Repro Tumours

Question 1

Give 2 reasons why not taking oral contraceptive pill and never having children predisposes to ovarian cancer?

Answer 1

Increased number of menstrual cycles

Egg productive - ovary epithelium

Question 2

Why does serous ovarian tumour show psomamma bodies?

Answer 2

Psomamma bodies = calcification

Papillary Growth - Ischaemic tips of papillae - favours calcification (dystrophic)

Question 3

What do seminomas look like histologically?

Answer 3

Classical appearance off sheets of cells with clear cytoplasm
Fairly uniform cellular appearance with a central nucleus
Pink stripes present - fibrovascular cords - blood vessels of the tumour run through here

Question 4

What in terms of blood tests can you use to differentiate between seminoma and non-seminomatous germ cells tumour?

Answer 4

NSGCTs -> AFP and hCG elevated

Seminoma -> no markers.

Question 5

What age group are vulval cancers mainly seen in and what is the main type of vulval cancer?

Answer 5

Older people - 80s

SCC - 90%

Question 6

In terms of the cervix what affect does oestrogen have on it?

Answer 6

Causes eversion leading to metaplasia from simple columnar to stratified squamous epithelium.

Can cause ectropian

Question 7

What causes CIN?

Answer 7

HPV infection 16/18

Question 8

What are some risk factors for CIN and Carcinoma?

Answer 8

HPV related - sexual partner with HPV, multiple partners and early age of first intercourse
Early age of first pregnancy 
Smoking
Low SEC 
Immunosurpression 
Multiple births

Question 9

Give 3 treatment options for advanced cervical cancer?

Answer 9

Hysterectomy
Lymph node dissection
Chemoradiotherapy

Question 10

What thickness does the endometrium have to be to be classified as endometrial hyperplasia?

Answer 10

> 11mm

Question 11

Which type of endometrial cancer is more aggressive?

Answer 11

Serous

Question 12

What extra step is needed in management of endometrial cancer as opposed to cervical cancer?

Answer 12

Bilateral salpingo-oopherectomy

Question 13

What is ovarian cancer often associated with a delayed diagnosis?

Answer 13

Because the early symptoms are vague and non specific

Bloating etc

Question 14

What are the 3 subtypes of ovarian tumours?

Answer 14

Sex cord stromal
Germ cell
Surface epithelium

Question 15

What can the effects of theca and granulosa cell tumours in adult patient cause?

Answer 15

Breast cancer
Endometrial hyperplasia
Endometrial carcinoma

Because they make oestrogen

Question 16

What is a Krukenberg tumour?

What is the most common origin site?

What cell is seen?

Answer 16

A malignancy in the ovary that raised and metastasised from a primary site primarily the GI tract.

Gastric adenocarcinoma

Signet-ring cell a

Question 17

Name 4 non-seminomatous cancers?

Answer 17

Teratoma
yolk sac tumour
Choriocarcinoma
Embryonal carcinoma

Question 18

What non-seminomatous germ cell tumour is AFP associated with?

B-hCG?

Answer 18

Yolk sac tumours

Choriocarcinoma

Question 19

What staging system is used for cervical tumours?

Answer 19

FIGO

Question 20

What operation is used to treat cryptorchidism?

Answer 20

Orchoplexy