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reproductive > ovary > Flashcards

ovary Flashcards

1
Q
  • Common cause of pelvic pain in women
  • Can lead to emergency room visits
  • Any growth on the ovary can cause pain
A

ovarian cysts

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2
Q

presentation of ovarian cysts

A

unilateral lower quandrant pain and it can be achy/crampy pain due to the stretching of ovarian capsule

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3
Q

functional cysts

A

most common cysts found on ovary, most rupture or get reabsorbed and no intervention is needed

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4
Q

Serous cystadenomas and Mucinous cystadenomas

A

bigger than functional cysts

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5
Q

ultrasound on ruptured ovarian cyst

A

peritoneal signs from free fluid

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6
Q

ultrasound on ovarian torsion

A

Ovary twists on its own pedicle disrupting blood supply

N/V accompanies pain

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7
Q

Ovarian cysts are COMMON in early pregnancy

A

yep

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8
Q

Precursor lesion for a majority of high-grade pelvic cancers

A

Serous Tubal Intraepithelial Carcinoma (STIC)

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9
Q

Ovarian surface epithelium hypothesis

A

chronic ovulation and inflammation/repair from endometriosis

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10
Q

ovarian risk of cancer

A

1/70 risk

  • infertility
  • early menarche
  • Lynch
  • environmental exposures such a high fat diet
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11
Q

ovarian cancer protective factors (3)

A
  1. tubal ligation and salpingectomy
  2. pregnancy
  3. OCPs
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12
Q

ovarian cancer often produce

A

a lot of fluid thus we see a lot of ascites

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13
Q

tumor markers for ovarian cancer

A

CA-125

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14
Q

CA-125 is a helpful test for

A

women that are post-menopausal and present with a pelvic mass

  • do not use this as a screening test- may be elevated due to other disorders
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15
Q

ovarian cancer spread

A

it spreads through the pelvic and abdominal viscera

  • there is also lymphatic dissemination
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16
Q

treatment of ovarian cancer

A

surgery to debulk and chemo

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17
Q

ovarian cancer prognosis

A

survival cancer depends on age and stage with younger age have a better prognosis

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18
Q

97% of GC tumors are such as mature teratomas

A

benign and more common in young women

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19
Q

tumor marker:

HCG

A

choriocarcinoma

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20
Q

tumor marker:

AFP:

A

yolk sac tumors

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21
Q

tumor marker:

LDH:

A

dysgerminoma

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22
Q

treatment for germ cell ovarina cancer

A

fertility sparing surgery

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23
Q

8% of all ovarian tumors
Arise from gonadal stroma and/or sex cords
“Female” (stromal and granulosa cells)
“Male” (Sertoli and Leydig cells)
Disease confined to ovary (stage 1) in 70%

A

sex cod-stroma ovarian cancer

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24
Q

cysts are are lined by follicle and theca cells. most regress spontaneously and it may be an incidental finding. occurs in reproductive age group

A

follicular cysts

25
Q

grnaulosa layer contains

A

aromatase

26
Q

cyst wall is composed of luteinized granulosa cells that may be assoicated with menstrual irregularities results from delayed resolution of the physciological corpus luteum and occur in the reproductive group

A

corpus luteum cyst

27
Q

Microscopically, the cyst wall is composed of endometrial-type glands, stroma and hemorrhage/hemosiderin. The cyst content is often thick altered blood, which gives the cyst its descriptive name of “chocolate cyst”.

A

endrometriotic cyst

28
Q

entrapped surface epithelium froming cyst

A

epithelial inclusion cysts

29
Q

ovarian tumors are usually ____ and there is a higher incidence of malignancy in _____

A

usually benign and higher incidence of malignancy in older patients

30
Q

most common type of tumor of the ovary

A

epithelial (70%) and 90% of the malignant tumors are epithelial

31
Q

These tumors arise from the surface epithelium of the ovary, or from surface epithelial inclusions within the ovarian cortex.

a. tubal type epithelium
b. endocervical type epithelium
c. endometrial type epithelium
d. secretory type endometrial epithelium
e. transitional type epithelium.

A

a. Serous: tubal type epithelium
b. Mucinous: endocervical type epithelium
c. Endometrioid: endometrial type epithelium
d. Clear cell tumors: secretory type endometrial epithelium
e. Transitional cell/Brenner: transitional type epithelium.

32
Q

Surface epithelial tumors show morphology similar to that found in the fallopian tube, endometrium and cervix, and thus recapitulate the cell types formed by the ____________

A

Mullerian duct

33
Q

risk factors for surface epithelial tumros

A
  1. genetics: BRCA1/2 and Lynch

2. increased ovulation

34
Q

Surface epithelial tumors may be

A

Benign
Borderline
Malignant

35
Q

Unilocular cysts, (up to 30cm in diameter)
Lined by tubal type epithelium
Contain thin clear serous fluid

A

cystadenoma- serous tumor that is benign

36
Q

Borderline serous tumors have a more _____ configuration, with _____ of high complexity,
But there is no ____________.

A

Borderline serous tumors have a more papillary configuration, with papillae of high complexity,
But there is no stromal invasion.

37
Q

serous tumors that are malignant are derived from

A

Serous Tubal Intraepithelial Carcinoma (STIC) cells of the fallopian tube, which drop off onto the ovary.

38
Q

calcified spherules found any papillary tumor,

common in serous carcinoma

A

psammoma bodies

39
Q

Usually malignant
Associated with endometriosis, and probably derive from foci of endometriosis
15% are associated with adenocarcinoma of the uterine endometrium

A

endometrioid tumors

40
Q
  • Occur in a young age group
  • Most are mature cystic teratomas (dermoid cysts), which are benign, and occur at a peak age of 20-30 years.
  • The other tumors are malignant and occur in children/young adults.
A

germ cell tumors

41
Q

Germ cell tumors derive from _______, some of which may have potential for further differentiation.

A

germ cells

42
Q

A neoplasm with differentiation towards somatic structures, containing tissue from two or all three of the embryonic layers (ectoderm, endoderm, mesoderm).

A

teratoma

43
Q
  • Also called a dermoid cyst
  • One of the most common ovarian tumors
  • Its peak incidence is in the 20-30 years age group.
A

mature teratoma

44
Q
  • Contains some embryonal tissues (immature elements), as well as the mature tissues. The most common immature element is neuroepithelium.
  • Malignant tumor
A

immature teratoma

45
Q
  • Most common malignant germ cell tumor.
  • They are generally are of low stage, are radiosensitive, and have an excellent prognosis.
  • They occur mostly in young adults.
  • This tumor is similar to the seminoma of the testis and the germinoma of the CNS/mediastinum.
A

dysgerminoma

46
Q
  • The least differentiated germ cell tumor
  • This is a highly malignant tumor
  • Has potential for differentiating towards endodermal sinus tumors, choriocarcinomas or teratomas.
A

embryonal carcinoma

47
Q
  • This is a highly malignant tumor,
  • Characteristic histology is the glomeruloid body (Schiller-Duval body)
  • Tumor characteristically produces Alpha Feto Protein (AFP)
    Detected in the serum, (and used for diagnosis and monitoring of therapy)
    Identified immunohistochemically in the tumor cells as a marker of this tumor
A

yolk sac tumor- endodermal sinus tumor

48
Q
  • A highly malignant tumor.
  • It metastasizes widely via the blood stream.
  • Two types: gestational and ovarian
  • Composed of malignant cytotrophoblast and syncytiotrophoblast
  • Produces human chorionic gonadotrophin (HCG)
    Detected in the serum
    Identified immunohistochemically in the tumor cells as a marker of the tumor
A

choriocarcinoma

49
Q

Stromal cells include (3)

A

fibroblasts, theca cells and Leydig cells.

50
Q

non-estrogenic granulosa stromal tumors

A

fibroma

51
Q
  • This is the most common of the stromal tumors.
  • Peri-menopausal age group
  • Present with a mass or ascites, especially in larger tumors
  • Meig’s syndrome (ovarian tumor, ascites and pleural effusion) is a classic but rare presentation.
  • They are benign, look like fibroids, and are composed of fibroblasts.
A

fibroma

52
Q

They differ from fibromas in that they are functional, and produce estrogen.

A

thecoma

53
Q

estrogenic side effects seen in thecoma

A
  1. abnl. uterine bleeding
  2. endometrial hyperplasia
  3. carcinoma
  4. breast cnacer
54
Q

Thecomas are _____, and arise in _____women.

These tumors have a ______ color due to the stomal theca cell accumulation of lipid.

A

Thecomas are benign, and arise in postmenopausal women.

These tumors have a yellowish color due to the stomal theca cell accumulation of lipid.

55
Q

The tumor is malignant.
Occur mainly in postmenopausal patients
Are often functional, producing estrogen

have a typical grooved nucleus (“coffee bean”)
Form small rosettes, which recapitulate immature follicles (“Call-Exner bodies”).

A

granulosa cell tumor

56
Q

Extremely rare
They occur typically in young women.
They are usually benign.
They are functional, and produce androgen.

A

sertoli stromal tumors

57
Q

Some ____% of ovarian malignant tumors are metastatic from other sites.

A

5-10

58
Q

The classic metastatic ovary tumor is the _________ tumor, which is bilateral metastatic gastric signet cell carcinoma.

A

Krukenberg

reproductive (27 decks)

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