Pathology of the ovaries Flashcards
1
Q
Epidemiology of ovarian cancer
A
- Higher risk with genetic predisposition
- HNPCC/ Lynch type II syndrome
- BRCA 1
- BRCA 2
- 90% sporadic
2
Q
Pathology of ovarian cancer
A
- Majority originate in fallopian tube
- Some from pre-existing benign ovarian cysts (low grade)
3
Q
Role of pathology in gynaecology
A
- Tumour typing: benign, borderline, malignant
- Tumour grade
- Tumour staging
- Gives an idea to prognosis therefore specific treatment
4
Q
Symptoms in ovarian cancer
A
- Vague → often late presenting
- Indigestion/ early satiety/ poor appetite
- Altered bowel habits/ pain
- Bloating/ discomfort/ weight gain
- Pelvic mass
- Asymptomatic
- Pressure symptoms
5
Q
Diagnosis of Ovarian cancer
A
- US scan of abdomen and pelvis
- CT scan - chest/abdo/ pelvis
- CA 125 (cancer biomarker)
- Image guided biopsy
- Surgery (diagnosis and management)
6
Q
CA 125 marker
A
- Glycoprotein antigen
- Sign of multiple types of malignancies: ovarian, colon/ pancreas/ breast
- Sign of benign condition: menstruation/ endometriosis/ PID/ Liver disease/ recent surgery/ effusions
- Raised in 80% of women with ovarian cancer
- Used in detecting and monitoring response to chemotherapy
7
Q
Risk fo malignancy index
A
- Ultrasound features
- Multi-locular
- Solid areas
- Bilateral
- Ascites
- Intra-abdominal
- Menopausal
- CA 125 levele
- RMI = U x M x CA 125
8
Q
Staging of ovarian cancer
A
- Stage 1: limited to ovaries with intact capsule
- Stage 2: one or both ovaries with pelvic extension
- Stage 3: one or both ovaries with peritoneal implants outside pelvis/ lymph node involvement
- Stage 4: distant metastasis
9
Q
Treatment of ovarian cancer
A
- Surgery
- Chemotherapy (adjuvant and Neo-adjuvant)
10
Q
Function of laparotomy in ovarian cancer
A
- Obtain tissue diagnosis → pathology
- Disease staging
- Disease clearance
- Disease debunking
11
Q
Chemotherapy in ovarian cancer
A
- Platinum and taxmen (taxol)
- Within 8 weeks of surgery
- Complete/ partial response
- Cure unlikely
12
Q
Screening of ovarian cancer
A
- Not proven to be effective and not recommended
- Limited sensitivity and specificity
- High risk women
- Cancer gene mutation carrier/ 2 or more relatives
- Prophylactic salpingo-oophrxectomy
- Pelvic examination
- Ultrasound scan of ovaries
- CA 125 levels
- Still residual risk of primary peritoneal cancer
13
Q
RMI
A
- Risk of malignancy index
