Ovarian Disorders Overview
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Questions and Answers

What is a common characteristic of follicular ovarian cysts?

  • They often appear as multiple cysts. (correct)
  • They are always large over 10 cm.
  • They can rarely secrete estrogen. (correct)
  • They arise from ruptured graafian follicles.

    • Which of the following is NOT a criterion for the diagnosis of Polycystic Ovary Syndrome (PCOS)?

  • Hyperandrogenism
  • Oligomenorrhea/anovulation
  • High levels of estrogen (correct)
  • Polycystic ovaries on ultrasound

    • What type of ovarian tumor is classified as a germ cell tumor?

  • Granulosa-theca cell tumor
  • Serous tumor
  • Dysgerminoma (correct)
  • Mucinous tumor

    • What age group is at the highest risk for PID and oophoritis?

    <p>Ages 20-35 years</p> Signup and view all the answers

    Which statement regarding serous tumors is accurate?

    <p>60% of serous tumors are benign.</p> Signup and view all the answers

    Luteal cysts are lined by which type of cells?

    <p>Luteal cells</p> Signup and view all the answers

    What is typically required for diagnosing PCOS?

    <p>At least one of the following three criteria must be met.</p> Signup and view all the answers

    What is a defining feature of chocolate cysts (endometriotic cysts)?

    <p>They contain blood and endometrial tissue.</p> Signup and view all the answers

    Which of the following tumors is classified as a sex-cord stromal tumor?

    <p>Fibroma</p> Signup and view all the answers

    Which of the following statements is true about oophoritis?

    <p>It can lead to extensive changes and potentially sterility.</p> Signup and view all the answers

    What characterizes a serous cystadenoma microscopically?

    <p>Single layer of tall columnar ciliated cells</p> Signup and view all the answers

    Which feature is NOT associated with papillary serous cystadenocarcinoma?

    <p>Single layer of epithelial cells</p> Signup and view all the answers

    What distinguishes borderline serous tumors from benign forms?

    <p>Microscopic resemblance to the malignant form</p> Signup and view all the answers

    Which characteristic is typical of mucinous cystadenoma?

    <p>Large, lobulated and thick, fibrous wall</p> Signup and view all the answers

    Which type of tumor is primarily associated with endometriosis?

    <p>Endometrioid tumors</p> Signup and view all the answers

    What is the major component distinguishing mature teratomas?

    <p>Development from totipotent cells</p> Signup and view all the answers

    What complication is NOT common for benign serous and mucinous cystadenomas?

    <p>Metastasis to distant organs</p> Signup and view all the answers

    How do Brenner tumors typically appear grossly?

    <p>Unilateral and may be cystic</p> Signup and view all the answers

    Which condition is indicative of malignancy in mucinous cystadenocarcinoma?

    <p>Presence of atypical cells</p> Signup and view all the answers

    What characteristic is shared by borderline forms of tumors?

    <p>Microscopic similarity to malignant tumors without invasion</p> Signup and view all the answers

    What is the primary age group for the occurrence of immature (malignant) teratoma?

    <p>Adolescents and young women</p> Signup and view all the answers

    Which microscopic feature is characteristic of dysgerminoma?

    <p>Sheets and cords of large cells with clear cytoplasm</p> Signup and view all the answers

    Which tumor is associated with Meigs syndrome?

    <p>Fibroma-thecoma</p> Signup and view all the answers

    What is a significant characteristic of granulosa-theca cell tumors?

    <p>They are common in postmenopausal women</p> Signup and view all the answers

    What is the typical presentation of a Krukenberg tumor?

    <p>Bilateral metastasis primarily from gastrointestinal tumors</p> Signup and view all the answers

    Which feature is a defining characteristic of sex cord-stromal tumors?

    <p>They can secrete hormones such as estrogen or androgen</p> Signup and view all the answers

    What percentage of granulosa-theca cell tumors are potentially malignant?

    <p>5%-25%</p> Signup and view all the answers

    Which type of tumor is described as bulky and solid, with areas of necrosis and hemorrhage?

    <p>Immature teratoma</p> Signup and view all the answers

    What type of tissue is NOT typically found in monodermal teratomas?

    <p>Cystic structures</p> Signup and view all the answers

    What is a common histological feature of fibroma-thecomas?

    <p>Well differentiated fibroblasts</p> Signup and view all the answers

    Study Notes

    Ovarian Disorders

    • Inflammation of the ovary (oophoritis): Oophoritis occurs when one or both ovaries become inflamed, often preceded by infection of fallopian tubes or peritoneum. It's part of chronic pelvic inflammatory disease (PID), affecting the upper genital tract (uterus, tubes, and ovaries). Females under 35 are at highest risk. It rarely develops before menstruation, during pregnancy, or after menopause. Extensive fibrosis can cause sterility.

    • Non-neoplastic cysts of ovary (Follicular ovarian cysts): Very common, arising from unruptured ovarian follicles. Often multiple, can grow large (over 10cm) but are usually small (approximately 1.5 cm). The lining resembles a normal follicle (granulosa and theca cells). They rarely secrete estrogen.

    • Luteal cysts: Cysts in the corpus luteum, approximately 2 cm in diameter (up to 3 cm). Usually multiple and lined by luteal cells. Secretes progesterone.

    • Chocolate cyst (endometriotic cyst): A specific type of cyst.

    • Germinal inclusion cyst: Cyst resulting from germinal epithelium development into ovarian stroma.

    • Polycystic ovary syndrome (PCOS): A common condition in 12-21% of women of reproductive age. Up to 70% remain undiagnosed. More prevalent in obese women. Can cause infertility. Requires two of three criteria for diagnosis: oligomenorrhea/anovulation, hyperandrogenism (hirsutism, raised free androgen index/free testosterone), and polycystic ovaries on ultrasound.

    Ovarian Tumors

    Classification of ovarian tumors:

    • Surface epithelial tumors: Serous, mucinous, Brenner, endometrioid, clear cell tumors

    • Clinicopathological features of surface epithelial tumors (Serous tumors): Show a significant proportion of benign cases (60%), with malignant cases (25%), and borderline (15%).

    • Serous cystadenoma: Grossly, they are small to large (up to 40cm) rounded masses with smooth walls. They're often unilateral, and unilocular, filled with clear yellowish fluid. Microscopic features include a single layer of tall columnar ciliated cells with small microscopic papillae.

    • Papillary Serous cystadenocarcinoma: Grossly, they exhibit solid papillary projections invading the cyst wall. Microscopically, they have more than one layer of cells showing malignancy characteristics, and may contain psammoma bodies.

    • Borderline serous tumors: Grossly similar to benign, microscopically similar to malignant without involvement of the stromal tissue.

    • Mucinous tumors: Benign cases (mucinous cystadenoma = roughly 80%) and malignant (mucinous cystadenocarcinoma = roughly 5-10%), with a borderline form.

    • **Mucinous cystadenoma: ** Large ovoid, lobulated, usually unilateral, multilocular, gelatinous material fills the cyst. Thick and fibrous walls. Microscopically, tall columnar cells with apical mucinous vacuolation.

    • Mucinous cystadenocarcinoma: Shows atypia in cells with invasion of the capsule and the presence of solid formations.

    • Endometrioid tumors: Approximately 20% of ovarian cancers, associated with ovarian endometriosis (50%). Gross characteristics show solid and cystic areas; 40% are bilateral. Microscopically, resembles endometrial adenocarcinoma.

    • Brenner tumors: Mostly benign, unilateral, and occasionally cystic. Varies from smaller lesions up to large masses. Dense fibrous stroma and nests of transitional cells.

    • Germ cell tumors: Teratomas (mature and immature) and dysgerminoma.

    • Teratomas (mature): Mostly cystic, small, called dermoid cysts; Lined with skin, hair, and sebaceous glands. Microscopically they are composed of epidermis, hair follicles, sebaceous glands, teeth, cartilage, bone, thyroid tissue, as well as other organ tissue. Malignant change (squamous cell carcinoma) in rare cases (1%).

    • Teratomas (immature): Bulky, solid tumors with necrosis and hemorrhage. Immature cells differentiating into cartilage, glands, bone, muscle, or nerves.

    • Dysgerminoma: Ovarian counterpart of seminoma. Usually in childhood, teens, or twenties. Solid, fleshy, yellowish-white to gray-pink; 90% are unilateral tumours. Microscopically, large cells with clear cytoplasm in sheets with scant fibrous stroma. Lymphocytes can be present.

    • Sex-cord stromal tumors: Arise from embryonic gonads or ovarian stroma. Frequently functional, secreting estrogen (granulosa or theca cell tumors) or androgen (Sertoli-Leydig cell tumor).

    • Granulosa-theca cell tumor: Common in postmenopausal women. Unilateral, solid and cystic areas. Usually encapsulated. Potentially malignant (5–25%).

    • Microscopically: Mixture of granulosa and theca cells. Granulosa cells in cords, sheets, or strands (rosettes). Theca cells are spindle-shaped with lipid droplets.

    • Fibroma-thecomas: Usually unilateral, solid, hard tumours. Well-differentiated fibroblasts. Often associated with hydrothorax/ascites (Meigs syndrome).

    • Sertoli-Leydig cell tumor: Produce androgens. Usually unilateral. Composed of Sertoli or Leydig cells.

    • Metastatic tumors: Primarily from gastrointestinal tract or breast. Krukenberg tumor is a bilateral metastatic ovarian cancer typically originating in the stomach's malignant cells spread throughout the peritoneal cavity.

    Complications of benign ovarian cysts

    • Torsion: Twisting of a pedicle leading to hemorrhage
    • Rupture: leading to acute abdomen
    • Pressure effects.
    • Malignant change

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    Diseases of Ovary PDF

    Description

    This quiz covers a range of ovarian disorders including oophoritis, non-neoplastic cysts, and luteal cysts. Understand the symptoms, risks, and implications of these conditions, particularly among females under 35. Test your knowledge of ovarian health and its impact on fertility.

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