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26 Cards in this Set

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Infections that cause salpingitis
N. Gonorrhea; Chlamydia; E. Coli; Mycoplasma; anaerobes
Endometriosis
Endometrial glands and stroma outside of the endometrium
Hormonally sensitive -- cycles with the normal endometrium
Can result in hemorrhage, scarring, and pain
Etiology: backwash; benign metastasis; metaplastic transformation
BRCA1 and BRCA2 chromosomes
17 & 13 respectively
Mutation --> lifetime risk of about 60% for developing ovarian cancer
Follicular cysts
Composed of follicle elements -- granulose and theca cells
Typically clinically insignificant
Sometimes large enough to produce an increase in estrogen
Increased estrogen --> endometrial hyperplasia and abnormal bleeding
Leuteal systs
Particularly persist during pregnancy
SECRETE PROGESTERONE
Manifest with menstrual irregularities and a mass
PCOD
A.K.A. Stein-Leventhal Disease
Women in their 20s and 30s
Result of abnormal LH and FSH
Signs and symptoms: obesity; acne; hirsutism; infertility; insulin resistance
Results in anovulation
Can lead to endometrial hyperplasia and carcinoma
3 main groups of Ovarian neoplasms
Surface Epithelial (most common)
Germ Cell
Sex Cord Stromal
5 subtypes of surface eptihelial tumors
Serous papillary
Mucinous
Endometrioid
Brenner
Clear Cell

All five can form tumors along the cystadenoma, borderline, carcinoma spectrum
Serous tumors
Hallmark is ciliated columnar cells ("tubal-like")
As grade gets worse, % chance of being bilateral increases
PSAMMOMA BODIES (also seen in papillary cancer of the thyroid)
Serous papillary carcinomas are the most common malignancy of the ovary
CA125 sometimes used as a marker (not reliable)
Mucinous tumors
Resemble endocervical epithelium OR intestinal epithelium
Less frequent, less often bilateral, more often multilocular
Filled with viscous, gelatinous fluid
Usually form EXTREMELY LARGE masses
Pseudomyxoma Peritoneii
"Jelly Belly"
2ndary to appendiceal/ovarian primary OR transformation of peritoneal cells
Abdomens filled with mucin
(great morbidity)
5 yr. survival is < 50%
Endometrioid Tumors
Benign and borderline tumors are less well defined
Gland fusion and cytologic atypia
15-20% of ovarian endometrioid associated with endometrial carcinomas
BUT, thought to represent TRUE SEPARATE PRIMARIES ("field effect")
Clear Cell Tumors
Cystadenomas and borderlines are extremely rare
Abundant clear cytoplasm
Often have papillae lined by "hobnail" cells
Brenner Tumors
Usually benign
Nests of cells that resemble UROTHELIAL cells of bladder
5 subtypes of germ cell tumors
TERATOMAS (90% [mature])
Dysgerminoma
Yolk sac
Embryonal
Choriocarcinoma

Except for MATURE teratomas, germ cell tumors are often malignant
Mature Teratoma
Benign, present in all age groups
Lined by epidermal tissue with underlying sebaceous glands
Cystic
Have ADULT-TYPE tissue from various germ cell layers
RARELY, malignancy can develop
Immature Teratoma
Usually have a solid component
Tissue is commonly NEURAL
High grade ones are malignant and require chemo
If rupture, peritoneal implants can develop (gliomatosis peritonei)
Dysgerminoma
Counterpart to testicular seminoma
Women in 20s and 30s
Typically unilateral with an EXCELLENT prognosis
Extremely radio and chemo sensitive
SECRETE beta-hCG
Yolk Sac Tumor
A.K.A. Endodermal Sinus Tumor
Schiller-Duvall Bodies
Occur in adolescents and young women
Aggressive
SECRETE ALPHA-FETOPROTEIN
Embryonal Carcinoma
Agressive
Young Women
Choriocarcinoma
Most occur in the uterus, but occasionally do occur in ovary
Spread HEMATOGENOUSLY
Respond to chemo, BUT complications (bleeding) can arise
SECRETE BETA-HCG
3 subtypes of Sex Cord Stromal Tumors
Fibromas
Granulosa Cell Tumors
Sertoli-Leydig Cell Tumors
Fibromas
Account for 80% of SCSTs
BENIGN
Well circumscribed
Solid, white cut surface
Histologically, bland spindle cells
May be estrogenic
Meig's Syndrome
Pleural effusions + Ascites + Ovarian Mass
Removal of mass --> regression of effusions
Granulosa Cell Tumor
SECRETE ESTROGEN
Bland small cells, nuclear grooves ("coffee beans")
CAL-EXNER BODIES (rings)
Very slow growing, when confined very good prognosis
Recur or metastasize 10 - 15 years
Krukenberg tumor
Bilateral enlargement of the ovaries
Due to metastatic signet ring carcinoma from GI tract
Usually, from the stomach