repro 4

Question 1

STIC

Answer 1

serous tubule intraepithelial carcinoma
in situ serous carcinoma arising at the fimbria
particulalarly ini women with BRCA mutations, high grade serous carcinoma of the ovary
p53 mutations
spread rapidly through the peritoneum
removal of the tuber/ovaries in BRCA women to try to prevent ovarian cancer

Question 2

BRCA

Answer 2

genes making tumour suppressor proteins
if mutations then DNA is not repaired causing mutations
people with inherited BRCA1 and BRCA2 at risk of cancer of breast and ovary

Question 3

cystic follicles

Answer 3

up ruptured follicles or those than ruptured then then closed again

Question 4

cropus luteum

Answer 4

shell left behind by a follicle which produces progesterone to support the pregnancy

Question 5

endometrioma

Answer 5

chocolate cyst

Question 6

PCOS

Answer 6

endocrine dysorder
globoid enlarged ovaries with multiple cysts
thick ovarian capsule, uniform cystic follicles, no corps luteum or corpus albicantia as not cycling

Question 7

ovarian neoplasms

Answer 7

most are benign in 20-40 yo 
malignant 40-70 yo 
vague clinical signs - bloating, fatigue, or no signs 
already spread at presentation 
so screening test

Question 8

benign cystic neoplasms

Answer 8

simple cyst
simple flat lining
excellent prognosis

benign serous cystadenoma 
lined by tubulars type ciliated cells 
20-40 year old women 
usually cystic, unilateral, smooth 
good prognosis, cure by excision 
common

Question 9

borderline cystic neoplasms

Answer 9

complex cysts
branching complex architecture
may recur or progress
not invasive

Question 10

malignant cystic neoplasm

Answer 10

invasive, may be fatal

Question 11

low grade serous ovarian carcinoma

Answer 11

uncommon
arise in the setting of cyst adenoma and borderline tumours
mutations in KRAS, BRAF
can spread widely to peritoneal surfaces but progress slowly and cause intestinal obstruction

Question 12

high grade serous ovarian carcinoma

Answer 12

common
more are bilateral
invade into other structures, spread widely through the peritoneum
poor prognosis
show solid and papillary areas with or without cysts
marked nuclear atypia and monster cells
P53, BRCA

Question 13

benign mutinous ovarian lesions

Answer 13

multiloculated, can be large or seen in combination with benign teratoma
tall columnar cells with apical mucin
most like intestinal epithelium, some resemble endocervix

Question 14

borderline mucinous ovarian lesions

Answer 14

older women, rarely bilateral
cystic and solid, more cytological are architectural atypia
non-invasive, intermediate prognosis

Question 15

mucinous ovarian carcinoma

Answer 15

rare, older women with invasive growth

poor prognosis

Question 16

endometrioid ovarian lesions

Answer 16

usually malignant 
50-60 yo 
often bilateral 
may be synchronous with endometrial endometriosis adenocarcinoma 
probably arise from endometriosis

Question 17

sex cord stromal tumours

Answer 17

may be hormonally active
derived from ovarian strooma
may produce oestrogen which may stimulate hyperplasia or endometrial carcinoma
may produce androgens which block puberty or cause amenorrhea or hirsutism and clitoral enlargement

Question 18

fibroma/fibrothecoma

Answer 18

sec cord stromal neoplasm
almost all benign
can cause Meigs syndrome

Question 19

granuloma of the sex cord stroma

Answer 19

mostly post menopausal women
make oestrogen
low grade malignancy

Question 20

sertoli-leydig

Answer 20

benign

masculinisation

Question 21

teratomas

Answer 21

germ cell tumour
usually benign
most testicular teratomas are malignant, unless occurring in prepubertal boys

Question 22

mature teratoma

Answer 22

occurs in young women
usually incidental
can cause mental state alterations
immature teratomas are malignant
can make any type of tissue - hair, teeth, brain etc
arise from ovum after the first meiotic division

Question 23

metastatic tumour of the ovary

Answer 23

krukenberg tumour - bilateral large metastatic tumours in both ovaries

Question 23

metastatic tumour of the ovary

Answer 23

krukenberg tumour - bilateral large metastatic tumours in both ovaries