Y5 - Ovarian tumour (benign and malignant)

Question 1

what provides a definitive diagnosis of ovarian cancer

Answer 1

surgery

Question 2

def of an epithelial ovarian cancer

Answer 2

a malignant transformation of the ovarian capsule epithelium

Question 3

what are different sub-types of ovarian cancer

Answer 3

epithelial, germ cell, and sex-cord tumours

Question 4

aetiology

Answer 4

genetic causes implicated

• BRCA1/2
• HNPCC mutations

Question 5

where do ovarian cancers often originate

Answer 5

the fallopian tubes at the distal fimbral portion

Question 6

does epithelial ovarian cancer invade organ space

Answer 6

normally no, usually attaches to the surface of organs

Question 7

epi

Answer 7

most lethal gynaecological cancer

elderly

Question 8

is ovarian cancer more common in white women or black women

Answer 8

white women

Question 9

RFs

Answer 9

increasing age
FHx of ovarian/breast cancer
never used OCP

Question 10

what does OCP protect against

Answer 10

ovarian cancer

Question 11

signs and symptoms

Answer 11

RFs
pelvic mass
-adnexal mass
GI symptoms > 3 months
-bloading
-nausea
-dyspepsia
-urinary incontinence

Question 12

features of BRCA1 mutation

Answer 12

found on chr 17q

autosomal dominant

Question 13

what is the increased risk of ovarian cancer with a BRCA1 mutation

Answer 13

35% increased lifetime risk

Question 14

features of BRCA2 mutation

Answer 14

found on chr 13q

Question 15

what is the increased risk of ovarian cancer with a BRCA2 mutation

Answer 15

30%

Question 16

first line investigation

Answer 16

pelvic ultrasound

• solid mass
• high blood flow (doppler)

Question 17

what cancer antigen marker is raised in ovarian cancer

Answer 17

CA 125

Question 18

what is the definitive test for ovarian cancer

Answer 18

surgery and histopathology

Question 19

why do patients commonly present at late stages of ovarian cancer

Answer 19

due to vague and non-specific symptoms

Question 20

what are the four stages of ovarian cancer

Answer 20

Stage 1 - confined to ovaries
Stage 2 - involves pelvic extension or primary peritoneal cancer
Stage 3 - spread to the peritoneum outside the pelvis or metastasis to retroperitoneal lymph ndoes
stage 4 - distant metastasis

Question 21

what are the cornerstones of ovarian cancer treatment

Answer 21

surgery and chemotherapy

Question 22

what is standard therapy for ovarian cancer

Answer 22

maximal surgical debulking and chemotherapy

Question 23

management for stage I ovarian cancer

Answer 23

surgery

Question 24

management for stages II-IV ovarian cancer with optimal debulking

Answer 24

IV and intraperitoneal chemotherapy with paclitaxel and cisplatin

Question 25

management for stages II-IV ovarian cancer with sub-optimal debulking

Answer 25

IV chemotherapy with carboplatin and paclitaxel OR docetaxel

Question 26

management for platinum sensitive recurrent disease

Answer 26

carboplatin and paclitacel or doxorubicin liposomal

Question 27

management for platinum resistant recurrent disease

Answer 27

doxorubicin liposomal

Question 28

prevention for ovarian cancer

Answer 28

OCP

Question 29

complications

Answer 29

intraperitoneal therapy failure
plantar-palmar erythrodysaesthesia
alopecia

Question 30

what causes plantar-palmar erythrodysaesthesia

Answer 30

doxorubicin liposomal

Question 31

what is plantar-palmar erythrodysaesthesia

Answer 31

paraesthesia with painful redness of palms and soles

Question 32

prognosis

Answer 32

majority of patients have remission after first line therapy

Question 33

what is the most important prognostic factor for relapse

Answer 33

treatment-free interval or time from completion of first line therapy to reoccurrance

Question 34

what has worse prognosis, platinum sensitive or platinum resistant ovarian cancer

Answer 34

platinum resistant