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48 Cards in this Set

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What are the ovary surface, ova, background stroma & sex cords, and granulosa & theca cells embryologically derived from?
Ovary surface: coelomic epithelium. Ova: Primordial germ cells. Background stroma & sex cords: Mesenchym. Granulasa & theca cells: Mesenchyme.
What is an ovarian follicular cyst? When does it occur? What are the SSx? What is the difference btnj a cystic follicle & a follicular cyst?
Solitary follicle cysts which enlarge w/o producing functional ovum; Common during menarche & menopause (when cycles are irreg); Pelvic pain, torsion (venous infarction), Cystic follicle: <2cm; Follicular cyst: >2cm
Clear, fluid-filled space w/ inner granulosa & outer theca layers
Cystic follicle (if <2cm) or follicular cyst (if >2cm)
Anovulation, Infertility, Obesity, Hirsuitism, Acne, NIDDM, HTN, Ovarian sclerocystic change
PCOS
__ __ gives rise to epithelial carcinomas. __ __ __ give rise to germ cell tumors. __ gives rise to sex cord & stromal tumors.
Coelomic epithelium; Primordial germ cells; Mesenchyme
What is the most common type of ovarian tumor?
Ovarian epithelial neoplasms; 85% of tumors
Where are they located and what is the pathogenesis?
Located w/in the parenchyma; Arise via ovulation: surface breaks heal & include surface epithelium inside ovarian parenchyma, followed by metaplasia of tissue (serous, mucinous, endometrioid, transitional types)
What are the ovarian epithelial neoplasm cell types in progression from benign to borderline (low malignant potential) to malignant
Serous (tubal), Mucinous, Endometrioid, Clear cell, Transitional
What is the most common type of ovarian epithelial tumor?
Serous (30%)
Serous ovarian neoplasms: __lateral, __ bodies, [benign/borderline/carcinoma], may spread diffusely throughout __
Often bilateral; Psammoma bodies; Can be any; Abdomen
Mucinous ovarian tumors contain __ or __-type epithelium, with the __ type being more aggressive. It is a borderline tumor that is nearly always __. It is a __-grade carcinoma & can be mimicked by metastasis from __.
endocervical, enteric-type, enteric,benign, low, appendix/ colon
Pseudomyxoma peritonei
Mucinous tumor of the ovary
What is the appearance of endometrioid ovarian tumors? Are they benign, borderline, or carcinoma? __ & __ endometrial carcinoma often occur together.
Uterine endometrial carcinoma; benign & borderline; Ovarian & uterine
What is the benign form of transitional cell ovarian tumors? How are the borderline/proliferative forms cured by? The carcinoma form is rare & resembles __ carcinoma.
Brenner tumor; Ovarian excision; Bladder
Mesenchyme gives rise to __ & __ tumors.
sex cord, stromal
What are sex cords? What do they give rise to in females and males and both sexes?
Embryonic tissues which produce the gonadal stroma; Females: granulosa & theca cells (1y estrogen producing cells of the ovary); Males: Sertoli & Leydig cells (T producing cells in testes); Both: background stroma composed of fibroblasts
What are the sex cord stromal tumors in females, males, and both sexes?
Females: Granulosa Cell tumors, Thecomas; Males: Sertoli-Leydig cell tumors; Both: Fibromas
What is a functional sex cord stromal tumor? What are the side effects of functional ovarian tumors?
Produces sex hormones & the clinical effects of hyperestrinism (abn uterine bleeding in post-menopausal women) & hypertestosteronism (loss of female 2y sex characteristics, hirsuitism, balding, breast atrophy, voice deepening, amenorrhea).
What are 3 functional sex cord stromal tumors & what do they produce?
Granulosa cell tumors & Thecomas: estrogen
Sertoli-Leydig cell tumors: testosterone
What is a granulosa cell tumor? What are the SSx & differentials? How is it treated?
Rare tumor seen chiefly in post-menopausal women; Hyperestrinism: abn uterine bleeding, which may indicate endometrial hyperplasia or carcinoma. Surgery is usually curative, but it can metastasize
What are sex cords? What do they give rise to in females and males and both sexes?
Embryonic tissues which produce the gonadal stroma; Females: granulosa & theca cells (1y estrogen producing cells of the ovary); Males: Sertoli & Leydig cells (T producing cells in testes); Both: background stroma composed of fibroblasts
Sertoli-Leydig Cell Tumor
Rare tumors seen in young women (25yo); 30% are virilizing w/ elevated serum testosterone, remainder have no hormonal effects; May be poorly differentiated; Poor prognosis at an advanced stage
What are the sex cord stromal tumors in females, males, and both sexes?
Females: Granulosa Cell tumors, Thecomas; Males: Sertoli-Leydig cell tumors; Both: Fibromas
Post-menopausal woman; Elevated estrogen; Abn uterine bleeding & possibly endometrial hyperplasia & carcinoma
Thecoma
What is a functional sex cord stromal tumor? What are the side effects of functional ovarian tumors?
Produces sex hormones & the clinical effects of hyperestrinism (abn uterine bleeding in post-menopausal women) & hypertestosteronism (loss of female 2y sex characteristics, hirsuitism, balding, breast atrophy, voice deepening, amenorrhea).
__ tumors are often mixed w/ fibromas
Thecoma
What are 3 functional sex cord stromal tumors & what do they produce?
Granulosa cell tumors & Thecomas: estrogen
Sertoli-Leydig cell tumors: testosterone
What is the most common ovarian stromal tumor? Is it benign or malignant? What age group is this typically seen in & what is it ofen combined with?
Ovarian fibroma; Benign is most common, but malignant variants may occur (=fibrosarcoma); Middle age, thecomas
What is a granulosa cell tumor? What are the SSx & differentials? How is it treated?
Rare tumor seen chiefly in post-menopausal women; Hyperestrinism: abn uterine bleeding, which may indicate endometrial hyperplasia or carcinoma. Surgery is usually curative, but it can metastasize
What is the common origin of germ cell tumors? What 4 lineages can it differentiate into?
Totipotent germ cell; Embryo: teratoma; Placenta: choriocarcinoma; Extraembryonic membranes: Yolk sac tumor; Germ cells: dysgerminoma (females) & seminoma (males)
Sertoli-Leydig Cell Tumor
Rare tumors seen in young women (25yo); 30% are virilizing w/ elevated serum testosterone, remainder have no hormonal effects; May be poorly differentiated; Poor prognosis at an advanced stage
What is the most common germ cell tumor? What age group is it seen in? What germ cell layers are represented? How is it treated? How can it be dx?
Mature teratoma (dermoid); Reproductive age women; All 3 layers represented: mature endoderm, ectoderm, & mesoderm; Benign tumors are tx by surgery; Can be dx radiologically by presence of bone or teeth
Post-menopausal woman; Elevated estrogen; Abn uterine bleeding & possibly endometrial hyperplasia & carcinoma
Thecoma
How can malignancy in teratomas occur?
1. Malignant transformation of mature teratoma (squamous cell carcinoma, adenocarcinoma, chondrosarcoma, etc. 2. Immature (& malignant) tissues rather than mature (embryonic tissues)
__ tumors are often mixed w/ fibromas
Thecoma
What is the prognosis of malignant teratomas?
Very aggressive tumors, w/ poor prognosis
What is the most common ovarian stromal tumor? Is it benign or malignant? What age group is this typically seen in & what is it ofen combined with?
Ovarian fibroma; Benign is most common, but malignant variants may occur (=fibrosarcoma); Middle age, thecomas
What is the most common malignant germ cell tumor in reproductive age women? What is the prognosis? What is the male counterpart called?
Dysgerminoma; Very txable w/ surgery & radiation; Seminoma
What is the common origin of germ cell tumors? What 4 lineages can it differentiate into?
Totipotent germ cell; Embryo: teratoma; Placenta: choriocarcinoma; Extraembryonic membranes: Yolk sac tumor; Germ cells: dysgerminoma (females) & seminoma (males)
What is the marker for yolk sac tumors/endodermal sinus tumor? Where is it most commonly seen? What is the prognosis?
alpha fetoprotein; male testis; aggressive
What is the most common germ cell tumor? What age group is it seen in? What germ cell layers are represented? How is it treated? How can it be dx?
Mature teratoma (dermoid); Reproductive age women; All 3 layers represented: mature endoderm, ectoderm, & mesoderm; Benign tumors are tx by surgery; Can be dx radiologically by presence of bone or teeth
How can malignancy in teratomas occur?
1. Malignant transformation of mature teratoma (squamous cell carcinoma, adenocarcinoma, chondrosarcoma, etc. 2. Immature (& malignant) tissues rather than mature (embryonic tissues)
What is the prognosis of malignant teratomas?
Very aggressive tumors, w/ poor prognosis
What is the most common malignant germ cell tumor in reproductive age women? What is the prognosis? What is the male counterpart called?
Dysgerminoma; Very txable w/ surgery & radiation; Seminoma
What is the marker for yolk sac tumors/endodermal sinus tumor? Where is it most commonly seen? What is the prognosis?
alpha fetoprotein; male testis; aggressive
A choriocarcinoma resembles __ tissue & is usually seen in the __ related to a current or recent __ (__ choriocarcinoma). What if it is found in the ovary?
placental; uterus; pregnancy; gestational; In ovary: nongestational choriocarcinoma
What is the serum marker for choriocarcinoma? What is this marker the same for?
Beta-hCG, same as nl pregnancy
What is the prognosis of choriocarcinoma in the ovary?
Agressive, with poor response to chemotherapy