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HRM > Ovary Witrak > Flashcards

Ovary Witrak Flashcards

1
Q

What causes Polycystic Ovarian Syndrome (PCOS)?

A

Don’t know…it is thought to maybe be hypothalamic or pituitary malfunction

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2
Q

What are some characteristics of PCOS?

A

Menstrual irregularity

Hyperandrogenism

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3
Q

What are some of the potential downstream effects of the menstrual irregularity seen with PCOS?

A

Anovulation → chronic/sustained estrogen effect → increased risk of endometrial hyperplasia/carcinoma

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4
Q

What are some of the potential downstream effects of the hyperandrogenism seen with PCOS?

A

Hyperandrogenism → Hirsutism, acne, and male pattern balding

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5
Q

What are some associations of PCOS?

A

Enlarged ovaries with polycystic features
Obesity
Insulin resistance/Diabetes

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6
Q

A transvaginal ultrasound is performed on a patient, and polycystic ovaries are seen. Is this enough to diagnose this patient with PCOS?

A

NO…polycystic ovaries can be seen in normal women

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7
Q

What are the potential ovarian tumor origins?

A

Ovarian surface (Mullerian) epithelium
Sex cord/stromal cells
Germ Cells
Metastatic from somewhere else

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8
Q

What origin of ovarian tumors occurs most often?

A

Ovarian surface (Mullerian) epithelium

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9
Q

What are the two main types of Mullerian epithelium ovarian tumors?

A

Serous

Mucinous

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10
Q

Do serous tumors tend to be unilateral or bilateral?

A

Serous tend to be bilateral

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11
Q

Do mucinous tumors tend to be unilateral or bilateral?

A

Mucinous tend to be unilateral

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12
Q

What is the most common cause of GYN cancer death?

A

Epithelial ovarian carcinoma

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13
Q

What familial cancer syndromes are associated with epithelium ovarian carcinoma?

A

BRCA1 (35-46%)
BRCA2 (13-23%)
Lynch (3-14%)

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14
Q

What cancer marker is associated with epithelial ovarian carcinoma?

A

CA-125

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15
Q

How is CA-125 used?

A

Used to follow for tumor recurrence and to monitor treatment

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16
Q

Are sex cord/stromal cell ovarian tumors usually bad?

A

Not really…usually low grade/stage and are surgically curable

Rarely reoccur or metastasize

17
Q

What are three types of sex cord/stromal cell ovarian tumors?

A

Fibroma/thecoma
Granulosa cell tumors
Sertoli/Leydig cell

18
Q

What type of sex cord/stromal cell ovarian tumors is most common?

A

Fibroma/thecoma (70%)

19
Q

What is often seen with fibroma?

A

Large tumors

Ascites and pleural effusion (Meig’s syndrome)

20
Q

What type of sex cord/stromal cell ovarian tumor most commonly causes neoplastic estrogen excess?

A

Granulosa cell tumor…makes sense…

21
Q

Are sex cord/stromal cell tumors typically unilateral or bilateral?

A

Sex cord/stromal cell tumors are typically unilateral

22
Q

What is the average age of diagnosis with a sex cord tumor?

A

50 (12% < 30)

23
Q

What are the symptoms associated with sex cord tumors?

A 
Adrenal mass/pelvic displacement
Precocious puberty
Abnormal uterine bleeding
Endometrial hyperplasia/CA
Hirsutism/overt virilization
24
Q

What markers can by used for stromal cell tumors?

A

Estrogen
Androgen
Inhibin

25
Q

What category of ovarian tumors makes up 70% of ovarian neoplasms in 10-30yo women?

A

Germ Cell Tumors (GCTs)

26
Q

What is an example of a benign GCT?

A

Mature cystic teratoma (majority of germ cell tumors)

27
Q

Are mature cystic teratomas typically unilateral or bilateral?

A

Mature cystic teratomas are bilateral 10-12% of the time

28
Q

What is the female equivalent of testicular seminoma?

A

Dysgerminoma

29
Q

Is dysgerminoma usually bad?

A

Make up 33% of all malignant GCTs

Rarely aggressive

30
Q

What do dysgerminoma cells resemble? (Pathoma)

A

Oocytes…large cells with clear cytoplasm and central nuclei

31
Q

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?

A

Yolk sac tumors are the most common germ cell tumor in kids

Serum α-fetoprotein is often elevated

32
Q

Besides yolk sac tumors, what are some other aggressive malignant GCTs?

A

Immature teratomas

Mixed germ cell tumor

33
Q

What are some rare forms of GCTs?

A

Pure embryonal carcinoma
Non-gestational choriocarcinoma
Pure polyembryoma

34
Q

What are some general symptoms of GCTs?

A

Mass/torsion/rupture

35
Q

What is a Kruckenburg carcinoma?

A

Bilateral mucinous carcinoma usually from the stomach

Signet cells are seen on histology

HRM (40 decks)

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