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41 Cards in this Set
- Front
- Back
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what are the 3 major components of the ovary from which tumors arise?
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surface = Müllerian epithelium derived from coelomic epithelium
germ cells, pluripotent stroma, including sex cords |
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most commonly ovarian tumors arise from which component of the ovary?
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surface epithelium in 90%
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what are the histologic subtypes of surface epithelial tumors of the ovary?
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serous, mucinous, endometrioid, clear-cell, transitional-cell (Brenner tumor)
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what percentage of serous epithelial tumors of the ovary are malignant or border-line?
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40%
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what percentage of mucinous epithelial tumors of the ovary are malignant or border-line?
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20%
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what are the most common epithelial ovary tumors in descending frequency?
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serous
endometrioid mucinous clear-cell transitional cell, ie Brenner tumor |
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which epithelial ovary carcinoma is most often bilateral?
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serous carcinoma
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which epithelial ovary carcinoma is rarely bilateral?
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mucinous carcinoma
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what are the histological subtypes of germ cell tumors of the ovary?
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malignant teratoma and dysgerminoma are malignant
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what are the two major types of stromal tumors of the ovary?
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sex cord derived
and unspecific stroma (extremely rare) |
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what percentage of teratoma of the ovary are malignant?
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5%
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what are common primary tumors of ovarian metastases?
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endometrium and breast
and colonic and gastric cancer |
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what percentage of all femal genital tract cancer is ovarian cancer?
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only 5%
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where does ovarian cancer rank in freqency compared to other tumors of the female genital tract?
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third
behind endometrium and cervix cancer |
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what is an important fact of ovarian cancer concerning mortality of female genital tract tumors?
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main cause of death of tumors of the female genital tract
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what percentage of tumors of the ovary are stage III or IV at diagnosis?
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60% !
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what is the 5 year survival rate in ovarian cancer?
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20-40% overall
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what are risk factors for ovarian cancer?
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age
no children, infertility, long anovulatory cycles |
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what are protective factors for ovarian cancer?
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intake of oral contraceptives
increasing numbers of pregnancies s/p ligature of tube |
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what are genetic predispositions for ovarian cancer?
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Hereditary Breast Ovarian Cancer Syndrome (HBOC)
Familial Ovarian Cancer Syndrome HNPCC (= Lynch syndrome) |
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what types of genetic predispositions are there for ovarian cancer?
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three, two specific for "female" tumors, one unspecific
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what is the typical metastatic pattern for ovary cancer?
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intraperitoneal spread
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in what percentage does hematogenous spread in ovarian cancer occur?
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5-10%, thus slightly higher than for cervical and endometrian cancer
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with what mutation is Hereditary Breast and Ovarian Cancer Syndrome (HPOC) associated with?
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mutation of BRCA1 gene on chromosome 17q
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what is the life time risk for ovarian cancer with Hereditary Breast and Ovarian Cancer Syndrome?
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40%
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how can epithelial ovarian carcinoma be ranked in terms of aggressiveness and metastatic activity?
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serous carcinoma with early metastasis
endometrioid carcinoma considerably less aggressive than serous mucinous carcinoma, potential for metastasis is low |
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what is the most important tumor marker in epithelial ovarian cancer?
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CA-125
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how useful is the tumor marker CA-125?
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low sensitivity and low specificity!
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when is CA-125 useful?
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follow-up for detection of relapse
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what is the imaging of choice for ovarian cancer?
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ultrasonography, not CT or MRI!!!
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what method is used for staging of ovarian cancer?
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operation!!
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what is the principal operative procedure for ovarian cancer?
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laparatomy, not laparascopy!!!
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what are the two main phases in therapy of ovarian cancer?
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first phase with aim of R0 (no residual tumor) or at least maximal tumor-debulking
second phase with aggressive chemotherapy |
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what is the typical chemotherapy scheme for ovarian cancer?
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platin plus taxan
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what is stage I for ovarian cancer?
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stage Ia and Ib
capsule is intact stage Ic integrity of capsule is compromised with positive cytology |
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what is stage II for ovarian cancer?
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stage IIa
affection of uterus or tube stage IIb other pelvic organs affected stage IIc additionally cytology positive |
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what is stage III for ovarian cancer?
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beyond true pelvis
or retroperitoneal lymph nodes positive |
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what is stage IV for ovarian cancer?
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distant metastasis
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what are the principal therapeutic approaches in ovarian cancer?
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primary operation for earlier stages
neo-adjuvant chemotherapy with intervall-debulking secondary tumor-debulking after relapse with second line chemotherapy to follow palliative surgery |
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what are possible screening methods for ovarian cancer?
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vaginal sonography and measurement of CA-125 as tumor marker
but controverse |
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what percentage of malignant ovarian tumors are serous cell carcinoma?
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~50%
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