Tumors / Cysts Flashcards
- rare, attributable to fact that epithelium of fallopian tubes does not shed cyclically (like endometrium)
- muscularis is thin and composed of cells that don’t respond to estrogenic stimulation
Tumors of Fallopian Tubes
_____ are the most common lesions & these tumors account for 1% of all GYN malignancies
Adenocarcinomas
- Common
- Follicles enlarge during proliferative phase
- If follicle does not rupture, remains filled w/ fluid and enlarge
- Remain small / have little clinical significance
Ovarian Cysts
Where are ovarian cysts usually found?
Cortex of ovary
broken grocery bag
Ruptured Follicular Cyst
- If ovulated follicle transforms into corpus luteum & transforms into fibrotic corpus albicans, so a cavity could fill w/ fluid, leading to formation of _____.
Corpus Luteal Cyst
- Ovaries are bilaterally enlarged & studded w/ follicular cysts
- Cause functional disturbance
- Amenorrhea, obesity, hirsutism, infertility
- Young women (2nd / 3rd decades)
- Ovaries: multicystic w/ thick, tough, pearly white capsule
Polycystic Ovarian Syndrome
Another name for PCOS (Polycystic Ovarian Syndrome)
Stein–Leventhal syndrome
Polycystic Ovarian Syndrome
Pathology of which condition?
- Continuous/abnormal stimulation of ovary by FSH & LH
- (NOT periodic or sequential such as in follicular cysts & luteinized cysts which produce Androgens / male virulism)
PCOS
How are Ovarian Neoplasms divided into subtypes?
Based on their cells of origin
What are the 4 subtypes of Ovarian Neoplasms
- Tumors of surface/germinal epithelium
- Tumors of germ cells
- Tumors of sex cord stromal cells
- Metastases involving ovaries
- On day ___ of menstrual cycles, the egg is discharged through single layer of cuboidal that lines surface of ovary.
- Trauma to surface of ovary monthly can be source of this tumor
Day 14
Tumor of surface/germinal epithelium
(Ovarian Neoplasm)
Which neoplasm?
- Women w/ tumor secreting way too much estrogen
- This same tumor can produce androgens –> bearded lady
Tumor of sex cord stromal cells
(Ovarian Neoplasm)
Ovarian Neoplams
- Are tumors usually benign or malignant?
Benign tumors are more common
Which neoplasm?
- 2nd most common GYN cancer
- Ranks 1st for deaths of GYN cancers (most deadly)
- Causes more deaths than all other tumors of reproductive tract
Ovarian Neoplasms
Which ovarian neoplasm is most common?
Tumors of surface/germinal epithelium
- Rupture at ovulation
- Each time the ruptured site heals each month, the proliferation of cells are at increased risk of transforming into tumors
What would decrease a woman’s risk of Ovarian Neoplams caused by tumors of surface/germinal epithelium?
Birth Control Pills (suppress ovulation)
- What are the 3 categories of Tumors of Surface Epithelium (Ovarian Neoplasms)?
- Which ones are cystic?
- Which ones are solid?
- Serous (cystic)
- Mucinous (cystic)
- Endometroid (solid)
All tumors of surface epithelium (ovarian neoplasms) are either _______ or ________.
- Adenomas
- Adenocarcinomas
Serous and Mucinous tumors of surface epithelium (ovarian neoplasms) are classified as ____, _____, or _____.
- Benign
- Borderline
- Malignant
-
Which surface tumor (ovarian neoplasm) is most common?
- Several cysts lumped together within common outer capsule
- Most are benign
- If malignant are usually bilateral
- These tumors mimic fallopian tube epithelium
- Uncommon before puberty
Serous Tumors
“jelly fish w/ a cyst”
Serous Cystadenoma
(Ovarian Neoplasm - Tumor of Surface Epithelium - Serous Tumor)
- Usually benign
- Mimics fallopian tube epithelium
“Fat Starfish”
Serous Tumor of Borderline Malignancy
(Ovarian Neoplasms - Tumor of Surface Epithelium)
Nemo eggs
Serous Cystadenocarcinoma
Guts covered in blood
Serous Cystadenocarcinoma
Which neoplasm?
- Usually benign (7:1)
- Usually unilateral
- Cavity filled w/ thick yellow/clear jelly
- If ruptured or if malignant tumor invades peritoneum –> entire body filled w/ mucus
- Mimics endocervical epithelium
Mucinous Tumor
(Ovarian neoplasm - Surface Tumor)
Mucinous Tumor ruptures or malignant tumor invades peritoneum, entire belly filled w/ mucus.
Pseudomyxoma peritonei
Yellow jelly
Mucinous Cystadenoma
Barnicles
Mucinous Cystadenocarcinoma
Pseudomyxoma peritonei
- ruptured tumor
- malignant tumor invading peritoneum –> belly filled w/ mucous from Mucinous Tumor of Surface Epithelium
- Solid tumor
- Composed of glands which resemble endometrial glands
- 15-30% w/ carcinoma of endometrium
- 15% w/ benign endometriosis
- Surface epithelium is solid / char by dense fibrous stroma w/ scattered nests of transitional epithelium
Endometroid & Brenner Tumors
Brown balls
Brenner Tumor
- Tumors which produce no sxs, so once recognized is usually too late to treat pt
- Surgery / Chemo don’t help much…
- Benign tumors w/ excellent prognosis w/ 5 yr survival rate of 100%
- Prognosis depends on stage of tumor
Surface Epithelium Tumors
(Ovarian Neoplasms)
Which ovarian neoplasm?
- Have good prognosis, but 5 yr survival is 80%
“Borderline” Surface Epithelial Tumors
Which ovarian neoplasm?
- 5 yr survival is 10-40% depending on stage
Malignant Surface Epithelial Tumor
- Tumor occurs in women younger than 25 yrs
- Most common ovarian tumor in women under 25 yrs
- Dermoid cyst is 95% of these tumors
- MIDLINE tumors
Germ Cell Tumors
What is the most common Germ Cell Tumor?
Benign Cystic Teratoma (95%)
(Dermoid Cyst)
- Cyst that is lined on inside w/ hairy skin
- Wall contains teeth, bone, cartilage, skin appendages (sweat/sebacceous glands) = bad odor
- Benign, but should be resected bc/ if left in place may become malignant
Benign Cystic Teratoma
(Dermoid Cyst)
Mature Cystic Teratoma (Benign Cystic Teratoma)
(dermoid cyst)
Mature Cystic Teratoma (Benign Cystic Teratoma)
(Dermoid Cyst)
“White foot stepping on crunchy soil”
Mature Cystic Tertoma (Benign Cystic Teratoma)
(Dermoid Cyst)
- Ovarian counterpart of male Seminoma
- Uncommon, but makes up half of all malignant germ cell tumors
- Usually occurs in childhood
- ALL are malignant! But only 1/3 are aggressive
Dysgerminoma
- Ovarian counterpart of Yolk Sac Tumor of male testes
- Too rich in AFP (alpha fetoprotein)
- Rare, grows aggressively/rapidly
- Predominantly in children and young adults
Endodermal Sinus Tumor
- Usually exists in combination w/ other germ cell tumors of ovaries (teratocarcinomas)
- Identical to placenta or testicular lesions
- Elaborates HCG to help w/ diagnosis
- “ugly” and bulky
- highly lethal
Choriocarcinoma
