-
What is the most important cause of Primary Amenorrhea?
Turners Syndrome
-
What are the Types of Ovarian Non-neoplastic Cysts?
What are the most common lesions of the overy? What are the different types?
- •Follicular – pre-ovulatory
- •Luteal – post-ovulatory
Non-neolpastic lesions
-
Follicular cysts verses Luteal cysts
Which is more common?
Where do they develope?
Hostology?
- Follicular:
- -Most common type
- -Arise fro the ovarian cortex
- Leuteal:
- -arise from the corpus leuteum
- -see fribin and fluid accumulation in the center of the Corpus leuteum
-
 What is this? How can you tell?
- This is a Follicular Cyst.
- In the second pic you can see the theca cells with the Granulosa cells on top
-
What is PCOD?
What do you see Elevated in PCOD?
What does PCOD present with clinically?
What do you see?
poorly regulated enzymes involved in androgen synthesis
- See:
- High LH
- HIGH testosterone
- Low FSH
- -NO CORPUS LUTEUM
- –Persistent anovulation – amenorrhea
See hirsutism, Acne and alopecia
-
-
What are the Four locations that Ovarian Neoplasias can be derived from?
Which is the most common?
- Surface epithelial cells (common 70%)
- Germ cells
- Sex cord stroma
- and Metastasis
-
What are the Major types of Surface epithelial tumors?
-
•Serous
- •Mucinous
- •Endometrioid
- •Other (Clear Cell, Brenner)
-
SURFACE EPITHELIAL TUMORs
What do they present like?
Any markers for detection?
- Malignant: weakness, weight loss, cachexia, ascites,
- •G.I. complaints, dysuria, pelvic pressure
• CA-125= useful for following serous and endometrioid
-
What are some ways to prevent Surface epithelial tumors?
-
•Tubal ligation reduces risk by 50+
- -Oral contraception decrease by 50%
- -Prophylatic bilateral salpingo-oophorectomy
-
Ovarian Surface Epithelial Tumors
What is the difference between the way the Benign, the border line and the malignant tumors present?
- Benign
- •Lined by single layer of bland epithelium
borderline
- •Lined by stratified layers of epithelium
- •Mild nuclear atypia and few mitoses
- Malignant
- •Highly atypical cells & high mitotic index
- •Stromal invasion
-
what is the most common malignant ovarian tumor?
Is it bilateral? Age?
What do you see Hystologically?
The tumors may have ??
-
•Serous Cystadenocarcinoma
- -usually bilateral, Women over 50
- - Psammoma bodies
- •Cystic change
- •Papillary projections
- •Necrosis
-
what are these? what are they associated with?
psommoma bodies
Serous Cystadenocarcinoma
-
What does this patient have?
Serous Cystadenocarcinoma
-
Mucinous Surface Epithelial Tumors
Bilateral?
-
•Uncommonly bilateral (< 5% - 10%)
•Tend to be large, multilocular
-
This is a Mucinous Cystadenoma
-
PSEUDOMYXOMA PERITONEI
Where is it from?
What are its complications?
appendix = usual source
Intestinal obstruction
-
This is a Pseudomyxoma Peritonei
-
Endometrioid Carcinoma of the Ovary
Where are they from?
what are the mutations?
What do you see inside?
•Most are from surface epithelium; metaplasia
Mutations= PTEN, KRAS, beta-catenin, microsatellite instability
- See Chocolate and bloody material inside.
-
Endometrioid Carcinoma of the Ovary
-
Brenner Tumor
What does it look like?
-
•Uncommon, usually benign, unilateral and solid, yellow – consists of URETHRAL Nests..looks like a BEAN
-
-
What is the Most Common Germ cell tumor in the overy?
What can they contain?
Teratomas
•May contain ectoderm, mesoderm or endodermal elements (MOST are ectodermal differentiation)
-
-
What is a monodermal teratoma?
Give an example?
•Specialized tissue overgrows all other tissue elements
-Ex: Tyroid-- Struma ovarii
-
Immature Teratoma
What do you see?
Can see 3 germ layers. NEURAL elemets common
-
What is a Dysgerminoma?
What is it associated with? In males it is..?
Bilateral?
What do you see in the stroma?
•Most common malignant germ cell tumor
- - Turners sundrome and congenital malformations
- - Serminomas
- - usually unilateral
- -Lymphocutes in stroma
-
-
Endodermal Sinus (Yolk Sac) Tumor
Sex?
Markers?
Histology?
- Seen in young girls
-AFP
-Schiller-Duval body (central blood vessel enveloped and lined by germ cells)
-
What is this? How can you tell?
It is a Endodermal Sinus (Yolk Sac) Tumor
See Schiller-Duval body (central blood vessel enveloped and lined by germ cells)
-
CHORIOCARCINOMA
What do you see?
-
•Aggressive
•High levels of human chorionic gonadotropin (B-hcg)
-
Ovarian Sex Cord-Stromal Tumors
What are they?
Types?
• Arise from specialized ( sex cord) or non-specialized ( stromal) cells
- •Granulosa – Theca cell
- •Thecoma - Fibroma
- •Sertoli-Leydig cell (Androblastoma)
-
Granulosa Cell Tumor
What are the types?most common?
What are produced?
Clinical signs and symptoms?
- 1.Juvenile type
- 2.Adult type – majority (95%)15-80 years
Production of • Estrogens and androgens
- •Abnormal menses
- •Estrogen related complications including endometrial hyperplasia and carcinoma
- •Vague abdominal pain
- •Acute abdominal pain caused by tumor rupture or torsion
- •Clitoral enlargement
-
What is this? How can you tell?
This is Granulosa Cell Tumor Adult type
See the Call-Exner bodies
-
Thecoma-Fibroma Tumors
Clinical Presentation?
Are they
-
•Mass, 90% unilateral
•Ascites, Hydrothorax (Meigs Syndrome)
-
Visually, what is the diffference between a Thecoma and a Fibroma?
- Thecomas:
- • yellow
- •Cystic change occasionally present
- Fibromas:
- •Grey-white, firm tumor
-
-
Sertoli-Leydig Cell Tumors(Androblastomas)
What do you see?
- •Defeminization characteristics
- -Oligomenorrhea or amenorrhea, atrophy of breast and uterus, hirsutism, clitoral hypertrophy, acne and temporal alopecia
-
Sertoli-Leydig Cell Tumor (Androblastoma)
-
Krukenberg tumor (Classic)
What is it?
What will you see?
Metastatic Tumor of the Ovary
See Metastatic signet-ring carcinoma involving both ovaries
-
Krukenberg Tumor (Classic)
-
What Ovarian Tumors are unilateral?????
-
Unilateral:
- 1.Mucinous Neoplasms
- 2.Dysgerminoma
- 3.Thecoma/Fibroma
- 4.Brenner
|
|
