduces risk of developing ovarian cancer

48
Q

What is HNPCC

A

lynch syndrome

49
Q

What is the most common type of ovarian cancer?

A

Serous tumour

50
Q

Which type of ovarian cancer has an association with lynch syndrome?

A

Endometrioid tumour

51
Q

Brenner tumour is a tumour of which type of epithelium

A

Transitional epithelium

52
Q

Benign ovarian tumour + pleural effusion + ascites

which condition does this make you think of?

A

Meig’s syndrome

53
Q

Germ cell tumours tend to affect older women/younger women ?

A

Younger

54
Q

65% germ cell tumours produce elevated

A

HcG and AFP

55
Q

if cancer extends or implants on uterus/fallopian tubes, what stage is it ?

A

Stage 2

56
Q

If cancer extends into the lining of the abdomen, what stage is it?

A

Stage 3A or 3B

57
Q

Mainstay of treatment of epithelial tumours in patients fit for surgery

A

Debulking surgery + chemotherapy

58
Q

Relapsed ovarian cancer, what is the treatment of choice?

A

Chemotherapy

Reproduction SOH (50 decks)

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