Pathologies of the Ovaries Flashcards
Polycystic ovarian syndrome normally occurs after menarche. T/F?
True
What are the symptoms of polycystic ovarian syndrome?
Oligomenorrhoea
Hirsutism
Infertility
Obesity
Why are ovarian tumours difficult to manage?
Often assymptomatic until well advanced
Clinical presentations between different types of tumour are often similar
Ovarian tumours can twist on their pedicles. What is the term for this?
Torsion
Ovarian tumours can twist on their pedicles. What symptoms would this cause?
Severe abdominal pain
Abdominal swelling can occur in ovarian malignancy. In this case, what is causing the swelling?
Ascites
What types of tumours are encompassed by ovarian sex cord stromal tumours?
Granulosa and theca cell tumours
Sertoli and leading cell tumours
Tumours of fibroblasts in stroma
What age of women commonly get granulosa cell tumours?
Age 45-55
Granulosa cell tumours are rare. T/F?
False
What hormone is secreted by granulosa cell tumours to cause abnormal vaginal bleeding?
Oestrogen
Granulosa cell tumours commonly recur or metastasise. T/F?
False
Ovarian fibromas and thecfmas are usually malignant. T/F?
False - they are usually benign
Meig’s syndrome describe a clinical condition in which there is an ovarian fibroma and also…?
Ascites and pleural effusion
How is Meig’s syndrome cured?
Removal of the ovarian fibroma
What type of tumour is an ovarian tumour with ascites most likely to be?
Carcinoma
What type of tumours are Brenner tumours?
Mixed surface epithelial / stromal tumours which are usually benign
Epithelial ovarian tumours make up the majority of ovarian neoplasms. T/F?
True
Describe the appearance of a benign serous cyst adenoma?
Cyst has a thin wall lined by epithelium which resembles normal Fallopian tube epithelium
No cytological abnormalities, epithelium is one cell thick with no tufts, papillary area or solid growth
In most cases the borderline serous cystadenoma is confirmed to the ovary. T/F?
True
Borderline serous cyst adenomas can recur years after they are removed.T/F?
True
What are the risk factors for epithelial ovarian cancer?
Nulliparity
Family history
Prolonged oral contraceptive use may increase the risk of epithelial ovarian cancer.T/F?
False - this may reduce the risk
What are the different types of malignant surface epithelial tumours?
High grade serous Low grade serous Endometrioid Clear-cell carcinoma Mucinous
Malignant serous tumours usually occur at an older age than benign tumours. T/F?
True
Benign serous carcinomas are always unilateral. T/F?
False- they can be bilateral
Describe the appearance of benign serous tumours
Smooth, shining serial cover and cysts filled with a clear serous fluid, lined by a single layer of tall columnar epithelium (some of which are ciliated)
Low grade serous carcinomas commonly recur following excision. T/F?
True
What mutations are commonly seen in low grade serous carcinoma?
BRAF
KRAS
Low grade serous carcinomas commonly have p53 mutations. T/F?
False - these never have p53 mutations
Low grade serous carcinomas respond well to chemotherapy. T/F?
False - this is why excision is the mainstay of treatment for these tumours
What is the most common type of ovarian carcinoma?
High grade serous carcinoma
In which group of women does high grade serous carcinoma usually present?
Peri-menopausal or post-menopausal
High grade serous carcinomas have commonly spread beyond the ovary by the time of presentation. T/F?
True
Which genes are typically mutated in a high grade serous carcinoma of the ovary?
BRCA1 and p53
What are psammoma bodies?
Concentrically laminated calcified concretions which are common in the papillae of serous tumours in general
How are high grade serous carcinomas of the ovary treated?
Surgery and chemotherapy
The majority of mutinous ovarian tumours are benign. T/F?
True
Metastases to the ovary form which area of the body can mimic primary ovarian mutinous carcinomas?
GI tract
Describe the appearance of mutinous ovarian tumours
Large, multi nodular
No psammoma bodies
Cysts lined by cells with abundant mutinous cytoplasm
The prognosis of mutinous ovarian tumours is slightly better than for serous ovarian tumours. T/F?
True
Which condition are clear cell carcinomas of the ovaries associated with?
Endometriosis
What type of chemotherapy are clear cell carcinomas resistant to?
Platinum based chemotherapy
Describe the appearance of clear cell carcinomas of the ovaries.
Usually large and can be solid or cystic
High grade tumours
Many different growth patterns
Don’t always have a clear cytoplasm
How can clear cell carcinomas be differentiated from high grade serous carcinomas of the ovaries?
Clear cell carcinomas do not have p53 mutations
Which gene is commonly mutated in ovarian endometriosis carcinoma?
PTEN tumour suppressor gene
What type of epithelial ovarian tumour is characterised by neoplastic tubular glands?
Ovarian endometrioid carcinoma
Immature germ cell tumours are more likely to be benign than mature germ cell tumours. T/F?
False - the opposite is true
What is the other name for teratomas?
Dermoid cysts
Other than teratomas, what other germ cell tumours can occur?
Dysgerminoma
Embryonal carcinoma
Yolk sac tumour
Choriocarcinoma
What is a teratoma?
A tumour composed of totipotent germ cells which can differentiate into mature tissue of any of the three germ layers
In what age group of women are teratomas most likely to be found?
Young women
Describe the appearance fo teratomas?
Smooth capsule often filled with sebaceous secretion and matted hair
Sometimes foci of bone, cartilage, teeth and other recognisable lines of development
Most are cystic but some can have solid areas
Neuroectodermal elements are associated with more aggressive behaviour of a teratoma. T/F?
True
