Ovary Witrak Flashcards
What causes Polycystic Ovarian Syndrome (PCOS)?
Don’t know…it is thought to maybe be hypothalamic or pituitary malfunction
What are some characteristics of PCOS?
Menstrual irregularity
Hyperandrogenism
What are some of the potential downstream effects of the menstrual irregularity seen with PCOS?
Anovulation → chronic/sustained estrogen effect → increased risk of endometrial hyperplasia/carcinoma
What are some of the potential downstream effects of the hyperandrogenism seen with PCOS?
Hyperandrogenism → Hirsutism, acne, and male pattern balding
What are some associations of PCOS?
Enlarged ovaries with polycystic features
Obesity
Insulin resistance/Diabetes
A transvaginal ultrasound is performed on a patient, and polycystic ovaries are seen. Is this enough to diagnose this patient with PCOS?
NO…polycystic ovaries can be seen in normal women
What are the potential ovarian tumor origins?
Ovarian surface (Mullerian) epithelium
Sex cord/stromal cells
Germ Cells
Metastatic from somewhere else
What origin of ovarian tumors occurs most often?
Ovarian surface (Mullerian) epithelium
What are the two main types of Mullerian epithelium ovarian tumors?
Serous
Mucinous
Do serous tumors tend to be unilateral or bilateral?
Serous tend to be bilateral
Do mucinous tumors tend to be unilateral or bilateral?
Mucinous tend to be unilateral
What is the most common cause of GYN cancer death?
Epithelial ovarian carcinoma
What familial cancer syndromes are associated with epithelium ovarian carcinoma?
BRCA1 (35-46%)
BRCA2 (13-23%)
Lynch (3-14%)
What cancer marker is associated with epithelial ovarian carcinoma?
CA-125
How is CA-125 used?
Used to follow for tumor recurrence and to monitor treatment
Are sex cord/stromal cell ovarian tumors usually bad?
Not really…usually low grade/stage and are surgically curable
Rarely reoccur or metastasize
What are three types of sex cord/stromal cell ovarian tumors?
Fibroma/thecoma
Granulosa cell tumors
Sertoli/Leydig cell
What type of sex cord/stromal cell ovarian tumors is most common?
Fibroma/thecoma (70%)
What is often seen with fibroma?
Large tumors
Ascites and pleural effusion (Meig’s syndrome)
What type of sex cord/stromal cell ovarian tumor most commonly causes neoplastic estrogen excess?
Granulosa cell tumor…makes sense…
Are sex cord/stromal cell tumors typically unilateral or bilateral?
Sex cord/stromal cell tumors are typically unilateral
What is the average age of diagnosis with a sex cord tumor?
50 (12% < 30)
What are the symptoms associated with sex cord tumors?
Adrenal mass/pelvic displacement Precocious puberty Abnormal uterine bleeding Endometrial hyperplasia/CA Hirsutism/overt virilization
What markers can by used for stromal cell tumors?
Estrogen
Androgen
Inhibin
What category of ovarian tumors makes up 70% of ovarian neoplasms in 10-30yo women?
Germ Cell Tumors (GCTs)
What is an example of a benign GCT?
Mature cystic teratoma (majority of germ cell tumors)
Are mature cystic teratomas typically unilateral or bilateral?
Mature cystic teratomas are bilateral 10-12% of the time
What is the female equivalent of testicular seminoma?
Dysgerminoma
Is dysgerminoma usually bad?
Make up 33% of all malignant GCTs
Rarely aggressive
What do dysgerminoma cells resemble? (Pathoma)
Oocytes…large cells with clear cytoplasm and central nuclei
Yolk sac (endodermal sinus) tumors are also malignant, but they tend to be more AGGRESSIVE. Who usually develops these tumors? what serum marker is elevated in these markers?
Yolk sac tumors are the most common germ cell tumor in kids
Serum α-fetoprotein is often elevated
Besides yolk sac tumors, what are some other aggressive malignant GCTs?
Immature teratomas
Mixed germ cell tumor
What are some rare forms of GCTs?
Pure embryonal carcinoma
Non-gestational choriocarcinoma
Pure polyembryoma
What are some general symptoms of GCTs?
Mass/torsion/rupture
What is a Kruckenburg carcinoma?
Bilateral mucinous carcinoma usually from the stomach
Signet cells are seen on histology
