Pathologies of the Ovaries

Question 1

Polycystic ovarian syndrome normally occurs after menarche. T/F?

Answer 1

True

Question 2

What are the symptoms of polycystic ovarian syndrome?

Answer 2

Oligomenorrhoea
Hirsutism
Infertility
Obesity

Question 3

Why are ovarian tumours difficult to manage?

Answer 3

Often assymptomatic until well advanced

Clinical presentations between different types of tumour are often similar

Question 4

Ovarian tumours can twist on their pedicles. What is the term for this?

Answer 4

Torsion

Question 5

Ovarian tumours can twist on their pedicles. What symptoms would this cause?

Answer 5

Severe abdominal pain

Question 6

Abdominal swelling can occur in ovarian malignancy. In this case, what is causing the swelling?

Answer 6

Ascites

Question 7

What types of tumours are encompassed by ovarian sex cord stromal tumours?

Answer 7

Granulosa and theca cell tumours
Sertoli and leading cell tumours
Tumours of fibroblasts in stroma

Question 8

What age of women commonly get granulosa cell tumours?

Answer 8

Age 45-55

Question 9

Granulosa cell tumours are rare. T/F?

Answer 9

False

Question 10

What hormone is secreted by granulosa cell tumours to cause abnormal vaginal bleeding?

Answer 10

Oestrogen

Question 11

Granulosa cell tumours commonly recur or metastasise. T/F?

Answer 11

False

Question 12

Ovarian fibromas and thecfmas are usually malignant. T/F?

Answer 12

False - they are usually benign

Question 13

Meig’s syndrome describe a clinical condition in which there is an ovarian fibroma and also…?

Answer 13

Ascites and pleural effusion

Question 14

How is Meig’s syndrome cured?

Answer 14

Removal of the ovarian fibroma

Question 15

What type of tumour is an ovarian tumour with ascites most likely to be?

Answer 15

Carcinoma

Question 16

What type of tumours are Brenner tumours?

Answer 16

Mixed surface epithelial / stromal tumours which are usually benign

Question 17

Epithelial ovarian tumours make up the majority of ovarian neoplasms. T/F?

Answer 17

True

Question 18

Describe the appearance of a benign serous cyst adenoma?

Answer 18

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

Question 19

In most cases the borderline serous cystadenoma is confirmed to the ovary. T/F?

Answer 19

True

Question 20

Borderline serous cyst adenomas can recur years after they are removed.T/F?

Answer 20

True

Question 21

What are the risk factors for epithelial ovarian cancer?

Answer 21

Nulliparity

Family history

Question 22

Prolonged oral contraceptive use may increase the risk of epithelial ovarian cancer.T/F?

Answer 22

False - this may reduce the risk

Question 23

What are the different types of malignant surface epithelial tumours?

Answer 23

High grade serous
Low grade serous
Endometrioid
Clear-cell carcinoma
Mucinous

Question 24

Malignant serous tumours usually occur at an older age than benign tumours. T/F?

Answer 24

True

Question 25

Benign serous carcinomas are always unilateral. T/F?

Answer 25

False- they can be bilateral

Question 26

Describe the appearance of benign serous tumours

Answer 26

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)

Question 27

Low grade serous carcinomas commonly recur following excision. T/F?

Answer 27

True

Question 28

What mutations are commonly seen in low grade serous carcinoma?

Answer 28

BRAF | KRAS

Question 29

Low grade serous carcinomas commonly have p53 mutations. T/F?

Answer 29

False - these never have p53 mutations

Question 30

Low grade serous carcinomas respond well to chemotherapy. T/F?

Answer 30

False - this is why excision is the mainstay of treatment for these tumours

Question 31

What is the most common type of ovarian carcinoma?

Answer 31

High grade serous carcinoma

Question 32

In which group of women does high grade serous carcinoma usually present?

Answer 32

Peri-menopausal or post-menopausal

Question 33

High grade serous carcinomas have commonly spread beyond the ovary by the time of presentation. T/F?

Answer 33

True

Question 34

Which genes are typically mutated in a high grade serous carcinoma of the ovary?

Answer 34

BRCA1 and p53

Question 35

What are psammoma bodies?

Answer 35

Concentrically laminated calcified concretions which are common in the papillae of serous tumours in general

Question 36

How are high grade serous carcinomas of the ovary treated?

Answer 36

Surgery and chemotherapy

Question 37

The majority of mutinous ovarian tumours are benign. T/F?

Answer 37

True

Question 38

Metastases to the ovary form which area of the body can mimic primary ovarian mutinous carcinomas?

Answer 38

GI tract

Question 39

Describe the appearance of mutinous ovarian tumours

Answer 39

Large, multi nodular No psammoma bodies Cysts lined by cells with abundant mutinous cytoplasm

Question 40

The prognosis of mutinous ovarian tumours is slightly better than for serous ovarian tumours. T/F?

Answer 40

True

Question 41

Which condition are clear cell carcinomas of the ovaries associated with?

Answer 41

Endometriosis

Question 42

What type of chemotherapy are clear cell carcinomas resistant to?

Answer 42

Platinum based chemotherapy

Question 43

Describe the appearance of clear cell carcinomas of the ovaries.

Answer 43

Usually large and can be solid or cystic High grade tumours Many different growth patterns Don't always have a clear cytoplasm

Question 44

How can clear cell carcinomas be differentiated from high grade serous carcinomas of the ovaries?

Answer 44

Clear cell carcinomas do not have p53 mutations

Question 45

Which gene is commonly mutated in ovarian endometriosis carcinoma?

Answer 45

PTEN tumour suppressor gene

Question 46

What type of epithelial ovarian tumour is characterised by neoplastic tubular glands?

Answer 46

Ovarian endometrioid carcinoma

Question 47

Immature germ cell tumours are more likely to be benign than mature germ cell tumours. T/F?

Answer 47

False - the opposite is true

Question 48

What is the other name for teratomas?

Answer 48

Dermoid cysts

Question 49

Other than teratomas, what other germ cell tumours can occur?

Answer 49

Dysgerminoma Embryonal carcinoma Yolk sac tumour Choriocarcinoma

Question 50

What is a teratoma?

Answer 50

A tumour composed of totipotent germ cells which can differentiate into mature tissue of any of the three germ layers

Question 51

In what age group of women are teratomas most likely to be found?

Answer 51

Young women

Question 52

Describe the appearance fo teratomas?

Answer 52

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

Question 53

Neuroectodermal elements are associated with more aggressive behaviour of a teratoma. T/F?

Answer 53

True