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Erin Y3 - Reproduction > Ovarian Tumours > Flashcards

Ovarian Tumours Flashcards

1
Q

Types of ovarian tumours

A

Epithelial
Germ cell
Sex cord/stromal
Metastatic

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2
Q

Where do metastatic ovarian tumours come from?

A

GI tract
Breast
Pancreas
Endometrium

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3
Q

Features of metastatic ovarian tumours

A

Bilateral and small

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4
Q

Presentation of ovarian cancer

A 
Presents late
Non-specific symptoms
Bloating
Early satiety
New onset IBS >50 = think about ovarian cancer
Ascites
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5
Q

Peak age of ovarian cancer

A

75

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6
Q

Risk factors for ovarian cancer

A

↑Number of ovulations: early menarche, late menopause, nulliparity
Genetics: family history (relative <50yrs), Lynch syndrome, BRCA1, BRCA2
Endometriosis

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7
Q

Protective factors against ovarian cancer

A

COC
Breastfeeding
Pregnancy

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8
Q

Investigations for ovarian cancer

A 
CA125 (is raised in 80% of ovarian cancers)
Pelvic ultrasound
CA125:CEA
RMI (risk of malignancy index)
CXR/CT
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9
Q

What is CA125:CEA ratio used for?

A 
Higher ratio (>30) = more likely to be ovarian origin
Lower ratio (<30)  = primary elsewhere (e.g. GI)
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10
Q

How do you calculate RMI?

A

CA125 level x US score x menopausal score

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11
Q

Where can ovarian cancer spread?

A 
Peritoneum
Para-aortic nodes
Liver
Lungs
Bone
Brain
Greater omentum (epithelial cancer spread)
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12
Q

Treatment of ovarian cancer

A

Surgery + adjuvant chemotherapy

debulking surgery + carcoplatin + paclitaxel

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13
Q

What additional tests are done in women <40 with suspected ovarian cancer?

A

Additional tumour markers to look for germ cell tumours:
alpha foeto-protein
LDH (serum lactic dehydrogenase)
hCG

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14
Q

Why is chemotherapy not used for borderline ovarian tumours?

A

Because they are slow growing

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15
Q

What are the characteristics of borderline ovarian tumours?

A

Does not invade the stroma but has malignant characteristics

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16
Q

Types of epithelial ovarian tumours

A 
Serous
Endometrioid
Clear cell
Mucinous
Urothelial-like/Brenner
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17
Q

Types of serous carcinoma

A

High grade serous carcinoma

Low grade serous carcinoma

18
Q

Precursor for high grade serous carcinoma

A

Serous tubal intraepithelial carcinoma

19
Q

Precursor for low grade serous carcinoma

A

Serous borderline tumour

20
Q

What ovarian cancers are associated with ovarian endometriosis and Lynch syndrome?

A

Endometroid

Clear cell

21
Q

What is the most common ovarian cancer?

A

Serous carcinoma

22
Q

Which epithelial ovarian tumours are often benign?

A

Mucinous

Urothelial-like/Brenner

23
Q

What age group do germ cell ovarian tumours commonly affect?

A

Affect children/young women

24
Q

Types of germ cell ovarian tumours

A 
Mature cystic teratoma (dermoid cyst)
Immature teratoma
Dysgerminoma
Yolk sac/endodermal sinus tumour
Choriocarcinoma
25
Q

Most common germ cell tumour of the ovary

A

Mature cystic teratoma (dermoid cyst)

26
Q

Most common malignant germ cell tumour

A

Dysgerminoma

27
Q

Why can dermoid cysts contain teeth, hair and skin?

A

Made of pluripotent cells

28
Q

Types of sex cord/stromal ovarian tumours

A

Fibroma/thecoma
Granulosa cell tumour
Sertoli-Leydig cell tumour

29
Q

Which ovarian tumour is associated with Meigs syndrome?

A

Fibroma/thecoma

30
Q

What is Meigs syndrome?

A

Benign ovarian tumour + ascites + pleural effusion

31
Q

Which sex cord/stromal ovarian tumour secretes oestrogen?

A

Granuloma cell tumour

can cause abnormal bleeding, precocious pseudopuberty, endometrial cancer

32
Q

Which sex cord/stromal ovarian tumour has exner bodies?

A

Granulosa cell tumour

33
Q

Which sex cord/stromal ovarian tumour can produce androgens?

A

Sertoli-Leydig cell tumour

34
Q

Stage 1A ovarian cancer

A

Tumour limited to one ovary

35
Q

Stage 1B ovarian cancer

A

Tumour limited to both ovaries

36
Q

Stage 1C ovarian cancer

A

Cancer involving ovarian surface/rupture/surgical spill/tumour in washings

37
Q

Stage 2A ovarian cancer

A

Extension or implants on uterus/uterine tube

38
Q

Stage 2B ovarian cancer

A

Extension to other pelvic intraperitoneal structures

39
Q

Stage 3A ovarian cancer

A

Microscopic extrapelvic peritoneal involvement

40
Q

Stage 3B ovarian cancer

A

Macroscopic peritoneal metastasis beyond the pelvis >2cm in dimension

41
Q

Stage 3C ovarian cancer

A

Macroscopic peritoneal metastasis beyond the pelvis >2cm in dimension, and involvement of pelvic/para-aortic lymph nodes

42
Q

Stage 4 ovarian cancer

A

Distant metastases

Erin Y3 - Reproduction (9 decks)

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