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22 Cards in this Set

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Epithelial tumors in the ovary arise in what 2 ways?
1) Directly from epithelium

2) Epithelial cysts (invaginations)
Can ovarian tumors grow to be very large?
YES
Benign cystadenomas are lined by what?
Benign - surrounded by single sheet of bland epithelial cells
What is most likely malignant?

Solid mass
Cystic mass
Solid AND cystic mass
Solid and cystic masses MOST LIKELY.

Solid masses can be benign or malignant

Cysts usually benign
What to look for in these repro. tract malignancies?
Poor borders

Hemorrhage and Necrosis

Mitosis...atypia
Where is the likely spread of ovarian cancer?
Peritoneal Surfaces

Omentum
What is the most important factor in prognosis?
EARLY INTERVENTION
What is one of the key distinguishing features between borderline tumors and malignant tumors?
NO INVASION! Upon invasion, tumor is malignant/metastatic.
Is it possible to distinguish borderline and malignant grossly?
NO. Only histologically
What are extraovarian implants?
They are NOT metastases. Can be independent primary tumors.

IMPORTANT: prognosis risk is correlated with invasiveness of implants. If yes, treat like low grade carcinoma
What is pseudomyxoma peritonei?
Mucinous fluid that causes bowel obstruction. Requires laparotomies.

NOT ASSOCIATED WITH OVARIAN...LIKELY GI, APPENDIX TUMORS
Is it easy to distinguish primary ovarian tumors from metastastic tumors?

What are some give aways?
NO!

IF BILATERAL and SMALL, likely metastases.

Mucinous overian tumors are usually LARGE and UNILATERAL (large because takes a while to detect...unilateral because likely no spread yet)
What is the Krukenber tumor to the ovary?
It is a special metastases that ONLY MILDLY ENLARGES THE OVARY.

Solid tumor.

HISTOLOGICALLY looks like rings (nuclei spread to the sides)
What is a dermoid cyst?
Dermoid cyst is a benign teratoma that constitutes 95% of germ cell tumors.

Contain differentiated cell types from ALL OVER THE BODY.
When do dermoid cysts usually occur?
In the first 2 decades of life.

Most malignant tumors in first 2 decades.
What is a dysgerminoma?
Dysgerminoma is THE MOST COMMON MALIGNANT TUMOR.

It is a malignant germ cell tumor. Histologically it is similar to a seminoma of the testes.

High survival rates.
When do dysgerminomas occur?
Repro.ductive years. 80% in 2nd and 3rd decades.
Which is the most malignant sex-cord stromal tumor?
Granulosa cell tumors. All have malignant potential, though curable.

THECAL-FIBROMA group is mostly benign.
What hormones can these sex cord stromal tumors produce?
Can produce estrogen, which could cause endometrial hyperplasia.
What is the HALLMARK cell of granulosa tumors?
Call-Exner bodies.
What are the four main tumor types in ovarian cancer?
1) Epithelium

2) Germ cell

3) Sex cord - stromal

4) metastases
How are surface epithelial tumors classified?
Two tiers...

Differentiated cell type

AND

Biologic malignancy potential (Benign, borderline, malignant)