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17 Cards in this Set
- Front
- Back
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What percentage of ovarian malignancies are sex-cord-stromal tumours?
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5%
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List histological subtypes of SCSTs
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Granulosa-Stromal Cell tumours
granulosa cell fibroma thecoma Androblastomas Sertoli Sertoli-Leydig Leydig |
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Benign or malignant:
a) Granulosa-cell tumour b) Fibroma c) Thecoma |
a) low-grade malignant
b) benign c) benign (b&c can rarely have malignant features - fibrosarcomas) |
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List two serum "markers" of granulosa cell tumours.
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Estradiol
Inhibin MIS, mullerian inhibitory substance, is an experimental marker for GCT |
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In post-menopausal women, what is the rate of endometrial:
a) hyperplasia b) cancer associated with a concurrent GCT? |
a) 25-50%
b) 5% |
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a) What is the typical prognosis of SCSTs?
b) What age groups are primarily affected? |
a) Excellent - majority diagnosed in Stage I and generally of low malignant potential/indolent growth pattern.
b) all age groups |
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What is Meig's syndrome?
What is pseudo-Meig's syndrome? |
a) Ovarian Fibroma, Ascites, Pleural effusion (classically right-sided)
b) Ovarian Fibroma, Ascites, Pleural effusion (classically right-sided) b) Non-fibroma ovarian/adnexal mass, Ascites, Pleural effusion (classically right-sided) |
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What hereditary syndromes can be associated with SCSTs?
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Peutz-Jeghers syndrome
Ollier disease |
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How do SCSTs typically present?
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Abdomino-pelvic mass/pain
Precocious puberty (premenarche) Amenorrhea PMB (menopausal) |
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For SCSTs, which subtypes develop from the coelomic epithelium (sex-cords)?
Which develop from the mesenchyme (stroma)? |
a)
Granulosa cell Sertoli b) Fibroma Leydig Theca |
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What is the natural history of SCSTs?
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Low malignant potential
Usually unilateral Typically diagnosed Stage I 5yr survival 90-95% Relapses can happen 5-30 yrs later typically in the pelvis or abdomen, focally Stage II-VI at diagnosis carries worse prognosis 10-50% 5yr survival |
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a) Describe the two different types of granulosa cell tumour:
b) What is the specific histocytological finding? |
a)
Adult (95%) Juvenile (5%) b) Call-Exner Body |
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What hormone do thecoma's usually produce?
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Estrogen
(since they typically develop in menopausal women, they are strongly associated with PMB and endometrial hyperplasia/cancer). |
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What ovarian SCSTs produce androgens?
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Sertoli-Leydig
Leydig |
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What is the histocytological finding in Leydig tumours?
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Crystals of Reinke
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Management of SCSTs is primarily based on:
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Initial cytoreductive surgery +/- staging
Surgery can be fertility sparing or TAH/BSO Surveillance vs Chemo/Radiation |
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a) What prognostic factors can be used to decide if Stage I SCST should be treated with post-op adjuvant chemotherapy?
b) When should post-op adjuvant chemotherapy be offered/recommended? |
a)
Size Age Mitotic Index Tumour Rupture Capsular excrescences b) Stage >= II or those with risk factors as above |
