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71 Cards in this Set

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How are Ovarian Tumors classified?
1. tumors of surface epithelium
2. Germ cell tumors
3. Sex Cord stromal tumors
Epithelial ovarian tumor that has Fallopian Tube-like epithelium
Serous
Epithelial Ovarian tumors with Endocervical-like epithelium
Mucinous
Epithelial Ovarian tumor that is malignant and resembles Endometrium
Endometrioid
Rare, malignant Epithelial Ovarian Tumor that is composed of sheets of cells filled with Glycogen
Clear cell
Benign Epithelial Ovarian tumor with nests of cells resembling bladder Transitional Epithelium interspersed in fibrous stroma
Brenner tumor
Describe the histology of Serous Cystadenoma's
Single layer of Ciliated Tubal-type epithelium
Serous Cystadenoma = benign cysts with Fallopian Tube-like epithelium
What is this showing?
What is the gross appearance of Mucinous Cystadenoma?
1. vary in size
2. Cystic, Multilocular
3. Thick mucinous fluid
What is the histology of Mucinous Cystadenoma?
Tall Columnar cells filled mucin
Mucinous Cystadenoma

Benign
What is this showing?

Benign or Malignant?
Brenner Tumor = benign tumor with islands of Transitional-like epithelium in a fibrous stroma
What is this showing?
This is the MOST COMMON MALIGNANT tumor of the Ovary
Serous Cystadenocarcinoma = 30% of all Ovarian CA's
This ovarian cancer has Psammoma bodies
Papillary Serous Cystadenocarcinoma
Papillary Serous Cystadenocarcinoma
What are all these showing?
Papillary Serous Cystadenocarcinoma

Psammoma body
What are these showing?

What specifically is the bottom showing?
A malignant ovarian tumor that can rupture or metastasize and produce Pseudomyxoma Peritonei with multiple peritoneal tumor implants, all producing large quantities of intraperitoneal mucinous material
Mucinous Cystadenocarinoma
Mucinous Cystadenocarcinoma
What are all of these showing?
Endometrioid Adenocarcinoma

Malignant
What is this showing?

Benign or Malignant?
Clear Cell Adenocarcinoma of the ovary

Prognosis is even worse than the bad prognosis that we have for other ovarian cancers
What is this showing?

What is important about it?
What is the lab finding in Malignant Epithelial Ovarian Tumors?
CA-125
What are the clinical features of Malignant Epithelial Ovarian Tumors
1. BAD prognosis
2. Early metastasis
3. Peritoneal implants
4. CA-125
5. Treatment: Surgery, chemo, radiotherapy
What are the 4 Malignant Epithelial Ovarian TUmors?
1. Serous Cystadenocarcinoma
2. Mucinous Cystadenocarcinoma
3. Endometroid
4. Clear cell
What are the 3 Benign Epithelial Ovarian Tumors?
1. Serous Cystadenoma
2. Mucinous Cystadenoma
3. Brenner tumor
What are the key features of Borderline Epithelial Ovarian Tumors
1. Low malignant potential
2. worrisome histology, excellent prognosis
3. Serous or Mucinous
4. Epithelial stratification, mitosis, atypia
5. NO STROMAL INVASION
What is the treatment for Borderline Epithelial Ovarian Tumors?
Surgery, even with Metastasis
Borderline Epithelial Ovarian tumors
-Left = Mucinous tumor
-Right = Serous tumor

**NO Stromal Invasion
What are these showing?
-Left?
-Right?
Jelly-belly = Numerous Peritoneal implants of Mucus-secreting cells
Pseudomyxoma Peritonei
What are the possible sources of Pseudomyxoma Peritonei?
1. Mucinous Cystadenocarcinoma
2. Mucinous Cystadenoma
3. Carcinomatous mucocele of the appendix
4. Bowel
What is the treatment for Pseudomyxoma Peritonei?
-repeated debulking

- Chemotherapy
This is the most Malignant Germ Cell tumor of the Ovary
Dysgerminoma = Ovarian Seminoma
What is Dysgerminoma analogous to in the male?
Testicular Seminoma
Germ cell ovarian tumor with glycogen-filled tumor cells
Dysgerminoma
-similar to Seminoma cells of Testicular germ cell tumors
What age group does Dysgerminoma commonly occur at?
10-30 years
What is the prognosis of Dysgerminoma?
Excellent prognosis
Most common Germ Cell Tumor
Mature Teratoma = Dermoid cyst
Describe the key properties of Mature Teratomas
1. Benign
2. 3 germ cell layers
3. Cystic
What is Struma Ovarii?
Mature Teratoma comprised of almost all Thyroid tissue = can show high Thyroid levels in a patient with normal Thyroids
Mature Teratoma

Benign
What are these showing?

Benign or Malignant?
Mature Teratoma
What is this?
Dermoid cysts of Mature Teratomas
What are these?
Mature Teratoma

Several different tissues present
What is this?

How do you know?
Germ cell tumor that has 3 Germ Cell layers, is Malignant, has embroyonal tissue that is usually neural
Immature Teratoma
Immature Teratoma
What are these?
Another name for Endodermal Sinus Tumor
Yolk Sac Tumor
-Highly malignant
-affects a young age group
-tumor is hemorrhagic and necrotic
-Schiller-Duval bodies
Endodermal Sinus Tumor = Yolk Sac tumor
Germ cell tumor that secretes AFP
Endodermal Sinus Tumor = Yolk Sac tumor
A girl with ovarian cancer at the age of 3
Yolk Sac tumor
Yolk Sac Tumor

Schiller-duval bodies
What ovarian tumor?
Agressive and malignant ovarian tumor with areas of necrosis and hemorrhage composed of neoplastic Syncytiotrophoblasts and Cytotrophoblasts
Choriocarcinoma of the ovary
A young girl presents with precocious sexual development. She yields a + pregnancy test with the presence of hCG. She swears she is a virgin
Choriocarcinoma
Choriocarcinoma of the Ovary

Syncytiotroph's and Cytotroph's with areas of necrosis and hemorrhage
What tumor is this?
How do you know?
What syndrome is associated with an increased risk for Dysgerminoma?
Turner's syndrome
What are the 3 Ovarian Sex Cord Stromal tumors
1. Fibroma-Thecoma
2. Granulosa Cell tumor
3. Sertoli-Leydig cell tumor
Most common Sex Cord / Stromal tumor
Fibroma
When do most Ovarian Fibroma's occur?
around Menopause
A woman presents with Ascitis (distended stomach) and Pleural effusions (hydrothorax). What tumor does she most likely have? What syndrome is this?
Ovary Fibroma (Sex cord tumor)

Meig's Syndrome
What is the clinical triad in Meig's Syndrome?
1. Ovarian Fibroma
2. Ascites = distended stomach
3. Pleural effusion
Ovarian Fibroma

Benign
What is this tumor?

Benign or Malignant?
Benign, POSTMENOPAUSAL Ovarian tumor that has round lipid-containing cells in addition to fibroblasts. Also secretes Estrogen
Ovarian Thecoma
What are Thecomas associated with increasing the risk of? Why?
Endometrial Hyperplasia and Endometrial Cancer

Because they secrete Estrogen
Thecoma
This was shown to secrete Estrogen, what is it?
Ovarian tumor:
-secretes Estrogen
-Call-Exner bodies
-associated with Endometrial Hyperplasia/Cancer
Granulosa Cell Tumor
Granulosa Cell Tumor

Call-Exner bodies = follicles filled with Eosinophilic secretions
What is this tumor?

What are the characteristic features on the right?
Granulosa Cell Tumor
A girl with this tumor (Coffee-bean nuclei) came in and was found to have Precocious Puberty. She was also at an increased risk of Endometrial Hyperplasia/Cancer
Ovarian tumor that secretes Androgen
Sertoli-Leydig Cell tumors = Androblastoma = Arrhenoblastoma
A 25 year old woman presented with facial and chest hair. She was found to have what ovarian tumor?
Sertoli-Leydig Cell tumor
Androgens

Sertoli-Leydig Cell tumor
What do these cells secrete?

What tumor?
What are the properties of Metastatic Ovarian cancer? Where do they commonly come from?
Usually BILATERAL

Breast, Colon, Stomach
What are Krukenburg Tumors?
1. Adenocarcimona mucin-producing
2. Contains Signet Ring Cells from the Stomach
Krukenberg tumors = bilateral

Gastric Adenocarcinoma
After histologic examination, there appeared to be Signet Ring Cells in the specimen.
-What is the name of this tumor?
-Where did it likely come from?