Path 6 Ex 4

Front 1

Multiple ovarian follicular cysts due to hormone imbalance

Back 1

Polycystic ovarian disease characterized by increased LH and low FSH.

Front 2

How does it polycystic ovarian disease present?

Back 2

Usually obese young woman with infertility, oligomenorrhea and hirsutism( LH increase). Some pts have insulin resistance and may develop DM2 10-15 yrs later. bilaterally enlarged ovaries with sclerotic cortex, numerous follicle cysts (“oyster ovaries”)

Front 3

Endometrial carcinoma risk increases with PCOD because

Back 3

androgen conversion to estrone in adipose tissue leads to high levels of estrone which increases risk

Front 4

the 2 most common subtypes of surface epithelial tumor are

Back 4

serous (full of watery fluid) and mucinous (full of mucous like fluid), both are cystic. Both can be bening, borderline or malignant

Front 5

surface epithelial benign tumor in a premenopausal women 30-40 yrs is usually

Back 5

cystadenoma composed of a single cyst with a simple lining.

Front 6

A malignant surface epithelial tumor in a postmenopausal women 60-70 yrs old is usually

Back 6

Cystadenocarcinoma and it's composed of complex cysts with a thick, shaggy lining.

Front 7

Whats the surface epithelial cell tumor with characteristics of both benign and malignant tumors?

Back 7

Borderline, which have a better prognosis than malignant tumors but still have metastatic potential.

Front 8

Serous low grade tumor characteristics

Back 8

Well-defined papillary structures and many psammoma bodies
Low grade cytologic atypia
Probably arise via borderline tumors
Better prognosis

Front 9

Serous high grade tumor characteristics

Back 9

Solid and papillary growth with fewer psammoma bodies
High grade cytologic atypia with hobnailing
Probably arise de novo
May orginate from tubal fimbriae
Worse prognosis

Front 10

Serous low grade tumor markers

Back 10

KRAS, BRAF

Front 11

Serous High grade characteristics

Back 11

p53, BRCA

Front 12

May arise in endometriosis; contain viscous brown fluid (“chocolate”)

Back 12

ENDOMETRIOID. Benign and borderline variants are rare
May be associated with synchronous primary endometrioid adenocarcinoma of the uterus
P 53 mutation.

Front 13

Endometrioid carcinoma characterisitcs

Back 13

Less common than serous carcinoma, more common than mucinous carcinoma;
less often bilateral than serous,
more often bilateral than mucinous

Front 14

Clear cell carcinoma also may arise from endometriosis and it is rarely bilateral, and where there is bilateral then

Back 14

rule out metastatic clear cell carcinoma, such as metastatic renal cell carcinoma.

Front 15

Malignant mucinous surface epithelial tumor marker is

Back 15

KRAS

Front 16

Malignant mucinous tumors are rarely bilateral, and when they are it indicates

Back 16

metastases to ovaries, usually GI source, especially appendix

Front 17

Solid, unilateral, often incidental finding in ovary of postmenopausal woman.

Back 17

BRENNER TUMOR. Most are benign; rare borderline and malignant variants

Front 18

Germ cell tumors benign are

Back 18

“Dermoid”-Mature Cystic Teratoma

Front 19

Malignant Germ cell tumors are

Back 19

-Immature Teratoma,
-Carcinoma arising in Mature Cystic Teratoma,
-Dysgerminoma,
- Endodermal Sinus Tumor,
-Choriocarcinoma,
-Mixed

Front 20

germ cell tumors mimic tissues normally produced by germ cells, which tissues correspond to
Cystic teratoma and embryomal carcinoma:
Dysgerminoma
Endodermal sinus tumor
Choriocarcinoma

Back 20

Cystic teratoma and embryomal carcinoma: fetal tissue
Dysgerminoma: oocytes
Endodermal sinus tumor: yolk sac
Choriocarcinoma: placental tissue

Front 21

benign teratoma are usually

Back 21

(Mature Cystic Teratoma, aka “Dermoid”). Most are unilateral with Complex cystic structure containing cheesy sebaceous material, hair, teeth (!)

Front 22

Teratoma with almost exclusively of one type of tissue: struma ovarii=thyroid tissue

Back 22

Monodermal teratoma

Front 23

Malignancy arising in Mature Cystic Teratoma; rare occurrence in older women; usually

Back 23

squamous cell carcinoma

Front 24

Immature teratoma who gets it and what is it?

Back 24

Occurs in younger women (average age=18)
cystic and solid tumor with all 3 germ layers appearing IMMATURE
Can be very aggressive, especially if contain a lot of immature neural tissue

Front 25

The most common germ cell tumor is

Back 25

Teratoma

Front 26

The most common malignant germ cell tumor is

Back 26

dysgerminoma

Front 27

Usually unilateral, occurs in 2nd and 3rd decades, solid.
-May occur in the setting of gonadal dysgenesis.

Back 27

DYSGERMINOMA. Good prognosis responds to radiotherapy

Front 28

Testicular counterpart of dysgerminoma is

Back 28

Seminoma

Front 29

What type of receptor does dysgerminoma produce?

Back 29

Receptor tyrosine kinase c-Kit

Front 30

pediatric tumor, usually unilateral with papillary structures (“Schiller-Duval bodies) and hyaline globules are characteristic

Back 30

ENDODERMAL SINUS TUMOR

Front 31

ENDODERMAL SINUS TUMOR produces

Back 31

alpha-fetoprotein and alpha-one-antitrypsin
- Can be aggressive, but chemotherapy can be effective

Front 32

Malignant tumor composed of trophoblast and syncyntiotrophoblasts; mimics placental tissue but villi is abscent

Back 32

---CHORIOCARCINOMA very bad prognosis. Produces B-hCG and it is characteristic.

Front 33

In general: tumors of adults, unilateral, solid, benign sex cord stromal tumor

Back 33

Pure fibroma: fibroblastic, no hormone production

Front 34

Fibromas are associated with what syndrome?

Back 34

Meigs syndrome: pleural effusions and ascites which resolves after removal of tumor

Front 35

Germ cell tumor associated with production of androgen leading to hirsutism and virilization

Back 35

Sertoli-Leydig cell tumor which is unilateral and benign

Front 36

GRANULOSA-theca CELL TUMOR is proliferation of

Back 36

Theca cells and granulosa cells. These are unilateral and considered benign with low malignant potential

Front 37

Granulosa-theca tumors produce estrogen with causes different signs at different stages
Prior to puberty-
Reproductive age-
Postmenopause

Back 37

-Precocious puberty
-Menorrhagia or metrorrhagia
-Endometrial hyperplasia with postmenopausal bleeding most common

Front 38

Most frequent primary sites of metastatic carcinoma

Back 38

Mullerian sites, breast, GI tract

Front 39

bilateral clear cell carcinoma could represent

Back 39

metastatic renal cancer

Front 40

bilateral mucinous borderline/carcinoma with pseudomyxoma peritoneii (mucin deposits often with neoplastic cells in peritoneum) could represent

Back 40

metastatic appendiceal cancer

Front 41

most famous metastatic carcinoma to the ovary:

Back 41

KRUKENBERG TUMOR=metastatic signet ring cell carcinoma to the ovaries; usually gastric primary

Front 42

-suppurative salpingitis may be caused by

Back 42

gonococcus, Chlamydiae; may lead to chronic salpingitis

Front 43

ADENOCARCINOMA OF THE FALLOPIAN TUBE

Back 43

dominant tubal mass with mucosal involvement; may be associated with BRCA mutations;