Path 9 Ovary

Question 1

Polycystic Ovarian Disease symptoms

Answer 1

Hirsutism

• Persisten anovulation
• Metabolic Syndrome (Obesity, DM II)
• Virilism (rarely)

Question 2

Polycystic Ovarian Disease risk

Answer 2

Endometrial cancer

Question 3

Polycystic Ovarian Disease hormones

Answer 3

Increased LH -> Theca cells -> Increased Testosterone -> Obesity -> Increased Estrogen -> Decreased FSH -> Decreased Progesterone

Question 4

PCO gross appearance

Answer 4

Enlarged smooth grey ovaries with bilateral subcortical cysts

Question 5

Serous ovarian tumor (epithelium)

Answer 5

Resembles fallopian tube (papillary)

Question 6

Mucinous ovarian tumor (epithelium)

Answer 6

Resembles endocervix

Question 7

Endometroid ovarian tumor (epithelium)

Answer 7

Resembles endometrium

Question 8

Serous cystadenocarcinoma

Answer 8

Most common malignant ovarian tumor

• Columnar ciliated cells
• BRCA 1, 2 mutations
• p53 predicts grade

Question 9

Mucinous cystadenocarcinoma

Answer 9

Columnar epithelial cells with apical mucin

-Pseudomyxoma peritonei

Question 10

Endometroid carcinomas

Answer 10

Often accompanied by endometrial carcinoma

-May arise from endometriosis

Question 11

Brenner tumor

Answer 11

Benign

• Nests of bladder transitional-type epithelial cells
• Look like glomeruli

Question 12

Malignant surface epithelial tumors

Answer 12

Usually presents after metastasis

-CA-125 positive

Question 13

Germ cell tumors

• fetal tissue
• oocytes
• yolk sac
• placental tissue

Answer 13

• Teratoma
• Dysgerminoma
• Endodermal sinus tumor
• Choricarcinoma

Question 14

Teratoma typing

Answer 14

Mature - benign
Immature - malignant
Monodermal - Struma ovarii

Question 15

Mature teratoma

Answer 15

Benign dermoid cyst

-Can transfrom into melanoma, thyroid carcinoma, sq carcinoma

Question 16

Monodermal teratoma

Answer 16

Struma ovarii

-Mature thyroid tissue

Question 17

Immature teratoma

Answer 17

Found at earlier ages (prepubertal)

-Resemble embryonal or fetal tissue

Question 18

Dysgerminoma

Answer 18

Equivalent to seminoma (malignant, good prognosis)

• Dx with Oct3, Oct4
• Tx against c-KIT (tyrosine kinase)

Question 19

Dysgerminoma genetic cause

Answer 19

Turner’s syndrome (gonadal dysgenesis)

Question 20

Dysgerminoma histo

Answer 20

Sheets of clear cells

• Lymphocytic infiltrate
• Scant fibrous stroma

Question 21

Endodermal sinus tumor

Answer 21

Yolk sac tumor (common in children)

-Dx with AFP

Question 22

Endodermal sinus tumor histo

Answer 22

Schiller-Duval body resembles glomerulus (germ cells around central blood vessel)

Question 23

Choriocarcinoma

Answer 23

Trophoblasts and syncytioblasts

• hCG marker
• poor prognosis due to early hematogenous spread

Question 24

Granulosa theca cell tumor

Answer 24

Stromal tumor (postmenopausal)

• Generates large amounts of estrogen
• > Precocious puberty
• > Endometrial hyperplasia/carcinoma
• > Cystic breast disease

Question 25

Granulosa theca cell tumor histo

Answer 25

Call-Exner bodies (haphazard gland like structures filled with acidophilic material)

Question 26

Meigs syndrome

Answer 26

Ovarian fibroma, pleural effusion, ascites

Question 27

Gorlin syndrome

Answer 27

Basal cell nevus syndrome

-Ovarian fibroma, basal cell carcinomas, ondontogenic keratocysts

Question 28

Sertoli-leydig cell tumor

Answer 28

Masculinization

-Reinke crystals

Question 29

Krukenberg tumor

Answer 29

Signet ring cells, metastatic from stomach