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ovarian tumours Flashcards

1
Q

what are the three main subtypes of ovarian tumour

A

epithelial
germ cell
stromal/sex cord

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2
Q

what are the main types of epithelial ovarian tumour

A 
serous 
mucinous 
endometrioid
transitional (Brenner)
clear cell
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3
Q

what are the main types of sex cord/stromal tumours

A 
theca
fibroma 
fibrothecoma 
sertoli cell
leydig cell
granulosa cell
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4
Q

what are the main types of germ cell ovarian tumour

A 
teratoma 
dysgerminoma 
choriocarcinoma 
yolk sac 
embryonal
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5
Q

what is the commonest type of ovarian tumour

A

epithelial

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6
Q

what is commonest epithelial ovarian tumour

A

serous tumour

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7
Q

are serous ovarian tumour most commonly malignant or benign

A

benign (60%)
borderline (15%)
malignant (25%)

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8
Q

malignant serous carcinoma occurs in which age group

A

older patients

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9
Q

serous ovarian tumour are histologically similar to

A

normal fallopian tubal epithelium

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10
Q

how are serous ovarian tumours classified

A

benign: no cellular proliferation or invasion
borderline: cellular proliferation and minor nuclear atypia without invasion
malignant: cellular proliferation and nuclear atypia and stroll invasion

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11
Q

radiographic features of serous ovarian tumours

A

unilocular (single cyst)
homogenous
bilateral
psammomatous calcification

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12
Q

what features suggest malignancy over benign cystic neoplasia

A 
large cystic mass
thick irregular walls and septa 
papillary projections 
large soft tissue component
ascites 
evidence of invasive spread or adenopathy
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13
Q

radiographic features of mucinous tumours

A

larger than serous
multilocular with small cystic components
calcification not very common
unilateral

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14
Q

endometrioid tumours tend to be benign/malignant

A

malignant

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15
Q

‘appearance of tubular glands and bears a strong resemblance to the endometrium’

A

endometrioid tumour

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16
Q

gross morphological appearance of endometrioid tumour

A

mass with solid and cystic areas

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17
Q

peak age for clear cell tumour

A

55 years

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18
Q

gross appearance of clear cell tumour

A

large unilocular cystic mass with protruding solid nodules

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19
Q

are clear cell tumours more likely to be benign or malignant

A

malignant

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20
Q

are mucinous tumours likely to be benign or malignant

A

benign

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21
Q

Brenner cell tumour re histologically similar to which other type of epithelium

A

urothelium (transitional)

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22
Q

radiographic features of Brenner tumour

A

multilocular cystic mass with solid component or mostly solid mass

usually small

often lack of invasion

calcification is common

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23
Q

are Brenner tumour mostly benign or malignant

A

benign

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24
Q

germ cell tumours are more common in which age group

A

children and adolescents

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25
what is the commonest primary benign tumour of the ovary and commonest germ cell tumour
teratoma
26
what are the two main subtypes of teratoma
mature | immature
27
mature ovarian teratoma is also known as
dermoid cyst
28
teratomas are best assessed with which imaging modality
USS
29
clinical presentation of mature teratoma
tend to be asymptomatic can predispose to ovarian torsion (acute pelvic pain)
30
what are the criteria of a teratoma
well-differentiated derivations from at least two of; ectoderm mesoderm endoderm
31
how do teratomas appear on USS
cystic adnexal mass with some mural components
32
at which point is resection of mature teratoma recommended
7 cm
33
complications of mature teratoma
ovarian torsion rupture malignant transformation (SCC) superimposed infection
34
immature teratoma are most common in which age group
first two decades
35
how do immature teratomas differ from mature teratomas
presence of immature or embryonic tissue more immature tissue = higher grade
36
macroscopic appearance of immature teratoma
large, encapsulated mass with prominent solid component features such as hair, cartilage, bone, calcification
37
which markers are associated with immature teratoma
elevated serum AFP
38
where can immature teratomas metastasise to
peritoneum, liver, lung
39
treatment of immature teratoma
oophorectomy | post-op chemo if distant mets
40
what is the most common malignant germ cell tumour
dysgerminoma
41
dysgerminomas typically affect which age group
2nd-3rd decade
42
macroscopic appearance of dysgerminoma
solid | multilobulated
43
yolk sac tumour affect which age group
2nd decade
44
macroscopic appearance of yolk sac tumour
well-encapsulate round to oval mass
45
markers associated with yolk sac tumours
AFP
46
radiographic features of yolk sac tumour
large, complex pelvic mass that extends into the abdomen contains solid and cystic components
47
prognosis of yolk sac tumour
early lymphatic spread and invasion fast growing
48
are yolk sac tumours benign or malignant
malignant
49
are embryonal tumours benign or malignant
malignant
50
average age of embryonal tumour
14 years
51
clinical presentation of embryonal tumour
precocious puberty | menstrual irregularity
52
markers for embryonal tumour
b-hCG | AFP
53
treatment of embryonal tumour
salpingo-oophrxectomy and chemo
54
choriocarcinoma are formed from what type of tissue
placental trophoblastic tissue
55
choriocarcinoma most commonly occur during
pregnancy
56
gestational choriocarcinoma show what kind of spread
haematogenous
57
radiographic features of choriocarcinoma
vascular solid tumours with cystic, haemorrhage and necrotic areas
58
what is the mainstay of treatment of choriocarcinoma
chemo
59
are fibromas benign or malignant
benign
60
what age group get fibroma
middle aged
61
fibromas are composed of what cell type
spindle cells forming variable amounts of collagen
62
appearance of fibroma
chalky-white surface with a whorled appearance similar to fibrosis
63
what is Meigs syndrome
ovarian fibroma with ascites and pleural effusion
64
fibrothecoma occur in which age group
mostly postmenopausal women
65
why might a patient with fibrothecoma present with abnormal bleeding and endometrial hyperplasia
theca component of tumour can produce oestrogen
66
what types of tissue are in a fibrothecoma
fibrous tissue | thecal cells
67
why are thecomas described as functional ovarian tumours
they secrete oestrogen
68
thecfmas affect which age group
postmenopausal women
69
clinical presentation of thecoma
uterine bleeding
70
microscopic appearance of thecoma
swollen lipid-laden stromal cells with a small component of fibroblasts
71
sertoli-leydig tumours present in which age group
<30 | mean age 14
72
clinical presentation
virilisation | abdominal pain/mass
73
clinical presentation of granulosa cell tumour
nonspecific symptoms (abdo pain, distension, bloating) uterine bleeding
74
granulosa cell tumours secrete...
oestrogen inhibin mullerian inhibiting substance
75
granulosa cell tumours may be associated with...
endometrial hyperplasia endometrial polyps endometrial carcinoma
76
CA-125 is elevated in...
most ovarian malignancies
77
AFP levels are elevated in...
immature ovarian teratomas yolk sac tumours
78
b=HCG is raised in...
some dysgerminomas
79
genetic predispositions to ovarian cancer
BRCA1/2 | Lynch syndrome
80
stage 1 ovarian cancer
limited to ovaries 1a: one ovary 1b: two ovaries 1c: 1/2 ovaries with rupture/surface spread
81
stage 2 ovarian cancer
one or both ovaries with pelvic extension 2a: extension to uterus/Fallopian tubes 2b: other pelvic intraperitoneal tissues
82
stage 3 ovarian cancer
1/2 ovaries or Fallopian tubes with spread to peritoneum outside the pelvis/mets to retroperitoneal nodes 3a: nodes only 3b: mets <2 cm 3c: mets >2 cm
83
stage 4 ovarian cancer
distant mets 4a: pleural effusion 4b: distant mets

3 REPRO (40 decks)

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