Ovary Pathology Flashcards
clinical presentation of serous adenocarcinoma
- MC type of ovarian cancer
- 60% bilateral
- Postmenopausal women (mean age 63)
- Abdominal pain
- Abdominal distension
- Dysuria
- Early satiety***
- Constipation
- Diarrhea
- Nausea/vomiting
cystoadenomas
- Benign
- Very common
- Smooth, glistening cyst wall
- Unilocular or multi-locular
- Variable size from 4 -30 cm
- 15-20% bilateral
- Single layer of columnar, ciliated tubal-like epithelium
- Cystic lesions with papillary projections
- Filled with clear, serous fluid
Cystadenofibromas
- Benign
- Cystic and solid neoplasms
- Less common than cystadenomas
Follicular cyst
- Very common
- Reproductive age
- Follicular cysts arise when rupture fails
- Unilocular, smooth, thin walled, fluid filled
- Asymptomatic
- Generally, resolve without intervention within 2 months
Corpus luteal cyst
- Cysts occur when corpus luteum fails to involute and continues to enlarge
- More complex on ultrasound
- Lined by luteinizing granulosa cells
Endometrioma
- Sequelae of endometriosis
- “Chocolate” cyst
- Ground glass, homogenous appearance, increased echogenicity on ultrasound
- Management based on patient goals (infertility, sx)
mean age for serous adenocarcinoma
63 (postmenopausal women)
Mucinous adenocarcinoma
- Primary mucinous ovarian carcinomas are rare
- Majority are stage I (65%)
- Clinical presentation: Large pelvic mass and abdominal distension
Endometrioid adenocarcinoma
- Common - 20% of all malignant ovarian tumors**
- Solid and cystic with friable soft masses, bloody fluid
- May have vaginal bleeding due to associated endometrial changes: 15% will have endometrial cancer of uterus present as well; Endometrial hyperplasia
- Bilateral 40% of patients
Clear cell adenocarcinoma
- 30-35% may be associated with endometriosis
- Mean age 57 years
- Most common neoplasm to be associated with paraneoplastic hypercalcemia
- Tumor size 15-30 cm
What is the MC type of ovarian CA?
serous adenocarcinoma
which ovarian neoplasm is associated with paraneoplastic hypercalcemia?
clear cell adenocarcinoma
which ovarian cancers are associated with p53 mutations?
serous adenocarcinoma
which ovarian cancers are associated with BRCA 1 genes?
serous adenocarcinoma
Mature cystic teratoma
- Most common ovarian neoplasm in reproductive age women
- Often discovered incidentally: Torsion or rupture
- Unilocular cysts with hair, teeth, and sebaceous material
- Bilateral in 10-15% cases
- Surgically excised if symptomatic
- Fertility preservation if possible
- 1% undergo malignant transformation
MC ovarian neoplasm in reproductive age females
ovarian teratomas
which other primary cancers are most likely to metastasize to the ovary?
- Breast
- GI: Colon, stomach, hepatobiliary, pancreas, appendix
- Uterus
- Fallopian tube
Krukenberg tumor
a metastatic lesion most typically from a gastric cancer
role of CA-125 in ovarian cancer
(not a lot of info in his slides)
- can be used as a diagnostic tool in a serous adenocarcinoma
- it is not specific enough to be a good test but can be useful when a pelvic mass is present and you need to get a baseline
