Pathoma: Ovarian Tumors Flashcards
What is included in the term “sex cord stroma”?
Granulosa cells
Theca cells
Stromal cells
The most common type of ovarian tumor is _____________.
surface epithelial tumor
There are two names for the epithelium that lines the ovaries: _______________.
germinal mesothelium and coelomic epithelium
The two most common subtypes of surface epithelial ovarian tumors are ______________.
mucinous and serous
Note: both of these are named for the type of fluid that they contain!
What is the term for benign ovarian tumors?
Cystadenoma
Cystadenomas most common present in younger, pre-menopausal women and appear as ____________.
cysts with flat lining
Describe cystadenocarcinoma.
- Malignant cyst with thick, shaggy lining
* More common in older, post-menopausal women (60-70)
What are borderline tumors?
Any kind of ovarian cancer that is between benign and malignant
These tumors can still metastasize, but they have a better prognosis than malignant ovarian cancers.
BRCA1 mutations increase the risk of which ovarian cancer?
Serous cystadenocarcinoma of the ovary and fallopian tube
Think BRCA raises the risk of watery CAncer under the BRidge.
Brenner tumors recapitulate which type of epithelium?
Urothelium
What is one reason surface epithelial ovarian tumors carry a poor prognosis?
They typically present late.
When surface epithelial ovarian cancers spread to the peritoneum, they often cause what pathology?
“Omental caking” –building up locally on the peritoneum
How is CA-125 used?
It isn’t great for screening, but in patients who’ve had ovarian cancer with high CA-125s it can be useful to monitor for recurrence.
Talk about how age can be used to predict the most likely ovarian tumor.
Age 15 - 35: germ cell tumors are most common
Age 35 - 50: benign surface epithelial tumors are most common
Age 65 and up: malignant surface epithelial tumors are most common
Germ cell tumors that produce fetal tissue are called _____________.
cystic teratomas
What kinds of germ cell tumors are there?
- Cystic teratoma
- Embryonal carcinoma
- Yolk sac tumor
- Dysgerminoma
- Choriocarcinoma
All of these arise from the oocyte!
______________ tumors present bilaterally in about 10% of cases.
Cystic teratomas
True or false: the most common type of germ cell tumor in a female is predominately benign.
True! Cystic teratomas are the most common female germ cell tumor and they are benign.
Caveat: immature teratomas – characterized by immature neuroepithelium – are malignant but they are less common.
Describe the cancer-within-a-cancer that can occur with teratomas.
Teratomas can develop mature tissue that then gets a somatic mutation that can metastasize. The most common somatic mutation is squamous cell carcinoma.
What is struma ovarii?
Teratomas that recapitulate thyroid tissue that leads to hyperthyroidism
The most common malignant germ cell tumor has what morphologic appearance?
Dysgerminomas are the most common malignant germ cell tumor and because they are oocytes they look like oocytes –large nuclei with clear cytoplasm.
Serum LDH may be elevated in ______________.
dysgerminomas
Schiller-Duval bodies are found in tumors arising from ______________.
the yolk sac
Beta-human chorionic gonadotropin will be elevated in those with tumors arising from _______-blasts.
tropho
The stem describes choriocarcinoma, a malignant proliferation of primitive placental cells.
What histologic feature will be absent in those with choriocarcinoma?
Villi
What makes choriocarcinoma so aggressive?
Trophoblasts are designed to find blood supply for the placenta. Choriocarcinomas then display rapid hematogenous spread; their classic description, then, is a small primary tumor with widespread metastasis.
Briefly characterize embryonal carcinomas.
- Large, primitive cells
* Early metastasis
Describe the various presentations of granulosa-theca cell tumors.
- Young children: early, primary puberty
- Adult, premenopausal women: heavy menstrual bleeding
- Postmenopausal adults: abnormal uterine bleeding without a menstrual cycle
Note: all of the above effects are mediated by excess estrogen.
Sertoli-Leydig cell tumors are very distinctive because of the _______________ in Leydig cells.
Reinke crystals –pink crystals within Leydig cells
A woman presents with an ovarian mass and pleural effusion. What description likely characterizes the mass?
Fibromas often cause pleural effusion and ascites in women and have a fatty/fibrotic appearance.
In the gastric cancer that can lead to Krukenberg tumor, why do they have the characteristic signet-ring look?
Their cytosols are full of mucin!
Pseudomyxoma peritonei arises from ______________.
a mucinous tumor of the appendix
