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Reproduction Pathology > Pathology of the Ovary > Flashcards

Pathology of the Ovary Flashcards

1
Q

5 year survival of ovarian cancer of all stages

A

30%

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2
Q

Usual age range of presentations of ovarian cancer

A

50s-70s

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3
Q

Under what age is it rare to see ovarian cancer in?

A

<30s

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4
Q

Genes involved in ovarian cancer in high risk families

A

HNPCC/Lynch type II familial cancer syndrome
BRCA 1
BRCA 2

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5
Q

BRCA genes type of inheritance

A

Autosomal dominant inheritance

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6
Q

Lifetime risk of ovarian cancer if have a BRCA gene

A

15-45%

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7
Q

If have a BRCA gene, what can you develop at a younger age?

A

Ovarian cancer

Breast cancer

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8
Q

What do BRCA genes do?

A

They are tumour suppressor genes involved in DNA repair and cell cycle control

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9
Q

Prognosis of family presentations because of mutations

A

Usually better prognosis as usually present earlier

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10
Q

What is known to be protective of ovarian cancer?

A

OCP

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11
Q

Possible origins of ovarian cancer

A

Most cases arise from the fallopian tube rather than the ovary itself
Some derive from pre-existing benign ovarian cysts (often low grade cancers)

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12
Q

Symptoms of ovarian cancer

A 
VAGUE
Indigestion/early satiety/poor appetite
Altered bowel habit/pain 
Bloating/discomfort/weight gain 
Pelvic mass
- asymptomatic
- pressure symptoms
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13
Q

Investigations of ovarian cancer

A

USS abdomen and pelvis
CT scan
CA-125
Surgery

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14
Q

What values of CA-125 are normal and what is abnormal?

A 
0-35 = normal 
>35 = elevated
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15
Q

What is CA-125?

A

Glyco-protein antigen raised in ovarian cancer but also raised in other things which cause peritoneal irritation e.g. breast and colon cancer and is also especially elevated in pre menopausal women

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16
Q

Conditions where CA-125 would be raised

A 
Malignancy
- ovary 
- breast 
- colon/pancreas
Menstruation/pre menopause
endometriosis 
PID
Liver disease 
Recent surgery 
Effusions
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17
Q

How many women with ovarian cancer have raised CA-125?

A

80%

18
Q

How many women with stage 1 ovarian cancer have raised CA-125?

A

50%

19
Q

What is CA-125 used for?

A

Detecting and monitoring epithelial ovarian tumours

20
Q

Risk of malignancy index (RMI) of ovarian cancer equation

A

RMI = U x M x CA 125

21
Q

Ultrasound features that give a score to U in the RMI in ovarian cancer

A 
Multi-locular
Solid areas
Bilateral 
Ascites
Intra-abdominal
22
Q

U score in RMI in ovarian cancer

A

USS
1 feature = 1
Two to 5 features = 3

23
Q

M in RMI in ovarian cancer stands for

A

Menopausal status

24
Q

M score in RMI in ovarian cancer

A

Pre menopause = 1

Post menopause = 3

25
Q

Staging of ovarian cancer

A

Stage 1 = limited to ovaries with capsule intact +/- cytology
Stage 2 = one or both ovaries with pelvic extension
Stage 3 = One or both ovaries with peritoneal implants outside pelvis or + nodes
Stage 4 = distant metastases

26
Q

Treatment of ovarian cancer

A
  1. Surgery (laparotomy)

2. Chemotherapy (within 8 weeks of surgery)

27
Q

In what stage of ovarian cancer is a cure unlikely with chemotherapy?

A

3rd/4th stage

28
Q

Cure rates of the stages of ovarian cancer

A 
1 = 85%
2 = 47%
3 = 15%
4 = 10%
29
Q

What stages of ovarian cancer do most women present with?

A

stage 3 or stage 4

30
Q

What can advanced ovarian cancer be seen as?

A

A chronic disease as it will relapse and have to be treated again

31
Q

When is screening for ovarian cancer carried out?

A

High risk women

  • cancer gene mutation carriers
  • 2 or more relatives
32
Q

What is used to screen high risk women for ovarian cancer?

A

Pelvic exam
USS of ovaries
CA-125

33
Q

What preventative measure can high risk women carry out if they are high risk for ovarian cancer?

A

Prophylactic oophorectomy and salpingectomy

34
Q

Nice guidelines state that serum CA125 should be performed in a woman (esp if > 50 y/o) if they have which symptoms on a regular basis?

A

Abdominal distention (or bloating)
Early satiety or loss of appetite
Pelvic or abdominal pain
Increased urinary urgency / frequency

35
Q

How does ovarian cancer initially spread?

A

Local invasion

36
Q

Is there currently a screening programme for ovarian cancer in the UK?

A

No

37
Q

What are granulosa cell tumours of the ovary associated with?

A

Development of endometrial hyperplasia

38
Q

Most common type of ovarian pathology associated with meigs syndrome

A

Fibroma

39
Q

Features of meigs syndrome

A

Benign ovarian tumour (usually fibroma)
Ascites
Pleural effusion

40
Q

Most common benign ovarian tumour in women < 25 y/o

A

Dermoid cyst (teratoma)

41
Q

Most common cause of ovarian enlargement in women of reproductive age

A

Follicular cyst

Reproduction Pathology (28 decks)

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