Ovary and fallopian tube

Question 1

What is presentation of PID?

What is the cause

Complication?

Answer 1

Fever, lower abdo/pelvic pain. Deep dyspareunia. Define as infection of the upper genital tract.

Ascending infection from STI e.g. chlamydia, gonorrhoea.

Salpingitis is an example

can lead to tubo-ovarian masses due to ovarian infection, which can rupture and cause sepsis.
Can lead to ectopic pregnancy which can cause haemorrhage.

Question 2

What cancers are there of the fallopian tube?

Answer 2

Papillary serous carcinoma

Endometroid carcinoma

Question 3

What is serous tubal intraepithelial carcinoma?

Answer 3

Precursor for high grade serous carcinoma, is in situ.

Question 4

What are the key mutations in HGSC?

Answer 4

p53 and BRCA1

Question 5

What are the key mutations in LGSC?

Answer 5

KRAS and BRAF

Question 6

What are the main differences in surface epithelial tumours?

Answer 6

Serous -contains fluid, has borderline middle one. Psammoma bodies

Mucinous - mucin secreting cells, borderline middle on. Older people. Looks like Krukenburg. No psammoma bodies

Endometroid - usually malignant, can be chocolate cyst which is benign. Often lost PTEN.

Clear cell - ass with endometriosis.

Question 7

What are germ cell tumours?

Answer 7

Teratoma, present in young people as ovarian masses,. immature are more aggressive and prone to torsion which can be an emergency.

Question 8

What are sex cord stromal tumours?

Answer 8

Rare, either granulosa or theca cell, or Sertoli or Leydig. Granulosa can make oestrogen and lead to endometrioid carcinoma.

Benign: fibroma and thecoma

Question 9

What is Meig’s syndrome

Answer 9

Ovarian fibroma + pleural effusion. Removing tumour solves problem.