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30 Cards in this Set
- Front
- Back
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21. Chemo used for germ cell tumours?
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a. Combination:
1. Bleomycin 2. Etoposide 3. Cisplatin (BEP) w/ good 5-year survival rates (60-85%) depending on type of tumour |
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22. From where are sex cord-stromal germ cell tumours derived?
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a. The cells surrounding the oocyte that produce steroid hormones or from the ovarian stroma.
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23. Growth characteristics of Sex cord-stromal tumours?
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a. Slow-growing tumours w/low malignant potential and are often found only incidentally, usually in women between 40-70 yrs old.
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24. In whom do Sertoli-Leydig ovarian tumours occur?
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a. Rare and occur most often in women <40.
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25. What do Sertoli-Leydig ovarian tumours secrete and effect?
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a. Androgens
b. Cause virilization of pts. |
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26. Most common type of sex cord-stromal tumour?
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a. Granulosa cell tumours (70%)
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27. Symptoms of Granulosa cell ovarian tumours?
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a. They secrete inhibit and estradiol, resulting in:
i. Feminization and potentially endometrial hyperplasia and/or cancer. |
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28. Pathognomonic features of Granulosa cell ovarian tumour?
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a. Call-Exner bodies.
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29. From what are Ovarian fibromas derived?
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a. From mature fibroblasts.
b. These are nonfunctional tumours. |
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30. Meigs syndrome triad?
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1. Ovarian tumour
2. Ascites 3. Right Hydrothorax |
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31. How are the sex cord-stromal tumours treated?
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a. Surgically, usually w/unilateral salpingo-oophorectomy in younger women
b. TAHBSO in women who have completed their child-bearing. |
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32. Do Sertoli-Leydig tumours recur?
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a. No, they do not frequently recur.
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33. Do granulosa cell tumours recur?
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a. Yes, they often have late occurrences 15-20 yrs later.
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34. Fallopian tube cancer?
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a. Rare malignancies that can occur at any age.
b. They behave very similar to epithelial ovarian cancers. |
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35. What type of cancers are Fallopian tube cancers usually?
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a. Usually adenocarcinomas arising from the mucosa or mets from other primary tumours.
b. Fallopian tube cancers are usually asymptomatic and are rarely diagnosed preoperatively. |
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36. What classic triad is considered pathognomonic for fallopian tube carcinoma?
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1. Pain
2. Profuse water discharge (hydrops tubae profluens) 3. Pelvic mass b. However, this only occurs in 15% of pts. |
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37. Tx of Fallopian tube cancers?
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a. Similar to epithelial ovarian cancers w:
1. TAHBSO 2. Omentectomy 3. Cytoreduction 4. Pelvic lymph node sampling followed by combination chemo. |
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38. Combination Chemo for Fallopian tube cancers (2)?
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a. Carboplatin and taxol.
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39. Overall 5-yr survival for Fallopian tube cancers?
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a. 45%.
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40. How is ovarian cancer primarily spread?
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a. By direct exfoliation of malignant cells from ovaries.
1. As a result, the sites of mets often follow the broad circulatory path of the peritoneal fluid. b. Lymphatic spread can also occur, most commonly to the retroperitoneal, pelvic, and para-aortic lymph nodes. c. Haematogenous spread is responsible for distant mets to the lung and brain. |
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41. Carcinomatous ileus?
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a. Intermittent bowel obstruction
b. In advanced disease, intraperitoneal tumour spread leads to accumulation of ascites in the abdomen and encasement of the bowel w/tumour. c. Often results in malnutrition, slow starvation, cachexia, and death. |
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42. What is ovarian carcinoma believed to result from?
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a. Malignant transformation of ovarian tissue after prolonged periods of chronic uninterrupted ovulation.
b. Ovulation disrupts the epithelium of the ovary and activates the cellular repair mechanism. |
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43. Lynch II syndrome (Hereditary nonpolyposis colorectal cancer syndrome or HNPCC)?
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a. Have high rates of familial breast, ovarian, colon, and endometrial cancer.
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44. Ovarian cancer risk w/BRCA1 mutation?
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a. 30-50%
b. BRCA2: 25%. |
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45. Risk factors for Ovarian cancer?
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1. Familial ovarian cancer syndrome
2. Familial history of breast and/or ovarian cancer 3. Personal hx of breast cancer 4. Increasing age 5. Early menarche (<12 yo) 6. Infertility 7. Nulliparity 8. Late-onset menopause (>50 yo) 9. Obesity (BMI >30). |
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46. Protective factors against ovarian cancer?
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a. Use of oral contraceptives (5+ yrs)
b. Multiparity c. Breastfeeding d. Tubal ligation e. Hysterectomy |
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47. Ovarian mets to umbilicus is known as?
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a. Sister Mary Joseph nodule.
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48. Primary diagnostic tool for investigating an adnexal mass?
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a. Pelvic U/S.
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49. Monitoring of ovarian malignancies?
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a. Serum tumour markers:
i. CA-125 ii. AFP iii. Lactate Dehydrogenase iv. hCG. |
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50. What does primary staging of ovarian cancers involve?
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a. Surgically staged:
1. TAHBSO 2. Omentectomy! 3. Peritoneal washings! 4. Pap smear of diaphragm 5. Sampling of pelvic and paraaortic LNs. |
