Path Spring 6 Female Neoplasms

Front 1

whats the most common ovarian tumor in pts under 20
over 20

Back 1

<20: germ cell tumors

>20: surface epithelium (coelomic)

**sex cord stroma is all ages, hormonally active

Front 2

what is the most common group of ovarian cancer

Back 2

surface epithelium


Serous
Mucinous
Endometroid
Brenner

Cystadenofibroma
Clear Cell

Front 3

in order what is the most to least common ovarian cancer

Back 3

most common is surface epithelium>20
germ cell <20
sex cord stroma
mets

Front 4

the surface ectoderm of ovary is most common tumor category type, what else is made of this same epithelium

Back 4

the inside on the uterus

**BOTH come from paramesonephrix dict

Front 5

what are the 2 theories of ovarian tumor formation

Back 5

tumors from the epithelium: its like an invagination of the PM that gets endocytosed. think about the surface lining

tumors are seeded from the fallopian tube

Front 6

Ovarian TUmors

1. mucinous
2. endometroid
3. serous
4. brenner
5. clear cell

Back 6

1. Mucinous: endocervical intestinal cell
2. endometroid: endometrial: 5%
3. serous: tubal lining. 50, 50, 50
4. brenner: transitional cells
5. endometrial cell sin preggo/

Front 7

are teratomas usually benign in the ovary

Back 7

yep!!!!!

Front 8

name all of the surface epithelial tumors of the ovary

Back 8

1. Serous

2. Mucinous

3. Endometroid

4. Brenner

5. Cystadenofibroma

6. Clear Cel

Front 9

This 17 y/o female presented with c/o increasing
abdominal girth and sensation of tightening of the
abdomen over the past year with mild weight gain.
There was no abdominal pain or discomfort.
Recently she had noticed an increasing cough and
dysphagia. She also complained of thoracic back
pain.
Menarche was at age 11. LMP 20 days earlier.
A pregnancy test was negative.
She weighed 100# and was 5’2” tall.

On physical p y examination there was an
abdomnal mass extending from the pubic
symphysis to the xyphoid process.
Ultrasound: cystic mass, left adnexa.
She was taken to surgery where a cystic tumor
Tumor involving the left ovary was excised.
The outer surface was smooth. The tumor
measured 31x24x13 cm; weighed 16 pounds.
What tumors of the ovary are cystic?
Which is most common?

Back 9

serous is the most common cyst in the ovary. 50% is malignant, 50% is BL

Front 10

how is a serous ovarian tumor treated

cystadenoma

Back 10

keep in mind this is the MOST common!

Front 11

what is the morphology of a serous ovarian tumor

Back 11

1. tubal type epithelium lines it
2. papillary processes

Front 12

cystadenoma and cystadenocarcinoma refer to what in regards to serous ovarian tumors

Back 12

cystadenoma is benign

cystadenocarcinoma is malignant

**50% of serous is benign

Front 13

what are some risk factors for serous carcinoma

Back 13

not having kids, BRCA
*more times you ovulate increases risk



decrease with OCP and tubal ligation

Front 14

what is a serous carcinoma of the ovary

Back 14

MUST KNOW- most common MALIGNANT tumor of the ovary

low grade- well differentiiated, better survival

High Grade- de novo, BRCA- better chemo response

Front 15

what pics of ovarian tumors are MUST knows

Back 15

1. serous
2. mucinous
3. teratoma

Front 16

where else is tehre serous carcinoma other than the ovary

Back 16

fallopian
peritoneal

Front 17

what is the association of BRCA with ovarian cacner

Back 17

huge relationship. BRCA is rare but if you have it sits pretty likely you will get ovarian cacner

Front 18

what are psammoma bodies

Back 18

microcalcifications that are associated with serous carcinoma


**psommomma bodies are found anywhere there is papillary carcinoma

Front 19

in serous carcinoma of the ovary there is a part that as it grows adn then dies it calcifies and leaves a remnant, what is this remnant

Back 19

psommama body

**its seen anywhere there is a papillary carcinoma like in serous carcinoma of the ovary

Front 20

what does the mucinous ovarian tumor look like

Back 20

benign CA, its surface epithelium. MUST be able to recognize it!!!


MULTIPLE cysts, can be HUGE!!!! lined with mucin secreting columnar cells

Front 21

what are the risks and associations of mucinous cystadenocarcinoma

Back 21

this is the malignant version of the HUGE multicyst mucinous tumor

malignant is rare but is association with:
1. SMOKING
2. Endometriosis
3. mucinous carcinoma assocaiton with pseudomyxoma peritonei

Front 22

tell me about mucinous canacer of the ovary

Back 22

its the second most common surface epithelial tum

Front 23

what is the benign HUGE ovarian cacner

Back 23

mucinous

multiple cysts! HUGE

Front 24

what type of ovarian cancer is associated with pseudomyxoma peritonei.

Back 24

maligniant mucinous tumor

**this is the one that is normally benign adn SUPER HUGE

Front 25

whats endometriod cancer of the ovary

morph
risks

Back 25

MALIGNANT- endometroid adenocarcinoma

MorphL makes adhesiosn
RISKS: endometriosis, HNPCC mutation

Front 26

the first and second most common ovarian tumors are....

Back 26

1. serous: 50% malignant, 50% of tumors, 50% are BL

2. Endometrioid Adenocarcinoma. usually malignant, HNPCC mutation

Front 27

what are the risks associated with endometroid adenocarcinoma of the ovary

Back 27

endometriosis
HNPCC

Front 28

ovarian clear cell adenocarcinoma is associated with what

Back 28

uncommon- always malignant

solid or cystic

associated with endometriosis or endometroid carcinoma

Front 29

whats a brenner tumor

Back 29

ovarian tumor of surface epithelium- has TRANSITIONAL CELLS

Front 30

whats the ovarian tumor with transitional cells

Back 30

brenner

**its a tumor of the surface epithelium

Front 31

what is the clinical presentaiton of ovarian tumors of the surface epithelium

Back 31

1. benign are asx
2. abs enlargement esp with like mucinous that get to be so huge

THE SEED THE PERITONEUM TO BE MORE SX

most of the malignant ones- endometroid , clear cell etc are usually BL at dx

CA 125

seen in ppl >20

Front 32

CA 125

Back 32

tumor marker for surface epithelium . shouldnt be use as a screen except in high risk groups like BRCA

Front 33

what decreases risk of ovarian CA

Back 33

OCP
tubal ligation

Front 34

what is the super important germ cell tumor of ovary

Back 34

teratoma- usually benign (dermoid cyst)


**others include, dysgerminoma, endodermal sinus, choriocarcinoma

Front 35

the mature germ cell tumors in a woman are...

the immature are...

Back 35

MATRUE: teratoma, often benign (dermoid cyst)

IMMAURE:
dysgerminoma- like a seminoma
Embryonal Carcinoma
Immature Teratoma
Choriocarcinoma
Endodermal Sinus (yolk sac)

seen in women <20

Front 36

the most common germ cell ovarian tumor is

Back 36

... MATURE (BENIGN) teratoma. the "unborn twin" aka dermoid cyst

most common in younger pts

the others that are less common germ cell tumros are

1. dysgerminoma
2. choriocarcinoma:
3. yolk sac: aggressive, AFP, yellow, schiller duval bodies

Front 37

whats a dermoid cyst

Back 37

mature teratoma,

Front 38

what are things are seen in mature teratomas of the ovary

Back 38

hair
skin/cart
fat
sebacious
thyroid
neuro tissue
etc, can be anytrhing. KNOW THIS PIC

Front 39

what are the monodermal teratomas teratomas

how do they act

Back 39

teratoma with a single tissue type

not usually malignant

2. types
1. strum ovarii: looks like thyroid
2. Carcinoid

Front 40

whats the morph of an immaure teratoma

Back 40

HUGE AGGRESSIVE. rare

<18 yo

Front 41

whats dysgerminoma

Back 41

its the female ovarian germ cell tumor that is like a male seminome
malignant, associated with turners
ldh, hCG

Front 42

what is the serum marker for choriocarcinoma?

Back 42

hCG

Front 43

what is the prognosis of choriocarcinoma
how does it compare with gestational carcinoma

Back 43

aggressive

Front 44

what ovarian germ cell tumor makes hCG

Back 44

choriocarcinoma

HIGHLY aggressive

Front 45

what is special about sex cord stroma cancer of the ovary

Back 45

makes hormones, good for testing

Fibroma
Granulosa theca- estrogen (INHIBIN)
Sertoli-Lyedig

Front 46

whats a granulosa cell tumor

Back 46

sex cord stromal cell that makes estrogen and has high inhibin

can cause precouscious puberty or endometrial hyperplasia

CAL EXNER BODIES that mimic ovarian follicles

yellow

Front 47

whats meigs syndrome

Back 47

benign ovarian fibroma
hydrothorax
ascites

Front 48

there is a girl with precocious puberty, she has endometrial hyperplasia adn Call Exner bodies, whats the CA. what lab is high

Back 48

granulosa cell CA

inhibin is high

yellow

Front 49

which ovarian CA makes estrogen

Back 49

granulosa- this means it can stim precouscious puberty or endometrial hyperplasia

makes call exner bodies that mimic normal follicles

inhibin is HIGH

yellow

Front 50

Call exner bodies

Back 50

seen in granulosa CA in the ovary

**makes estrogen, inhibin high

yellow

Front 51

whats a fibroma

Back 51

sex cord tumor of the ovary

Can be seen in Meigs
meigs is fibroma, hydrothorax and ascites

Front 52

andoblastoma is also known as whatt

Back 52

sertoli lyedig cell tumor

makes androgens
-virulization
-hirsituism
-amenorrhea

Front 53

which ovarian CA makes androgens

Back 53

sertoli-lyedig, aka gonadoblastoma

**it makes women mannish

Front 54

whats krukenburg tumor

Back 54

ovarian CA that came from gastric mets. shows SIGNET RING

Front 55

what is the primary gastric adenocarcinoma that mets to the ovary. how can you ID it

Back 55

krukenburg

**signet cell mets